Science.gov

Sample records for environment safety quality

  1. Integrating quality, safety, and environment management systems.

    PubMed

    Winder, C

    1997-01-01

    Internationally consistent ISO standards are in use, or are being developed, for quality systems, environmental management, and occupational health and safety. These standards outline a model for the management of quality, environment or safety. In many respects the process of developing management systems for these matters contains a number of common elements, including obtaining commitment from senior management; instituting consultative mechanisms; developing a policy; identifying components of the management program; resourcing, implementing, and reviewing the program; and integrating the program into the organization's strategic plan. The necessity of developing separate management systems for different organizational aspects is wasteful and inefficient. Better management systems will be developed if they are integrated into a single management structure.

  2. Exploring safety and quality in a hemodialysis environment with participatory photographic methods: a restorative approach.

    PubMed

    Marck, Patricia; Molzahn, Anita; Berry-Hauf, Rhonda; Hutchings, Loretta Gail; Hughes, Susan

    2014-01-01

    This study used principles and methods of good ecological restoration, including participatory photographic research methods, to explore perceptions of safety and quality in one hemodialysis unit. Using a list of potential safety and quality issues developed during an initial focus group, a practitioner-led photo walkabout was conducted to obtain photographs of the patient care unit and nurses' stories (photo narration) about safety and quality in their environment. Following a process of iterative coding, photos were used to discuss preliminary themes in a photo elicitation focus group with four additional unit staff The major themes identified related to clutter, infection control, unit design, chemicals and air quality, lack of storage space, and health and safety hazards (including wet floors, tripping hazards from hoses, moving furniture/chairs). The visual methods engaged researchers and unit nurses in rich dialogue about safety in this complex environment and provides an ongoing basis for monitoring and enhancing safety.

  3. Nursing work environment, patient safety and quality of care in pediatric hospital.

    PubMed

    Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito

    2016-06-01

    Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.

  4. Perceptions of Agricultural College Students on the Relationship between Quality and Safety in Agricultural Work Environments.

    PubMed

    Ramaswamy, Sai K; Mosher, Gretchen A

    2015-01-01

    Agriculture is a high-hazard industry that employs a large number of young workers below the age of 25. Recent studies have documented a strong positive correlation between quality management in agriculture and occupational safety as perceived by agricultural workers. Younger workers have been found to be at higher risk for occupational injuries and fatalities in agriculture. Furthermore, college students in agriculture have minimal exposure to safety and quality management principles in their coursework and thus may not be aware that the two concepts are associated Little research has studied how young workers perceive the relationship between safety and quality and how these perceptions vary based on demographic characteristics. This study builds on prior research that measured the interactions between employee perceptions of safety and quality in an agricultural work environment. Data were collected using a survey instrument adapted from a previously validated instrument. Analysis of 1017 responses showed that students perceived a high impact of quality practices on the reduction of safety hazards and safety incidents. Students' perceptions of quality and safety in agricultural work environments varied by gender, with female students perceiving the relationship between the two at a higher level than males. No significant difference in perceptions was observed based on students' academic classification, age group, field of study, or childhood environment. This study demonstrates that despite limited academic training in safety and quality, pre-professionals perceive the implementation of quality management as a very important factor in mitigating safety hazards and safety incidents. In addition, this study suggests that current academic training in these disciplines must be modified, since no differences in students' perceptions were observed based on academic classification or field of study.

  5. Rural hospital nursing: Better environments = shared vision and quality/safety engagement.

    PubMed

    Newhouse, Robin P; Morlock, Laura; Pronovost, Peter; Colantuoni, Elizabeth; Johantgen, Mary

    2009-04-01

    The aim of this study was to identify the independent effects among market forces, hospital factors, and the rural nursing work environment, controlling for hospital type, average daily census, and system or network membership. The hospital work environment affects both nurse and patient outcomes, yet little is known about the rural hospital setting. A national sample of rural hospital nurse executives (n = 233) completed the Nursing Environment Survey and the Essentials of Magnetism (EOM) instrument. Market variables explain 11.4% and hospital variables explain 27.2% of the variance in the total weighted EOM scale. System membership (beta = -.204), shared vision (beta = .531), and quality and safety activities (beta = .132) have significant independent effects on the total weighted EOM scale. Promoting shared vision and accelerating engagement in quality and safety initiatives will result in improvements in the nursing work environment in rural hospitals.

  6. Setting quality and safety priorities in a target-rich environment: an academic medical center's challenge.

    PubMed

    Mort, Elizabeth A; Demehin, Akinluwa A; Marple, Keith B; McCullough, Kathryn Y; Meyer, Gregg S

    2013-08-01

    Hospitals are continually challenged to provide safer and higher-quality patient care despite resource constraints. With an ever-increasing range of quality and safety targets at the national, state, and local levels, prioritization is crucial in effective institutional quality goal setting and resource allocation.Organizational goal-setting theory is a performance improvement methodology with strong results across many industries. The authors describe a structured goal-setting process they have established at Massachusetts General Hospital for setting annual institutional quality and safety goals. Begun in 2008, this process has been conducted on an annual basis. Quality and safety data are gathered from many sources, both internal and external to the hospital. These data are collated and classified, and multiple approaches are used to identify the most pressing quality issues facing the institution. The conclusions are subject to stringent internal review, and then the top quality goals of the institution are chosen. Specific tactical initiatives and executive owners are assigned to each goal, and metrics are selected to track performance. A reporting tool based on these tactics and metrics is used to deliver progress updates to senior hospital leadership.The hospital has experienced excellent results and strong organizational buy-in using this effective, low-cost, and replicable goal-setting process. It has led to improvements in structural, process, and outcomes aspects of quality.

  7. Pacific Northwest Laboratory annual report for 1988 to the Assistant Secretary for Environment, Safety, and Health: Part 5, Environment, safety, health, and quality assurance

    SciTech Connect

    Faust, L.G.; Pennell, W.T.; Selby, J.M.

    1989-02-01

    This document summarizes the research programs now underway at Battelle's Pacific Northwest Laboratory in the areas of environmental safety, health, and quality assurance. Topics include internal irradiation, emergency plans, dose equivalents, risk assessment, dose equivalents, surveys, neutron dosimetry, and radiation accidents. (TEM)

  8. Pacific Northwest Laboratory annual report for 1987 to the Assistant Secretary for Environment, Safety, and Health: Part 5: Environment, safety, health, and quality assurance

    SciTech Connect

    Faust, L.G.; Steelman, B.L.; Selby, J.M.

    1988-02-01

    Part 5 of the 1987 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Nuclear Safety, the Office of Environmental Guidance and Compliance, the Office of Environmental Audit, and the Office of National Environmental Policy Act Project Assistance. For each project, as identified by the Field Work Proposal, articles describe progress made during fiscal year 1987. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work.

  9. Pacific Northwest Laboratory annual report for 1989 to the Assistant Secretary for Environment, Safety, and Health - Part 5: Environment, Safety, Health, and Quality Assurance

    SciTech Connect

    Faust, L.G.; Doctor, P.G.; Selby, J.M.

    1990-04-01

    Part 5 of the 1989 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Environmental Guidance and Compliance, the Office of Environmental Audit, the Office of National Environmental Policy Act Project Assistance, the Office of Nuclear Safety, the Office of Safety Compliance, and the Office of Policy and Standards. For each project, as identified by the Field Work Proposal, there is an article describing progress made during fiscal year 1989. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work. 35 refs., 1 fig.

  10. The National Shipbuilding Research Program. 1997 Ship Production Symposium, Paper Number 7: Physiological Factors Affecting Quality and Safety in Production Environment

    DTIC Science & Technology

    1997-04-01

    1997 Ship Production Symposium Paper No. 7: Physiological Factors Affecting Quality And Safety In Production Environment U.S. DEPARTMENT OF THE NAVY...Research Program 1997 Ship Production Symposium, Paper No. 7: Physiological Factors Affecting Quality And Safety in Production Environment 5a...Paper presented at the 1997 Ship Production Symposium, April 21-23, 1997 New Orleans Hilton Hotel, New Orleans, Louisiana Physiological Factors

  11. Obstetric Safety and Quality.

    PubMed

    Pettker, Christian M; Grobman, William A

    2015-07-01

    Obstetric safety and quality is an emerging and important topic not only as a result of the pressures of patient and regulatory expectations, but also because of the genuine interest of caregivers to reduce harm, improve outcomes, and optimize care. Although each seeks to improve care by using scientific approaches beyond human physiology and pathophysiology, patient safety methodologies seek to avoid preventable adverse events, whereas health care quality projects aim to achieve the best possible outcomes. It is well-documented that an increasingly complex medical system controlled by human workers is a circumstance subject to recurrent failure. A safety culture encourages a proactive approach to mitigate failure before, during, and after it occurs. This article highlights the key concepts in health care safety and quality and reviews the background of the quality improvement sciences with particular emphasis on obstetric outcomes and quality measures.

  12. Quality and Safety in Health Care, Part XIV: The External Environment and Research for Diagnostic Processes.

    PubMed

    Harolds, Jay A

    2016-09-01

    The work system in which diagnosis takes place is affected by the external environment, which includes requirements such as certification, accreditation, and regulations. How errors are reported, malpractice, and the system for payment are some other aspects of the external environment. Improving the external environment is expected to decrease errors in diagnosis. More research on improving the diagnostic process is needed.

  13. Quality and Safety Matter

    NASA Astrophysics Data System (ADS)

    Manha, William D.

    2010-09-01

    One to the expressions for the most demanding quality was made by a well-known rocket scientist, for which this center was named, Dr. Wernher Von Braun in the Foreword of a book about the design of rocket engines that was first published by NASA in 1967: “Success in space demands perfection. Many of the brilliant achievements made in this vast, austere environment seem almost miraculous. Behind each apparent miracle, however, stands the flawless performance of numerous highly complex systems. All are important. The failure of only one portion of a launch vehicle or spacecraft may cause failure of an entire mission. But the first to feel this awesome imperative for perfection are the propulsion systems, especially the engines. Unless they operate flawlessly first, none of the other systems will get a chance to perform in space. Perfection begins in the design of space hardware. This book emphasizes quality and reliability in the design of propulsion and engine systems. It draws deeply from the vast know-how and experience which have been the essence of several well-designed, reliable systems of the past and present. And, with a thoroughness and completeness not previously available, it tells how the present high state of reliability, gained through years of research and testing, can be maintained, and perhaps improved, in engines of the future. As man ventures deeper into space to explore the planets, the search for perfection in the design of propulsion systems will continue.” Some catastrophes with losses of life will be compared to show lapses in quality and safety and contrasted with a catastrophe without loss of life because of compliance with safety requirements. 1. October 24, 1960,(USSR) Nedelin Catastrophe, Death on the Steppes, 124 deaths 2. October 25, 1966,(USA) North American Rockwell, Apollo Block I Service Module Service(SM) Propulsion System fuel tank explosion/fire and destruction of SM and test cell, test engineer/conductor/author, Bill Manha

  14. Argonne National Laboratory Internal Appraisal Program environment, safety, health/quality assurance oversight

    SciTech Connect

    Winner, G.L.; Siegfried, Y.S.; Forst, S.P.; Meshenberg, M.J.

    1995-06-01

    Argonne National Laboratory`s Internal Appraisal Program has developed a quality assurance team member training program. This program has been developed to provide training to non-quality assurance professionals. Upon successful completion of this training and approval of the Internal Appraisal Program Manager, these personnel are considered qualified to assist in the conduct of quality assurance assessments. The training program has been incorporated into a self-paced, computerized, training session.

  15. Impact of critical care environment on burnout, perceived quality of care and safety attitude of the nursing team.

    PubMed

    Guirardello, Edinêis de Brito

    2017-06-05

    assess the perception of the nursing team about the environment of practice in critical care services and its relation with the safety attitude, perceived quality of care and burnout level. cross-sectional study involving 114 nursing professionals from the intensive care unit of a teaching hospital. The following instruments were used: Nursing Work Index-Revised, Maslach Burnout Inventory and the Safety Attitude Questionnaire. the professionals who perceived greater autonomy, good relationships with the medical team and better control over the work environment presented lower levels of burnout, assessed the quality of care as good and reported a positive perception on the safety attitude for the domain job satisfaction. the findings evidenced that environments favorable to these professionals' practice result in lower levels of burnout, a better perceived quality of care and attitudes favorable to patient safety. avaliar a percepção da equipe de enfermagem sobre o ambiente da prática em unidades de cuidados críticos e sua relação com atitude de segurança, percepção da qualidade do cuidado e nível de burnout. estudo transversal com a participação de 114 profissionais de enfermagem da unidade de terapia intensiva de um hospital de ensino. Foram utilizados os instrumentos: Nursing Work Index-Revised, Inventário de Burnout de Maslach e o Questionário de Atitudes de Segurança. os profissionais que perceberam maior autonomia, boas relações com a equipe médica e melhor controle sobre o ambiente de trabalho, apresentaram menores níveis de burnout, avaliaram como boa a qualidade do cuidado e relataram uma percepção positiva da atitude de segurança para o domínio satisfação no trabalho. os achados evidenciaram que ambientes favoráveis à prática desses profissionais resultam em menores níveis de burnout, melhor percepção da qualidade do cuidado e atitudes favoráveis à segurança do paciente. evaluar la percepción del equipo de enfermer

  16. Fire Safety in Extraterrestrial Environments

    NASA Technical Reports Server (NTRS)

    Friedman, Robert

    1998-01-01

    Despite rigorous fire-safety policies and practices, fire incidents are possible during lunar and Martian missions. Fire behavior and hence preventive and responsive safety actions in the missions are strongly influenced by the low-gravity environments in flight and on the planetary surfaces. This paper reviews the understanding and key issues of fire safety in the missions, stressing flame spread, fire detection, suppression, and combustion performance of propellants produced from Martian resources.

  17. Health, Safety, and Environment Division

    SciTech Connect

    Wade, C

    1992-01-01

    The primary responsibility of the Health, Safety, and Environmental (HSE) Division at the Los Alamos National Laboratory is to provide comprehensive occupational health and safety programs, waste processing, and environmental protection. These activities are designed to protect the worker, the public, and the environment. Meeting these responsibilities requires expertise in many disciplines, including radiation protection, industrial hygiene, safety, occupational medicine, environmental science and engineering, analytical chemistry, epidemiology, and waste management. New and challenging health, safety, and environmental problems occasionally arise from the diverse research and development work of the Laboratory, and research programs in HSE Division often stem from these applied needs. These programs continue but are also extended, as needed, to study specific problems for the Department of Energy. The results of these programs help develop better practices in occupational health and safety, radiation protection, and environmental science.

  18. Software Quality Assurance for Nuclear Safety Systems

    SciTech Connect

    Sparkman, D R; Lagdon, R

    2004-05-16

    The US Department of Energy has undertaken an initiative to improve the quality of software used to design and operate their nuclear facilities across the United States. One aspect of this initiative is to revise or create new directives and guides associated with quality practices for the safety software in its nuclear facilities. Safety software includes the safety structures, systems, and components software and firmware, support software and design and analysis software used to ensure the safety of the facility. DOE nuclear facilities are unique when compared to commercial nuclear or other industrial activities in terms of the types and quantities of hazards that must be controlled to protect workers, public and the environment. Because of these differences, DOE must develop an approach to software quality assurance that ensures appropriate risk mitigation by developing a framework of requirements that accomplishes the following goals: {sm_bullet} Ensures the software processes developed to address nuclear safety in design, operation, construction and maintenance of its facilities are safe {sm_bullet} Considers the larger system that uses the software and its impacts {sm_bullet} Ensures that the software failures do not create unsafe conditions Software designers for nuclear systems and processes must reduce risks in software applications by incorporating processes that recognize, detect, and mitigate software failure in safety related systems. It must also ensure that fail safe modes and component testing are incorporated into software design. For nuclear facilities, the consideration of risk is not necessarily sufficient to ensure safety. Systematic evaluation, independent verification and system safety analysis must be considered for software design, implementation, and operation. The software industry primarily uses risk analysis to determine the appropriate level of rigor applied to software practices. This risk-based approach distinguishes safety

  19. Quality Learning Environments.

    ERIC Educational Resources Information Center

    Kleberg, John R.

    An Ohio State University project studying quality educational environments brought together experts from several fields from various countries to discuss issues and tour facilities in Europe and the United States. In addition, a survey of university staff, students, and faculty found that there is a strong relationship between school environment…

  20. Vaccine quality and safety

    PubMed Central

    Patil, Rajan R

    2014-01-01

    Background: There has been major controversy over vaccine safety in India following newspaper reports citing right to information (RTI) disclosure that there have been increasing vaccine related deaths following immunization in children in the recent years. Methods: Secondary data analysis. Results and Conclusion: Adverse effect following immunization (AEFI) events in recent years are being linked to closure of three government owned vaccine producing public sector units (PSU) closures in India. The media reports quoting government sources suggest that the total number of reported deaths due to AEFI in a pre-closure of vaccine PSUs 7 years (2001–2007) was 136, whereas it is 355 in the post vaccine PSU closure 3 years (2008 to 2010). There is an issue of comparability of numbers of AEFI deaths pre- (2001–2007) and post-vaccine PSU closure era (2008–2011) and linking increased AEFI deaths to vaccine PSU closure. PMID:24299731

  1. Quality and safety by design

    PubMed Central

    Battles, J B

    2006-01-01

    Rather than continuing to try to measure the width and depths of the quality chasm, a legitimate question is how does one actually begin to close the quality chasm? One way to think about the problem is as a design challenge rather than as a quality improvement challenge. It is time to move from reactive measurement to a more proactive use of proven design methods, and to involve a number of professions outside health care so that we can design out system failure and design in quality of care. Is it possible to actually design in quality and design out failure? A three level conceptual framework design would use the six quality aims laid out in Crossing the quality chasm. The first or core level of the framework would be designing for patient centered care, with safety as the second level. The third design attributes would be efficiency, effectiveness, timeliness, and equity. Design methods and approaches are available that can be used for the design of healthcare organizations and facilities, learning systems to train and maintain competency of health professionals, clinical systems, clinical work, and information technology systems. In order to bring about major improvements in quality and safety, these design methods can and should be used to redesign healthcare delivery systems. PMID:17142601

  2. Quality and safety aspects in histopathology laboratory

    PubMed Central

    Adyanthaya, Soniya; Jose, Maji

    2013-01-01

    Histopathology is an art of analyzing and interpreting the shapes, sizes and architectural patterns of cells and tissues within a given specific clinical background and a science by which the image is placed in the context of knowledge of pathobiology, to arrive at an accurate diagnosis. To function effectively and safely, all the procedures and activities of histopathology laboratory should be evaluated and monitored accurately. In histopathology laboratory, the concept of quality control is applicable to pre-analytical, analytical and post-analytical activities. Ensuring safety of working personnel as well as environment is also highly important. Safety issues that may come up in a histopathology lab are primarily those related to potentially hazardous chemicals, biohazardous materials, accidents linked to the equipment and instrumentation employed and general risks from electrical and fire hazards. This article discusses quality management system which can ensure quality performance in histopathology laboratory. The hazards in pathology laboratories and practical safety measures aimed at controlling the dangers are also discussed with the objective of promoting safety consciousness and the practice of laboratory safety. PMID:24574660

  3. Quality and safety aspects in histopathology laboratory.

    PubMed

    Adyanthaya, Soniya; Jose, Maji

    2013-09-01

    Histopathology is an art of analyzing and interpreting the shapes, sizes and architectural patterns of cells and tissues within a given specific clinical background and a science by which the image is placed in the context of knowledge of pathobiology, to arrive at an accurate diagnosis. To function effectively and safely, all the procedures and activities of histopathology laboratory should be evaluated and monitored accurately. In histopathology laboratory, the concept of quality control is applicable to pre-analytical, analytical and post-analytical activities. Ensuring safety of working personnel as well as environment is also highly important. Safety issues that may come up in a histopathology lab are primarily those related to potentially hazardous chemicals, biohazardous materials, accidents linked to the equipment and instrumentation employed and general risks from electrical and fire hazards. This article discusses quality management system which can ensure quality performance in histopathology laboratory. The hazards in pathology laboratories and practical safety measures aimed at controlling the dangers are also discussed with the objective of promoting safety consciousness and the practice of laboratory safety.

  4. Safety and Quality Training Simulator

    NASA Technical Reports Server (NTRS)

    Scobby, Pete T.

    2009-01-01

    A portable system of electromechanical and electronic hardware and documentation has been developed as an automated means of instructing technicians in matters of safety and quality. The system enables elimination of most of the administrative tasks associated with traditional training. Customized, performance-based, hands-on training with integral testing is substituted for the traditional instructional approach of passive attendance in class followed by written examination.

  5. Engaging staff to improve quality and safety in an austere medical environment: a case-control study in two Sierra Leonean hospitals.

    PubMed

    Rosen, Michael A; Chima, Adaora M; Sampson, John B; Jackson, Eric V; Koka, Rahul; Marx, Megan K; Kamara, Thaim B; Ogbuagu, Onyebuchi U; Lee, Benjamin H

    2015-08-01

    Inadequate observance of basic processes in patient care such as patient monitoring and documentation practices are potential impediments to the timely diagnoses and management of patients. These gaps exist in low resource settings such as Sierra Leone and can be attributed to a myriad of factors such as workforce and technology deficiencies. In the study site, only 12.4% of four critical vital signs were documented in the pre-intervention period. Implement a failure mode and effects analysis (FMEA) to improve documentation of four patient vital signs: temperature, blood pressure, pulse rate and respiratory rate. FMEA was implemented among a subpopulation of health workers who are involved in monitoring and documenting patient vital signs. Pre- and post-FMEA monitoring and documentation practice were compared with a control site. Participants identified a four-step process to monitoring and documenting vital signs, three categories of failure modes and four potential solutions. Based on 2100 patient days of documentation compliance data from 147 patients between July and November 2012, staff members at the study site were 1.79 times more likely to document all four patient vital signs in the post-implementation period (95% CI [1.35, 2.38]). FMEA is a feasible and effective strategy for improving quality and safety in an austere medical environment. Documentation compliance improved at the intervention facility. To evaluate the scalability and sustainability of this approach, programs targeting the development of these types of process improvement skills in local staff should be evaluated. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  6. Monitoring product safety in the postmarketing environment.

    PubMed

    Sharrar, Robert G; Dieck, Gretchen S

    2013-10-01

    The safety profile of a medicinal product may change in the postmarketing environment. Safety issues not identified in clinical development may be seen and need to be evaluated. Methods of evaluating spontaneous adverse experience reports and identifying new safety risks include a review of individual reports, a review of a frequency distribution of a list of the adverse experiences, the development and analysis of a case series, and various ways of examining the database for signals of disproportionality, which may suggest a possible association. Regulatory agencies monitor product safety through a variety of mechanisms including signal detection of the adverse experience safety reports in databases and by requiring and monitoring risk management plans, periodic safety update reports and postauthorization safety studies. The United States Food and Drug Administration is working with public, academic and private entities to develop methods for using large electronic databases to actively monitor product safety. Important identified risks will have to be evaluated through observational studies and registries.

  7. [Drinking water quality and safety].

    PubMed

    Gómez-Gutiérrez, Anna; Miralles, Maria Josepa; Corbella, Irene; García, Soledad; Navarro, Sonia; Llebaria, Xavier

    2016-11-01

    The purpose of drinking water legislation is to guarantee the quality and safety of water intended for human consumption. In the European Union, Directive 98/83/EC updated the essential and binding quality criteria and standards, incorporated into Spanish national legislation by Royal Decree 140/2003. This article reviews the main characteristics of the aforementioned drinking water legislation and its impact on the improvement of water quality against empirical data from Catalonia. Analytical data reported in the Spanish national information system (SINAC) indicate that water quality in Catalonia has improved in recent years (from 88% of analytical reports in 2004 finding drinking water to be suitable for human consumption, compared to 95% in 2014). The improvement is fundamentally attributed to parameters concerning the organoleptic characteristics of water and parameters related to the monitoring of the drinking water treatment process. Two management experiences concerning compliance with quality standards for trihalomethanes and lead in Barcelona's water supply are also discussed. Finally, this paper presents some challenges that, in the opinion of the authors, still need to be incorporated into drinking water legislation. It is necessary to update Annex I of Directive 98/83/EC to integrate current scientific knowledge, as well as to improve consumer access to water quality data. Furthermore, a need to define common criteria for some non-resolved topics, such as products and materials in contact with drinking water and domestic conditioning equipment, has also been identified. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Developing the health, safety and environment excellence instrument

    PubMed Central

    2013-01-01

    Quality and efficiency are important issues in management systems. To increase quality, to reach best results, to move towards the continuous improvement of system and also to make the internal and external customers satisfied, it is necessary to consider the system performance measurement. In this study the Health, Safety and Environment Excellence Instrument was represented as a performance measurement tool for a wide range of health, safety and environment management systems. In this article the development of the instrument overall structure, its parts, and its test results in three organizations are presented. According to the results, the scores ranking was the managership organization, the manufacturing company and the powerhouse construction project, respectively. The results of the instrument test in three organizations show that, on the whole, the instrument has the ability to measure the performance of health, safety and environment management systems in a wide range of organizations. PMID:23369610

  9. Quality in virtual education environments

    ERIC Educational Resources Information Center

    Barbera, Elena

    2004-01-01

    The emergence of the Internet has changed the way we teach and learn. This paper provides a general overview of the state of the quality of virtual education environments. First of all, some problems with the quality criteria applied in this field and the need to develop quality seals are presented. Likewise, the dimensions and subdimensions of an…

  10. Quality in virtual education environments

    ERIC Educational Resources Information Center

    Barbera, Elena

    2004-01-01

    The emergence of the Internet has changed the way we teach and learn. This paper provides a general overview of the state of the quality of virtual education environments. First of all, some problems with the quality criteria applied in this field and the need to develop quality seals are presented. Likewise, the dimensions and subdimensions of an…

  11. Quality assessment of urban environment

    NASA Astrophysics Data System (ADS)

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

    2015-01-01

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

  12. Human safety in the lunar environment

    NASA Technical Reports Server (NTRS)

    Lewis, Robert H.

    1992-01-01

    Any attempt to establish a continuously staffed base or permanent settlement on the Moon must safely meet the challenges posed by the Moon's surface environment. This environment is drastically different from the Earth's, and radiation and meteoroids are significant hazards to human safety. These dangers may be mitigated through the use of underground habitats, the piling up of lunar materials as shielding, and the use of teleoperated devices for surface operations. The lunar environment is detailed along with concepts for survival.

  13. Pediatric Quality and Safety: A Nursing Perspective.

    PubMed

    Butler, Gabriella A; Hupp, Diane S

    2016-04-01

    Patient safety and quality are 2 of many competing priorities facing health care providers. As safety and quality rise on the agenda of executives, payers, and consumers, competing priorities, such as financial sustainability, patient engagement, regulatory standards, and governmental demands, remain organizational priorities. Nursing represents the largest health care profession in the United States and has the ability to influence the culture of patient safety and quality. It is essential for hospital leadership to provide a culture whereby nurses and staff are actively engaged and feel comfortable speaking up. Transparency is critical in the strategy and implementation of improving quality and safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Systems Approaches to Surgical Quality and Safety

    PubMed Central

    Vincent, Charles; Moorthy, Krishna; Sarker, Sudip K.; Chang, Avril; Darzi, Ara W.

    2004-01-01

    Objective: This approach provides the basis of our research program, which aims to expand operative assessment beyond patient factors and the technical skills of the surgeon; to extend assessment of surgical skills beyond bench models to the operating theater; to provide a basis for assessing interventions; and to provide a deeper understanding of surgical outcomes. Summary Background Data: Research into surgical outcomes has primarily focused on the role of patient pathophysiological risk factors and on the skills of the individual surgeon. However, this approach neglects a wide range of factors that have been found to be of important in achieving safe, high-quality performance in other high-risk environments. The outcome of surgery is also dependent on the quality of care received throughout the patient's stay in hospital and the performance of a considerable number of health professionals, all of whom are influenced by the environment in which they work. Methods: Drawing on the wider literature on safety and quality in healthcare, and recent papers on surgery, this article argues for a much wider assessment of factors that may be relevant to surgical outcome. In particular, we suggest the development of an “operation profile” to capture all the salient features of a surgical operation, including such factors as equipment design and use, communication, team coordination, factors affecting individual performance, and the working environment. Methods of assessing such factors are outlined, and ethical issues and other potential concerns are discussed. PMID:15024308

  15. A collaborative perspective on nursing leadership in quality improvement. The foundation for outcomes management and patient/staff safety in health care environments.

    PubMed

    Gantz, Nancy Rollins; Sorenson, Lisa; Howard, Randy L

    2003-01-01

    By 2004, only organizations whose institutional operating strategies are built on a continual state of readiness and include performance improvement practices throughout the organization are going to successfully meet Joint Commission on Accreditation of Healthcare Organizations standards. As stewards of patient care, nurses maintain a unique role in identifying and guiding the intervention processes central to quality care, which prepares them to become key players/designers of a paradigm that demonstrates commitment to establishing and maintaining quality care. However, without recognition and support from organization leadership and physicians, the opportunity to effectively use the capabilities of nursing may be lost. The collaborative perspectives offered here attest to the fact that mutual belief and vision, coupled with creativity, strategic planning, and implementation, can effectively mobilize resources to establish priority measures and achieve quality patient/safety outcomes within the organization. Shifting the paradigm from just meeting the standards to continual readiness and performance improvement throughout the organization then becomes mission and mantra.

  16. System for controlling child safety seat environment

    NASA Technical Reports Server (NTRS)

    Dabney, Richard W. (Inventor); Elrod, Susan V. (Inventor)

    2008-01-01

    A system is provided to control the environment experienced by a child in a child safety seat. Each of a plurality of thermoelectric elements is individually controllable to be one of heated and cooled relative to an ambient temperature. A first portion of the thermoelectric elements are positioned on the child safety seat such that a child sitting therein is positioned thereover. A ventilator coupled to the child safety seat moves air past a second portion of the thermoelectric elements and filters the air moved therepast. One or more jets coupled to the ventilator receive the filtered air. Each jet is coupled to the child safety seat and can be positioned to direct the heated/cooled filtered air to the vicinity of the head of the child sitting in the child safety seat.

  17. Discharge of swine wastes risks water quality and food safety: Antibiotics and antibiotic resistance genes from swine sources to the receiving environments.

    PubMed

    He, Liang-Ying; Ying, Guang-Guo; Liu, You-Sheng; Su, Hao-Chang; Chen, Jun; Liu, Shuang-Shuang; Zhao, Jian-Liang

    2016-01-01

    Swine feedlots are widely considered as a potential hotspot for promoting the dissemination of antibiotic resistance genes (ARGs) in the environment. ARGs could enter the environment via discharge of animal wastes, thus resulting in contamination of soil, water, and food. We investigated the dissemination and diversification of 22 ARGs conferring resistance to sulfonamides, tetracyclines, chloramphenicols, and macrolides as well as the occurrence of 18 corresponding antibiotics from three swine feedlots to the receiving water, soil environments and vegetables. Most ARGs and antibiotics survived the on-farm waste treatment processes in the three swine farms. Elevated diversity of ARGs was observed in the receiving environments including river water and vegetable field soils when compared with respective controls. The variation of ARGs along the vertical soil profiles of vegetable fields indicated enrichment and migration of ARGs. Detection of various ARGs and antibiotic residues in vegetables fertilized by swine wastes could be of great concern to the general public. This research demonstrated the contribution of swine wastes to the occurrence and development of antibiotic resistance determinants in the receiving environments and potential risks to food safety and human health. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Approaching Safety through Quality: Factors Influencing College Student Perceptions.

    PubMed

    Ramaswamy, S K; Mosher, G A

    2016-04-01

    Quality management practices have been identified by previous literature as a factor that could potentially reduce the level of safety incidents and hazards in agricultural work environments. The present study used multivariate analysis to examine the effect of independent variables such as quality and safety awareness, work experience, safety and quality management experience, and the perceived importance of safety and quality on the role of quality management practices as a mitigating factor for safety hazards and incidents in agriculture. Variables were measured on a five-point scale using a survey questionnaire. Data were collected from approximately 900 undergraduates enrolled in the College of Agriculture and Life Sciences at a large land grant university in the U.S. The level of student work experience and student perceptions of the importance of quality explained a significant amount of the variance in student views of quality management practices as a mitigating factor for safety hazards and incidents. The findings of this study provide further evidence for using quality management practices as a basis for safety interventions targeted at the agricultural workforce.

  19. Playground safety and quality in chicago.

    PubMed

    Allen, Erin M; Hill, Amy L; Tranter, Erma; Sheehan, Karen M

    2013-02-01

    To assess playground safety and quality in Chicago, Illinois, identify disparities in access, and use the data to inform collaborative improvement. A cross-sectional survey of public park playgrounds in Chicago, Illinois, was conducted in 2009, 2010, and 2011 by using the National Program for Playground Safety Standardized Survey. All playgrounds were surveyed in 2009 and 2010; those that failed in 2010 were resurveyed in 2011. Playgrounds were assessed in 4 main categories: age-appropriate design, fall surfacing, equipment maintenance, and physical environment. Safety scores were generated from the assessment. Geographic information system mapping provided a visual description of the playground pass/fail rate based on neighborhood, child population, race/ethnicity, and poverty level. Of the ∼500 playgrounds, 467 were assessed in 2009, and 459 were assessed in 2010. In 2009, half of all playgrounds (55%) and in 2010, nearly two-thirds (61%) earned scores consistent with safe playgrounds (P < .001). Playgrounds scored poorest in fall surfacing and equipment maintenance. Geographic information system mapping showed neighborhoods with a higher percentage of children and impoverished families had fewer playgrounds and more failing playgrounds. In 2011, 154 (85%) of the playgrounds that failed in 2010 were surveyed. The mean playground score among failing playgrounds improved significantly between 2010 (61%) and 2011 (67%, P < .001). Since the playground improvement initiative began in 2009, considerable progress has been made in the safety scores, although access to high-quality playgrounds varies by neighborhood. Many failing playgrounds can be brought up to standard with improvement in fall surfacing and equipment maintenance.

  20. Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

    PubMed

    Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

    2016-02-01

    House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P < .001). This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Implementing Software Safety in the NASA Environment

    NASA Technical Reports Server (NTRS)

    Wetherholt, Martha S.; Radley, Charles F.

    1994-01-01

    Until recently, NASA did not consider allowing computers total control of flight systems. Human operators, via hardware, have constituted the ultimate safety control. In an attempt to reduce costs, NASA has come to rely more and more heavily on computers and software to control space missions. (For example. software is now planned to control most of the operational functions of the International Space Station.) Thus the need for systematic software safety programs has become crucial for mission success. Concurrent engineering principles dictate that safety should be designed into software up front, not tested into the software after the fact. 'Cost of Quality' studies have statistics and metrics to prove the value of building quality and safety into the development cycle. Unfortunately, most software engineers are not familiar with designing for safety, and most safety engineers are not software experts. Software written to specifications which have not been safety analyzed is a major source of computer related accidents. Safer software is achieved step by step throughout the system and software life cycle. It is a process that includes requirements definition, hazard analyses, formal software inspections, safety analyses, testing, and maintenance. The greatest emphasis is placed on clearly and completely defining system and software requirements, including safety and reliability requirements. Unfortunately, development and review of requirements are the weakest link in the process. While some of the more academic methods, e.g. mathematical models, may help bring about safer software, this paper proposes the use of currently approved software methodologies, and sound software and assurance practices to show how, to a large degree, safety can be designed into software from the start. NASA's approach today is to first conduct a preliminary system hazard analysis (PHA) during the concept and planning phase of a project. This determines the overall hazard potential of

  2. [Quality and safety management for radiotherapy].

    PubMed

    Pourel, N; Meyrieux, C; Perrin, B

    2016-09-01

    Quality and safety management have been implemented for many years in healthcare structures (hospitals treating cancer, private radiotherapy centres). Their structure and formalization have improved progressively over time. These recommendations aim at describing the link between quality and safety management through its organization scheme based on quality-safety policy, process approach, document management and quality measurement. Dedicated tools, such as experience feedback, a priori risk mapping, to-do-lists and check-lists are shown as examples and recommended as routine practice. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  3. Quality and safety aspects of infant nutrition.

    PubMed

    Koletzko, Berthold; Shamir, Raanan; Ashwell, Margaret

    2012-01-01

    Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health.

  4. Workplace Safety: Indoor Environmental Quality

    MedlinePlus

    ... Respiratory Disease Surveillance (ORDS) Office Environment Storm and Flood Cleanup Tuberculosis Follow NIOSH Facebook Flickr Pinterest Twitter ... Respiratory Disease Surveillance (ORDS) Office Environment Storm and Flood Cleanup Tuberculosis Follow NIOSH Facebook Flickr Pinterest Twitter ...

  5. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are more focused, concentrating on ES H management, ES H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual.

  6. 75 FR 73946 - Worker Safety and Health Program: Safety Conscious Work Environment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... Part 851 Worker Safety and Health Program: Safety Conscious Work Environment AGENCY: Office of the... ``Safety-Conscious Work Environment'' guidelines as a model. DOE published this petition and a request for... ``Safety-Conscious Work Environment'' by regulation be redundant, but it would also fail to add any...

  7. Predictors of Hospital Nurses' Safety Practices: Work Environment, Workload, Job Satisfaction, and Error Reporting.

    PubMed

    Chiang, Hui-Ying; Hsiao, Ya-Chu; Lee, Huan-Fang

    Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices. Increasing nurses' attention to patient safety by improving these predictors is recommended.

  8. 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.

  9. 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.

  10. Quality circles promote mine safety

    SciTech Connect

    Edwards, S.D.

    1983-04-01

    A ''quality circle'' is a small group of people (usually seven to 10 members), who meet on a regular basis to identify, analyze, and solve work-related problems. It is a means to develop employees rather than simply a technique to increase production or reduce waste. The ''people-oriented'' philosophy underlying quality circles is based on the idea that workers who are involved in decisions that affect their work become more productive. Quality circles are based on the concept of statistical analysis control first introduced in Japan by Dr. W. Edwards Deming. Today, there are more than 8,000,000 industrial workers in Japan participating in quality circles. This article outlines this concept as it evolved in quite a different setting, a surface coal mine in southwestern Illinois, United States.

  11. Creating and Enriching Quality and Safe Outdoor Environments

    ERIC Educational Resources Information Center

    Olsen, Heather

    2013-01-01

    Can teachers of young children create stimulating and enriching outdoor environments that are also safe? This article highlights early childhood outdoor safety standards and presents a framework for creating quality and SAFE™ outdoor environments in early childhood programs that support children's interest and best practice. The outdoor…

  12. Ensuring the quality of occupational safety risk assessment.

    PubMed

    Pinto, Abel; Ribeiro, Rita A; Nunes, Isabel L

    2013-03-01

    In work environments, the main aim of occupational safety risk assessment (OSRA) is to improve the safety level of an installation or site by either preventing accidents and injuries or minimizing their consequences. To this end, it is of paramount importance to identify all sources of hazards and assess their potential to cause problems in the respective context. If the OSRA process is inadequate and/or not applied effectively, it results in an ineffective safety prevention program and inefficient use of resources. An appropriate OSRA is an essential component of the occupational safety risk management process in industries. In this article, we performed a survey to elicit the relative importance for identified OSRA tasks to enable an in-depth evaluation of the quality of risk assessments related to occupational safety aspects on industrial sites. The survey involved defining a questionnaire with the most important elements (tasks) for OSRA quality assessment, which was then presented to safety experts in the mining, electrical power production, transportation, and petrochemical industries. With this work, we expect to contribute to the main question of OSRA in industries: "What constitutes a good occupational safety risk assessment?" The results obtained from the questionnaire showed that experts agree with the proposed OSRA process decomposition in steps and tasks (taxonomy) and also with the importance of assigning weights to obtain knowledge about OSRA task relevance. The knowledge gained will enable us, in the near future, to build a framework to evaluate OSRA quality for industrial sites.

  13. Resource, quality and safety management.

    PubMed

    Hovenga, Evelyn J S

    2010-01-01

    This chapter gives an educational overview of: * Resource management relative to sustainability and the use casemix systems * Types of resources and their information system needs to support their optimal management * Quality, performance measurement options and associated information needs * Casemix systems' characteristics, usage and need for enterprise systems.

  14. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are more focused, concentrating on ES H management, ES H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES H areas. This manual documents the processes to be used to perform the ES H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy.

  15. Management of nanomaterials safety in research environment.

    PubMed

    Groso, Amela; Petri-Fink, Alke; Magrez, Arnaud; Riediker, Michael; Meyer, Thierry

    2010-12-10

    Despite numerous discussions, workshops, reviews and reports about responsible development of nanotechnology, information describing health and environmental risk of engineered nanoparticles or nanomaterials is severely lacking and thus insufficient for completing rigorous risk assessment on their use. However, since preliminary scientific evaluations indicate that there are reasonable suspicions that activities involving nanomaterials might have damaging effects on human health; the precautionary principle must be applied. Public and private institutions as well as industries have the duty to adopt preventive and protective measures proportionate to the risk intensity and the desired level of protection. In this work, we present a practical, 'user-friendly' procedure for a university-wide safety and health management of nanomaterials, developed as a multi-stakeholder effort (government, accident insurance, researchers and experts for occupational safety and health). The process starts using a schematic decision tree that allows classifying the nano laboratory into three hazard classes similar to a control banding approach (from Nano 3--highest hazard to Nano1--lowest hazard). Classifying laboratories into risk classes would require considering actual or potential exposure to the nanomaterial as well as statistical data on health effects of exposure. Due to the fact that these data (as well as exposure limits for each individual material) are not available, risk classes could not be determined. For each hazard level we then provide a list of required risk mitigation measures (technical, organizational and personal). The target 'users' of this safety and health methodology are researchers and safety officers. They can rapidly access the precautionary hazard class of their activities and the corresponding adequate safety and health measures. We succeed in convincing scientist dealing with nano-activities that adequate safety measures and management are promoting

  16. Management of nanomaterials safety in research environment

    PubMed Central

    2010-01-01

    Despite numerous discussions, workshops, reviews and reports about responsible development of nanotechnology, information describing health and environmental risk of engineered nanoparticles or nanomaterials is severely lacking and thus insufficient for completing rigorous risk assessment on their use. However, since preliminary scientific evaluations indicate that there are reasonable suspicions that activities involving nanomaterials might have damaging effects on human health; the precautionary principle must be applied. Public and private institutions as well as industries have the duty to adopt preventive and protective measures proportionate to the risk intensity and the desired level of protection. In this work, we present a practical, 'user-friendly' procedure for a university-wide safety and health management of nanomaterials, developed as a multi-stakeholder effort (government, accident insurance, researchers and experts for occupational safety and health). The process starts using a schematic decision tree that allows classifying the nano laboratory into three hazard classes similar to a control banding approach (from Nano 3 - highest hazard to Nano1 - lowest hazard). Classifying laboratories into risk classes would require considering actual or potential exposure to the nanomaterial as well as statistical data on health effects of exposure. Due to the fact that these data (as well as exposure limits for each individual material) are not available, risk classes could not be determined. For each hazard level we then provide a list of required risk mitigation measures (technical, organizational and personal). The target 'users' of this safety and health methodology are researchers and safety officers. They can rapidly access the precautionary hazard class of their activities and the corresponding adequate safety and health measures. We succeed in convincing scientist dealing with nano-activities that adequate safety measures and management are promoting

  17. Quality and safety of detailed clinical models.

    PubMed

    Ritz, Derek

    2013-01-01

    This chapter describes quality and safety risks related to the development and use of Detailed Clinical Models (DCM) and mechanisms which may be employed to mitigate such risks. The chapter begins with a brief discussion of DCMs and the role they can play in mitigating patient safety risk. There is then a brief description of the risks which DCMs themselves may introduce, followed by the introduction of a standards-based risk assessment method and the ways this assessment method may be applied to DCMs in particular. A general description is then made of the ISO 9000-based approach to quality management systems (QMS) and, specifically, how such an approach may be applied to DCM development, maintenance, deployment and use. The chapter concludes with a discussion of specific DCM quality and safety challenges and governance approaches which may be employed to help address these.

  18. Assuring fish safety and quality in international fish trade.

    PubMed

    Ababouch, Lahsen

    2006-01-01

    International trade in fishery commodities reached US 58.2 billion dollars in 2002, a 5% improvement relative to 2000 and a 45% increase over 1992 levels. Within this global trade, developing countries registered a net trade surplus of US 17.4 billion dollars in 2002 and accounted for almost 50% by value and 55% of fish exports by volume. This globalization of fish trade, coupled with technological developments in food production, handling, processing and distribution, and the increasing awareness and demand of consumers for safe and high quality food have put food safety and quality assurance high in public awareness and a priority for many governments. Consequently, many countries have tightened food safety controls, imposing additional costs and requirements on imports. As early as 1980, there was an international drive towards adopting preventative HACCP-based safety and quality systems. More recently, there has been a growing awareness of the importance of an integrated, multidisciplinary approach to food safety and quality throughout the entire food chain. Implementation of this approach requires an enabling policy and regulatory environment at national and international levels with clearly defined rules and standards, establishment of appropriate food control systems and programmes at national and local levels, and provision of appropriate training and capacity building. This paper discusses the international framework for fish safety and quality, with particular emphasis on the United Nation's Food and Agricultural Organization's (FAO) strategy to promote international harmonization and capacity building.

  19. Parents' perceptions of water safety and quality.

    PubMed

    Merkel, Lori; Bicking, Cara; Sekhar, Deepa

    2012-02-01

    Every day parents make choices about the source of water their families consume. There are many contributing factors which could affect decisions about water consumption including taste, smell, color, safety, cost, and convenience. However, few studies have investigated what parents with young children think about water quality and safety in the US and how this affects the choices they are making. This study aimed to describe the perceptions of parents with regard to water quality and safety and to compare bottled water and tap water use, as well as to examine motivation for water choices. We conducted an online questionnaire to survey parents living in Pennsylvania about water quality and safety, and preference for bottled versus tap water. Parents were recruited through child care centers, and 143 surveys were returned. The survey results showed high overall scores for perception of tap water quality and safety, and a preference for tap water over bottled water. We found that parents were concerned for the environmental impact that buying bottled water may have but were also concerned about potential contamination of tap water by natural gas drilling processes and nuclear power plants. These findings regarding parental concerns are critical to inform pediatric health care providers, water sellers, and suppliers in order that they may provide parents with the necessary information to make educated choices for their families.

  20. Changing conversations: teaching safety and quality in residency training.

    PubMed

    Voss, John D; May, Natalie B; Schorling, John B; Lyman, Jason A; Schectman, Joel M; Wolf, Andrew M D; Nadkarni, Mohan M; Plews-Ogan, Margaret

    2008-11-01

    Improving patient safety and quality in health care is one of medicine's most pressing challenges. Residency training programs have a unique opportunity to meet this challenge by training physicians in the science and methods of patient safety and quality improvement (QI).With support from the Health Resources and Services Administration, the authors developed an innovative, longitudinal, experiential curriculum in patient safety and QI for internal medicine residents at the University of Virginia. This two-year curriculum teaches the critical concepts and skills of patient safety and QI: systems thinking and human factors analysis, root cause analysis (RCA), and process mapping. Residents apply these skills in a series of QI and patient safety projects. The constructivist educational model creates a learning environment that actively engages residents in improving the quality and safety of their medical practice.Between 2003 and 2005, 38 residents completed RCAs of adverse events. The RCAs identified causes and proposed useful interventions that have produced important care improvements. Qualitative analysis demonstrates that the curriculum shifted residents' thinking about patient safety to a systems-based approach. Residents completed 237 outcome assessments during three years. Results indicate that seminars met predefined learning objectives and were interactive and enjoyable. Residents strongly believe they gained important skills in all domains.The challenge to improve quality and safety in health care requires physicians to learn new knowledge and skills. Graduate medical education can equip new physicians with the skills necessary to lead the movement to safer and better quality of care for all patients.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

  1. Health care quality and safety issues.

    PubMed

    Cornett, Becky Sutherland

    2006-05-01

    Our health-care system is burdened with high costs, health-care disparities, overtreatment, undertreatment, high error rates, and fraud and abuse. At the same time, the United States has achieved spectacular medical advances using the latest technology. As a result, health-care quality measurement, publicly reported patient safety and quality indicators, and evaluation of patients' experience of care are watchwords of a new era of accountability for health-care professionals and organizations. The health-care industry is subject to increasing regulation, private sector challenges, and public demand to make significant improvements in all three components of the quality triad: structure, process, and outcome. This article examines regulatory initiatives and industry trends pertaining to patient safety and quality measurement and concludes with specific suggestions for the professions of speech-language pathology and audiology.

  2. Watershed safety and quality control by safety threshold method

    NASA Astrophysics Data System (ADS)

    Da-Wei Tsai, David; Mengjung Chou, Caroline; Ramaraj, Rameshprabu; Liu, Wen-Cheng; Honglay Chen, Paris

    2014-05-01

    Taiwan was warned as one of the most dangerous countries by IPCC and the World Bank. In such an exceptional and perilous island, we would like to launch the strategic research of land-use management on the catastrophe prevention and environmental protection. This study used the watershed management by "Safety Threshold Method" to restore and to prevent the disasters and pollution on island. For the deluge prevention, this study applied the restoration strategy to reduce total runoff which was equilibrium to 59.4% of the infiltration each year. For the sediment management, safety threshold management could reduce the sediment below the equilibrium of the natural sediment cycle. In the water quality issues, the best strategies exhibited the significant total load reductions of 10% in carbon (BOD5), 15% in nitrogen (nitrate) and 9% in phosphorus (TP). We found out the water quality could meet the BOD target by the 50% peak reduction with management. All the simulations demonstrated the safety threshold method was helpful to control the loadings within the safe range of disasters and environmental quality. Moreover, from the historical data of whole island, the past deforestation policy and the mistake economic projects were the prime culprits. Consequently, this study showed a practical method to manage both the disasters and pollution in a watershed scale by the land-use management.

  3. Macroergonomics in Healthcare Quality and Patient Safety

    PubMed Central

    Carayon, Pascale; Karsh, Ben-Tzion; Gurses, Ayse P.; Holden, Richard; Hoonakker, Peter; Hundt, Ann Schoofs; Montague, Enid; Rodriguez, Joy; Wetterneck, Tosha B.

    2014-01-01

    The US Institute of Medicine and healthcare experts have called for new approaches to manage healthcare quality problems. In this chapter, we focus on macroergonomics, a branch of human factors and ergonomics that is based on the systems approach and considers the organizational and sociotechnical context of work activities and processes. Selected macroergonomic approaches to healthcare quality and patient safety are described such as the SEIPS model of work system and patient safety and the model of healthcare professional performance. Focused reviews on job stress and burnout, workload, interruptions, patient-centered care, health IT and medical devices, violations, and care coordination provide examples of macroergonomics contributions to healthcare quality and patient safety. Healthcare systems and processes clearly need to be systematically redesigned; examples of macroergonomic approaches, principles and methods for healthcare system redesign are described. Further research linking macroergonomics and care processes/patient outcomes is needed. Other needs for macroergonomics research are highlighted, including understanding the link between worker outcomes (e.g., safety and well-being) and patient outcomes (e.g., patient safety), and macroergonomics of patient-centered care and care coordination. PMID:24729777

  4. Nonbibliographic Databases in a Corporate Health, Safety, and Environment Organization.

    ERIC Educational Resources Information Center

    Cubillas, Mary M.

    1981-01-01

    Summarizes the characteristics of TOXIN, CHEMFILE, and the Product Profile Information System (PPIS), nonbibliographic databases used by Shell Oil Company's Health, Safety, and Environment Organization. (FM)

  5. Environment, safety, and health regulatory implementation plan

    SciTech Connect

    Not Available

    1993-10-21

    To identify, document, and maintain the Uranium Mill Tailings Remedial Action (UMTRA) Project`s environment, safety, and health (ES&H) regulatory requirements, the US Department of Energy (DOE) UMTRA Project Office tasked the Technical Assistance Contractor (TAC) to develop a regulatory operating envelope for the UMTRA Project. The system selected for managing the UMTRA regulatory operating envelope data bass is based on the Integrated Project Control/Regulatory Compliance System (IPC/RCS) developed by WASTREN, Inc. (WASTREN, 1993). The IPC/RCS is a tool used for identifying regulatory and institutional requirements and indexing them to hardware, personnel, and program systems on a project. The IPC/RCS will be customized for the UMTRA Project surface remedial action and groundwater restoration programs. The purpose of this plan is to establish the process for implementing and maintaining the UMTRA Project`s regulatory operating envelope, which involves identifying all applicable regulatory and institutional requirements and determining compliance status. The plan describes how the Project will identify ES&H regulatory requirements, analyze applicability to the UMTRA Project, and evaluate UMTRA Project compliance status.

  6. UMTRA Project: Environment, Safety, and Health Plan

    SciTech Connect

    Not Available

    1995-02-01

    The US Department of Energy has prepared this UMTRA Project Environment, Safety, and Health (ES and H) Plan to establish the policy, implementing requirements, and guidance for the UMTRA Project. The requirements and guidance identified in this plan are designed to provide technical direction to UMTRA Project contractors to assist in the development and implementation of their ES and H plans and programs for UMTRA Project work activities. Specific requirements set forth in this UMTRA Project ES and H Plan are intended to provide uniformity to the UMTRA Project`s ES and H programs for processing sites, disposal sites, and vicinity properties. In all cases, this UMTRA Project ES and H Plan is intended to be consistent with applicable standards and regulations and to provide guidance that is generic in nature and will allow for contractors` evaluation of site or contract-specific ES and H conditions. This plan specifies the basic ES and H requirements applicable to UMTRA Project ES and H programs and delineates responsibilities for carrying out this plan. DOE and contractor ES and H personnel are expected to exercise professional judgment and apply a graded approach when interpreting these guidelines, based on the risk of operations.

  7. [Relation between radiation safety criteria of human and the environment].

    PubMed

    Kazakov, S V; Utkin, S S

    2008-01-01

    System approach is used for developing of procedures of complex radiation safety of human and the environment. Relation between radiation safety criteria of human and the environment is considered by the example of different strategies of water bodies using. It is demonstrated that as to water bodies (though the methodology and conclusions are correct to terrestrial ecosystems too) observance of human radiation safety standards on condition that environment resources are used unrestrictedly (considering radiation factor) is necessary and sufficient to protection of objects of the environment. It allows reaching compromise between anthropocentric and ecological approaches to radiation protection of the environment from general biospheric principles.

  8. Safety and quality in critical patient care.

    PubMed

    González-Méndez, María Isabel; López-Rodríguez, Luís

    The care quality has gradually been placed in the center of the health system, reaching the patient safety a greater role as one of the key dimensions of quality in recent years. The monitoring, measurement and improvement of safety and quality of care in the Intensive Care Unit represent a great challenge for the critical care community. Health interventions carry a risk of adverse events or events that can cause injury, disability and even death in patients. In Intensive Care Unit, the severity of the critical patient, communication barriers, a high number of activities per patient per day, the practice of diagnostic procedures and invasive treatments, and the quantity and complexity of the information received, among others, put at risk these units as areas for the occurrence of adverse events. This article presents some of the strategies and interventions proposed and tested internationally to optimize the care of critical patients and improve the safety culture in the Intensive Care Unit. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  9. Mainstreaming quality and safety: a reformulation of quality and safety education for health professions students

    PubMed Central

    Ironside, Pamela M; Ogrinc, Gregory S

    2011-01-01

    The urgent need to expand the ability of health professionals to improve the quality and safety of patient care in the USA has been well documented. Yet the current methods of teaching quality and safety to health professionals are inadequate for the task. To the extent that quality and safety are addressed at all, they are taught using pedagogies with a narrow focus on content transmission, didactic sessions that are spatially and temporally distant from clinical work, and quality and safety projects segregated from the provision of actual patient care. In this article an argument for a transformative reorientation in quality and safety education for health professions is made. This transformation will require new pedagogies in which a) quality improvement is an integral part of all clinical encounters, b) health professions students and their clinical teachers become co-learners working together to improve patient outcomes and systems of care, c) improvement work is envisioned as the interdependent collaboration of a set of professionals with different backgrounds and perspectives skilfully optimising their work processes for the benefit of patients, and d) assessment in health professions education focuses on not just individual performance but also how the care team's patients fared and how the systems of care were improved. PMID:21450779

  10. Mainstreaming quality and safety: a reformulation of quality and safety education for health professions students.

    PubMed

    Cooke, Molly; Ironside, Pamela M; Ogrinc, Gregory S

    2011-04-01

    The urgent need to expand the ability of health professionals to improve the quality and safety of patient care in the USA has been well documented. Yet the current methods of teaching quality and safety to health professionals are inadequate for the task. To the extent that quality and safety are addressed at all, they are taught using pedagogies with a narrow focus on content transmission, didactic sessions that are spatially and temporally distant from clinical work, and quality and safety projects segregated from the provision of actual patient care. In this article an argument for a transformative reorientation in quality and safety education for health professions is made. This transformation will require new pedagogies in which a) quality improvement is an integral part of all clinical encounters, b) health professions students and their clinical teachers become co-learners working together to improve patient outcomes and systems of care, c) improvement work is envisioned as the interdependent collaboration of a set of professionals with different backgrounds and perspectives skillfully optimising their work processes for the benefit of patients, and d) assessment in health professions education focuses on not just individual performance but also how the care team's patients fared and how the systems of care were improved.

  11. 43 CFR 3162.5 - Environment and safety.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Environment and safety. 3162.5 Section 3162.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... for Operating Rights Owners and Operators § 3162.5 Environment and safety. ...

  12. 43 CFR 3162.5 - Environment and safety.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Environment and safety. 3162.5 Section 3162.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... for Operating Rights Owners and Operators § 3162.5 Environment and safety. ...

  13. 43 CFR 3162.5 - Environment and safety.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Environment and safety. 3162.5 Section 3162.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... for Operating Rights Owners and Operators § 3162.5 Environment and safety. ...

  14. 43 CFR 3162.5 - Environment and safety.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Environment and safety. 3162.5 Section 3162.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... for Operating Rights Owners and Operators § 3162.5 Environment and safety. ...

  15. Predicting Air Quality in Smart Environments

    PubMed Central

    Deleawe, Seun; Kusznir, Jim; Lamb, Brian; Cook, Diane J.

    2011-01-01

    The pervasive sensing technologies found in smart environments offer unprecedented opportunities for monitoring and assisting the individuals who live and work in these spaces. As aspect of daily life that is often overlooked in maintaining a healthy lifestyle is the air quality of the environment. In this paper we investigate the use of machine learning technologies to predict CO2 levels as an indicator of air quality in smart environments. We introduce techniques for collecting and analyzing sensor information in smart environments and analyze the correlation between resident activities and air quality levels. The effectiveness of our techniques is evaluated using three physical smart environment testbeds. PMID:21617739

  16. Quality and Safety Implications of Emergency Department Information Systems

    PubMed Central

    Farley, Heather L.; Baumlin, Kevin M.; Hamedani, Azita G.; Cheung, Dickson S.; Edwards, Michael R.; Fuller, Drew C.; Genes, Nicholas; Griffey, Richard T.; Kelly, John J.; McClay, James C.; Nielson, Jeff; Phelan, Michael P.; Shapiro, Jason S.; Stone-Griffith, Suzanne; Pines, Jesse M.

    2013-01-01

    The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services “meaningful use” incentive programs, in tandem with the boundless additional requirements for detailed reporting of quality metrics, have galvanized hospital efforts to implement hospital-based electronic health records. As such, emergency department information systems (EDISs) are an important and unique component of most hospitals’ electronic health records. System functionality varies greatly and affects physician decisionmaking, clinician workflow, communication, and, ultimately, the overall quality of care and patient safety. This article is a joint effort by members of the Quality Improvement and Patient Safety Section and the Informatics Section of the American College of Emergency Physicians. The aim of this effort is to examine the benefits and potential threats to quality and patient safety that could result from the choice of a particular EDIS, its implementation and optimization, and the hospital’s or physician group’s approach to continuous improvement of the EDIS. Specifically, we explored the following areas of potential EDIS safety concerns: communication failure, wrong order–wrong patient errors, poor data display, and alert fatigue. Case studies are presented that illustrate the potential harm that could befall patients from an inferior EDIS product or suboptimal execution of such a product in the clinical environment. The authors have developed 7 recommendations to improve patient safety with respect to the deployment of EDISs. These include ensuring that emergency providers actively participate in selection of the EDIS product, in the design of processes related to EDIS implementation and optimization, and in the monitoring of the system’s ongoing success or failure. Our recommendations apply to emergency departments using any type of EDIS: custom-developed systems, best-of-breed vendor systems, or

  17. ICD-11 for quality and safety: overview of the WHO Quality and Safety Topic Advisory Group.

    PubMed

    Ghali, William A; Pincus, Harold A; Southern, Danielle A; Brien, Susan E; Romano, Patrick S; Burnand, Bernard; Drösler, Saskia E; Sundararajan, Vijaya; Moskal, Lori; Forster, Alan J; Gurevich, Yana; Quan, Hude; Colin, Cyrille; Munier, William B; Harrison, James; Spaeth-Rublee, Brigitta; Kostanjsek, Nenad; Ustün, T Bedirhan

    2013-12-01

    This paper outlines the approach that the WHO's Family of International Classifications (WHO-FIC) network is undertaking to create ICD-11. We also outline the more focused work of the Quality and Safety Topic Advisory Group, whose activities include the following: (i) cataloguing existing ICD-9 and ICD-10 quality and safety indicators; (ii) reviewing ICD morbidity coding rules for main condition, diagnosis timing, numbers of diagnosis fields and diagnosis clustering; (iii) substantial restructuring of the health-care related injury concepts coded in the ICD-10 chapters 19/20, (iv) mapping of ICD-11 quality and safety concepts to the information model of the WHO's International Classification for Patient Safety and the AHRQ Common Formats; (v) the review of vertical chapter content in all chapters of the ICD-11 beta version and (vi) downstream field testing of ICD-11 prior to its official 2015 release. The transition from ICD-10 to ICD-11 promises to produce an enhanced classification that will have better potential to capture important concepts relevant to measuring health system safety and quality-an important use case for the classification.

  18. Home safety and low-income urban housing quality.

    PubMed

    Gielen, Andrea C; Shields, Wendy; McDonald, Eileen; Frattaroli, Shannon; Bishai, David; Ma, Xia

    2012-12-01

    Living in substandard housing may be one factor that increases the risk of fire and burn injuries in low-income urban environments. The purposes of this study are to (1) describe the frequency and characteristics of substandard housing in urban homes with young children and (2) explore the hypothesis that better housing quality is associated with a greater likelihood of having working smoke alarms and safe hot water temperatures. A total 246 caregivers of children ages 0 to 7 years were recruited from a pediatric emergency department and a well-child clinic. In-home observations were completed by using 46 items from the Housing and Urban Development's Housing Quality Standards. Virtually all homes (99%) failed the housing quality measure. Items with the highest failure rates were those related to heating and cooling; walls, ceilings, and floors; and sanitation and safety domains. One working smoke alarm was observed in 82% of the homes, 42% had 1 on every level, and 62% had safe hot water temperatures. For every increase of 1 item in the number of housing quality items passed, the odds of having any working smoke alarm increased by 10%, the odds of having 1 on every level by 18%, and the odds of having safe hot water temperatures by 8%. Many children may be at heightened risk for fire and scald burns by virtue of their home environment. Stronger collaboration between housing, health care, and injury prevention professionals is urgently needed to maximize opportunities to improve home safety.

  19. The influence of handling qualities on safety and survivability

    NASA Technical Reports Server (NTRS)

    Anderson, S. B.

    1977-01-01

    The relationship of handling qualities to safety and survivability of military aircraft is examined which includes the following: (1) a brief discussion of the philosophy used in the military specifications for treatment of degraded handling qualities, (2) an examination of several example handling qualities problem areas which influence safety and survivability; and (3) a movie illustrating the potential dangers of inadequate handling qualities features.

  20. Occupational health and environment research 1983: Health, Safety, and Environment Division. Progress report

    SciTech Connect

    Voelz, G.L.

    1985-05-01

    The primary responsibility of the Health, Safety, and Environment (HSE) Division at the Los Alamos National Laboratory is to provide comprehensive occupational health and safety programs, waste processing, and environmental protection. These activities are designed to protect the workers, the public, and the environment. Evaluation of respiratory protective equipment included the XM-30 and M17A1 military masks, use of MAG-1 spectacles in respirators, and eight self-contained units. The latter units were used in an evaluation of test procedures used for Bureau of Mines approval of breathing apparatuses. Analyses of air samples from field studies of a modified in situ oil shale retorting facility were performed for total cyclohexane extractables and selected polynuclear aromatic hydrocarbons. Aerosols generation and characterization of effluents from oil shale processing were continued as part of an inhalation toxicology study. Additional data on plutonium excretion in urine are presented and point up problems in using the Langham equation to predict plutonium deposition in the body from long-term excretion data. Environmental surveillance at Los Alamos during 1983 showed the highest estimated radiation dose from Laboratory operations to be about 26% of the natural background radiation dose. Several studies on radionuclides and their transport in the Los Alamos environment are described. The chemical quality of surface and ground water near the geothermal hot dry rock facility is described. Short- and long-term consequences to man from releases of radionuclides into the environment can be simulated by the BIOTRAN computer model, which is discussed brirfly.

  1. Aviation Safety Program Atmospheric Environment Safety Technologies (AEST) Project

    NASA Technical Reports Server (NTRS)

    Colantonio, Ron

    2011-01-01

    Engine Icing: Characterization and Simulation Capability: Develop knowledge bases, analysis methods, and simulation tools needed to address the problem of engine icing; in particular, ice-crystal icing Airframe Icing Simulation and Engineering Tool Capability: Develop and demonstrate 3-D capability to simulate and model airframe ice accretion and related aerodynamic performance degradation for current and future aircraft configurations in an expanded icing environment that includes freezing drizzle/rain Atmospheric Hazard Sensing and Mitigation Technology Capability: Improve and expand remote sensing and mitigation of hazardous atmospheric environments and phenomena

  2. Evaluating the Clinical Learning Environment: Resident and Fellow Perceptions of Patient Safety Culture

    PubMed Central

    Bump, Gregory M.; Calabria, Jaclyn; Gosman, Gabriella; Eckart, Catherine; Metro, David G.; Jasti, Harish; McCausland, Julie B.; Itri, Jason N.; Patel, Rita M.; Buchert, Andrew

    2015-01-01

    Background The Accreditation Council for Graduate Medical Education has begun to evaluate teaching institutions' learning environments with Clinical Learning Environment Review visits, including trainee involvement in institutions' patient safety and quality improvement efforts. Objective We sought to address the dearth of metrics that assess trainee patient safety perceptions of the clinical environment. Methods Using the Hospital Survey on Patient Safety Culture (HSOPSC), we measured resident and fellow perceptions of patient safety culture in 50 graduate medical education programs at 10 hospitals within an integrated health system. As institution-specific physician scores were not available, resident and fellow scores on the HSOPSC were compared with national data from 29 162 practicing providers at 543 hospitals. Results Of the 1337 residents and fellows surveyed, 955 (71.4%) responded. Compared with national practicing providers, trainees had lower perceptions of patient safety culture in 6 of 12 domains, including teamwork within units, organizational learning, management support for patient safety, overall perceptions of patient safety, feedback and communication about error, and communication openness. Higher perceptions were observed for manager/supervisor actions promoting patient safety and for staffing. Perceptions equaled national norms in 4 domains. Perceptions of patient safety culture did not improve with advancing postgraduate year. Conclusions Trainees in a large integrated health system have variable perceptions of patient safety culture, as compared with national norms for some practicing providers. Administration of the HSOPSC was feasible and acceptable to trainees, and may be used to track perceptions over time. PMID:26217435

  3. Health, Safety, and Environment Division: Annual progress report 1987

    SciTech Connect

    Rosenthal, M.A.

    1988-04-01

    The primary responsibility of the Health, Safety, and Environment (HSE) Division at the Los Alamos National Laboratory is to provide comprehensive occupational health and safety programs, waste processing, and environment protection. These activities are designed to protect the worker, the public, and the environment. Many disciplines are required to meet the responsibilities, including radiation protection, industrial hygiene, safety, occupational medicine, environmental science, epidemiology, and waste management. New and challenging health and safety problems arise occasionally from the diverse research and development work of the Laboratory. Research programs in HSE Division often stem from these applied needs. These programs continue but are also extended, as needed to study specific problems for the Department of Energy and to help develop better occupational health and safety practices.

  4. Addressing the nursing work environment to promote patient safety.

    PubMed

    Lin, Laura; Liang, Bryan A

    2007-01-01

    The nursing work environment has a critical impact on patient safety. Yet confusion on the specific roles and competencies of nurses, staff ratio issues, and lack of nurse empowerment create weaknesses that result in safety risks. These interrelated issues must be addressed systemically to impact the nursing care system. Educational reform focusing upon standardized, higher level nursing education using a military model, appropriate staff ratio laws derived from the outcomes literature, and recurrent training incorporating policy-making powers can result in nurse empowerment and improved patient safety. Improving the nursing environment requires a broad approach to benefit patient safety. By treating the work environment as a complex system, approaches can result in greater nurse professionalism, empowerment, and patient safety.

  5. Management of safety and quality and the relationship with employee decisions in country grain elevators.

    PubMed

    Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

    2012-07-01

    Human factors play an important role in the management of safety and quality in an agricultural work environment. Although employee actions and decisions have been identified as a key component of successful occupational safety programs and quality management programs, little attention has been given to the employees' role in these types of programs. This research explored two safety relationships that have theoretical connections but little previous research: the relationship between safety climate and quality climate, and the relationship of the safety and quality climates between the organizational level and the group level within a workplace. Survey data were collected at three commercial grain handling facilities from 177 employees. Employees also participated in safety and quality decision-making simulations. Significant positive predictions were noted for safety and quality climate. Decision-making predictions are also discussed. This research suggests that organizational safety is an important predictor of group safety. In addition, recognizing the larger role that supervisors play in group workplace behavior, more should be done to increase employee perceptions of group-level involvement in quality climate to promote more quality-oriented decision-making by employees.

  6. Total Quality Management and the System Safety Secretary

    NASA Technical Reports Server (NTRS)

    Elliott, Suzan E.

    1993-01-01

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

  7. Total Quality Management and the System Safety Secretary

    NASA Technical Reports Server (NTRS)

    Elliott, Suzan E.

    1993-01-01

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

  8. Enhancing the quality and safety of the perioperative patient.

    PubMed

    Staender, Sven; Smith, Andrew

    2017-09-21

    Many possible hazards bedevil the perioperative patient. This review focuses on a number of aspects of perioperative management where the patient's quality and safety can be enhanced. Our understanding of the relationship between preoperative preparation and postoperative outcomes has improved. There have also been recent developments in our understanding of how to construct useful cognitive aids and make the best use of checklists by understanding the cultural environment supporting their use. Postoperatively, the concept of 'failure to rescue' in the surgical patients has been explored. A clear vision of what postoperative recovery should mean for practitioner and patients; careful risk stratification and prophylactic measures to avoid postoperative complications; the judicious use of checklists and other cognitive aids to complement clinical expertise in promoting safety within each local context; and the prompt recognition and rescue of postoperative problems when they occur are all important aspects of a safe perioperative care.

  9. Improving the safety and quality of cancer care.

    PubMed

    Burke, Harry B

    2017-02-15

    The cancer community is increasingly interested in improving its safety and quality. Improvement will be driven by the expansion of safety and quality research and by a commitment to publish studies that advance high-quality, safe cancer care. Cancer 2017;123:549-550. © 2016 American Cancer Society. © 2016 American Cancer Society.

  10. Fundamentals of quality and safety in diagnostic radiology.

    PubMed

    Bruno, Michael A; Nagy, Paul

    2014-12-01

    The most fundamental aspects of quality and safety in radiology are reviewed, including a brief history of the quality and safety movement as applied to radiology, the overarching considerations of organizational culture, team building, choosing appropriate goals and metrics, and the radiologist's quality "tool kit." Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. The quality/safety medical index: implementation and analysis.

    PubMed

    Reiner, Bruce I

    2015-02-01

    Medical analytics relating to quality and safety measures have become particularly timely and of high importance in contemporary medical practice. In medical imaging, the dynamic relationship between medical imaging quality and radiation safety creates challenges in quantifying quality or safety independently. By creating a standardized measurement which simultaneously accounts for quality and safety measures (i.e., quality safety index), one can in theory create a standardized method for combined quality and safety analysis, which in turn can be analyzed in the context of individual patient, exam, and clinical profiles. The derived index measures can be entered into a centralized database, which in turn can be used for comparative performance of individual and institutional service providers. In addition, data analytics can be used to create customizable educational resources for providers and patients, clinical decision support tools, technology performance analysis, and clinical/economic outcomes research.

  12. Environment, Safety, and Health Risk Assessment Program (ESHRAP)

    SciTech Connect

    Eide, Steven Arvid; Thomas Wierman

    2003-12-01

    The Environment, Safety and Health Risk Assessment Program (ESHRAP) models human safety and health risk resulting from waste management and environmental restoration activities. Human safety and health risks include those associated with storing, handling, processing, transporting, and disposing of radionuclides and chemicals. Exposures to these materials, resulting from both accidents and normal, incident-free operation, are modeled. In addition, standard industrial risks (falls, explosions, transportation accidents, etc.) are evaluated. Finally, human safety and health impacts from cleanup of accidental releases of radionuclides and chemicals to the environment are estimated. Unlike environmental impact statements and safety analysis reports, ESHRAP risk predictions are meant to be best estimate, rather than bounding or conservatively high. Typically, ESHRAP studies involve risk predictions covering the entire waste management or environmental restoration program, including such activities as initial storage, handling, processing, interim storage, transportation, and final disposal. ESHRAP can be used to support complex environmental decision-making processes and to track risk reduction as activities progress.

  13. Improving quality and safety education: The QSEN Learning Collaborative.

    PubMed

    Cronenwett, Linda; Sherwood, Gwen; Gelmon, Sherril B

    2009-01-01

    As part of a national initiative to improve quality and safety education in prelicensure nursing programs, 15 schools participated in a 15-month learning collaborative sponsored by Quality and Safety Education for Nurses, funded by the Robert Wood Johnson Foundation. This article presents the rationale, design, activities, and outcomes of the collaborative. Collaborative members revised curricula, developed new teaching strategies, and established the foundation for future faculty development efforts to advance teaching of quality and safety concepts in nursing education.

  14. Safety Considerations in the Ground Environment

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, Paul D.; Palo, Thomas E.

    2007-01-01

    In the history of humankind, every great space adventure has begun on the ground. While this seems to be stating the obvious, mission and spacecraft designers who have overlooked this fact have paid a high price, either in loss or damage to the spacecraft pre-launch, or in mission failure or reduction. Spacecraft personnel may risk not only their flight hardware, but they may also risk their lives, their co-workers lives and even the general public by not heeding safety on the ground. Their eyes may be on the stars but their feet are on the ground! One additional comment: Although the design requirements are very different for human rated and nonhuman rated flight hardware, while on the ground that flight hardware (and its ground support equipment) doesn't care about what it is flying on. On the ground, additional requirements are often levied to protect the work force and general public. (Authors' Note: The source material for this chapter is primarily taken from the Kennedy Space Center Handbook (KHB) 1700.7/45 SW Handbook S-100 Space Shuttle Payload Ground Safety Handbook and the authors' personal experiences.

  15. Recognizing and Responding to the "Toxic" Work Environment: Worker Safety, Patient Safety, and Abuse/Neglect in Nursing Homes.

    PubMed

    Pickering, Carolyn E Z; Nurenberg, Katie; Schiamberg, Lawrence

    2017-10-01

    This grounded theory study examined how the certified nursing assistant (CNA) understands and responds to bullying in the workplace. Constant comparative analysis was used to analyze data from in-depth telephone interviews with CNAs ( N = 22) who experienced bullying while employed in a nursing home. The result of the analysis is a multistep model describing CNA perceptions of how, over time, they recognized and responded to the "toxic" work environment. The strategies used in responding to the "toxic" environment affected their care provision and were attributed to the development of several resident and worker safety outcomes. The data suggest that the etiology of abuse and neglect in nursing homes may be better explained by institutional cultures rather than individual traits of CNAs. Findings highlight the relationship between worker and patient safety, and suggest worker safety outcomes may be an indicator of quality in nursing homes.

  16. Children's Safety in the Residential Environment.

    ERIC Educational Resources Information Center

    Brink, Satya

    The incidence and causes of children's accidents in the home are briefly described. Data on the most common types and locations of such accidents are provided in tables. Characteristics of children and the home environment that contribute to accidents are briefly discussed. In conclusion, problems associated with accident prevention strategies,…

  17. Association of nurse work environment and safety climate on patient mortality: A cross-sectional study.

    PubMed

    Olds, Danielle M; Aiken, Linda H; Cimiotti, Jeannie P; Lake, Eileen T

    2017-06-24

    There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes. To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality. Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics. Acute care hospitals in California, Florida, New Jersey, and Pennsylvania. The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients. Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression. In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316). We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Ten years after the IOM report: Engaging residents in quality and patient safety by creating a House Staff Quality Council.

    PubMed

    Fleischut, Peter M; Evans, Adam S; Nugent, William C; Faggiani, Susan L; Lazar, Eliot J; Liebowitz, Richard S; Forese, Laura L; Kerr, Gregory E

    2011-01-01

    Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

  19. Home Safety and Low-Income Urban Housing Quality

    PubMed Central

    Shields, Wendy; McDonald, Eileen; Frattaroli, Shannon; Bishai, David; Ma, Xia

    2012-01-01

    OBJECTIVES: Living in substandard housing may be one factor that increases the risk of fire and burn injuries in low-income urban environments. The purposes of this study are to (1) describe the frequency and characteristics of substandard housing in urban homes with young children and (2) explore the hypothesis that better housing quality is associated with a greater likelihood of having working smoke alarms and safe hot water temperatures. METHODS: A total 246 caregivers of children ages 0 to 7 years were recruited from a pediatric emergency department and a well-child clinic. In-home observations were completed by using 46 items from the Housing and Urban Development’s Housing Quality Standards. RESULTS: Virtually all homes (99%) failed the housing quality measure. Items with the highest failure rates were those related to heating and cooling; walls, ceilings, and floors; and sanitation and safety domains. One working smoke alarm was observed in 82% of the homes, 42% had 1 on every level, and 62% had safe hot water temperatures. For every increase of 1 item in the number of housing quality items passed, the odds of having any working smoke alarm increased by 10%, the odds of having 1 on every level by 18%, and the odds of having safe hot water temperatures by 8%. CONCLUSIONS: Many children may be at heightened risk for fire and scald burns by virtue of their home environment. Stronger collaboration between housing, health care, and injury prevention professionals is urgently needed to maximize opportunities to improve home safety. PMID:23147973

  20. Quality and Patient Safety Teams in the Perioperative Setting.

    PubMed

    Serino, Michele Fusco

    2015-12-01

    Quality and patient safety teams in the perioperative setting can provide perioperative personnel with a safety net to prevent avoidable errors, which is a necessity in today's complex surgical world. The primary goal of the quality and patient safety team should be to develop and implement a perioperative quality and patient safety strategic plan. The mission of the plan can be developed by surveying facility employees, choosing a quality methodology, and using an evidence-based approach to develop and implement quality programs and processes. To create and sustain a quality and patient safety team, it is important to select a heterogeneous group; define team roles; identify day-to-day, weekly, and monthly team responsibilities; actively participate in facility committees, meetings, and new employee orientation; conduct audits; and schedule project time. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  1. LANL Safety Conscious Work Environment (SCWE) Self-Assessment

    SciTech Connect

    Hargis, Barbara C.

    2014-01-29

    On December 21, 2012 Secretary of Energy Chu transmitted to the Defense Nuclear Facilities Safety Board (DNFSB) revised commitments on the implementation plan for Safety Culture at the Waste Treatment and Immobilization Plant. Action 2-5 was revised to require contractors and federal organizations to complete Safety Conscious Work Environment (SCWE) selfassessments and provide reports to the appropriate U.S. Department of Energy (DOE) - Headquarters Program Office by September 2013. Los Alamos National Laboratory (LANL) planned and conducted a Safety Conscious Work Environment (SCWE) Self-Assessment over the time period July through August, 2013 in accordance with the SCWE Self-Assessment Guidance provided by DOE. Significant field work was conducted over the 2-week period August 5-16, 2013. The purpose of the self-assessment was to evaluate whether programs and processes associated with a SCWE are in place and whether they are effective in supporting and promoting a SCWE.

  2. Advancing health care quality and safety through action learning.

    PubMed

    Mathews, Simon; Golden, Sherita; Demski, Renee; Pronovost, Peter; Ishii, Lisa

    2017-05-02

    Purpose The purpose of this study is to demonstrate how action learning can be practically applied to quality and safety challenges at a large academic medical health system and become fundamentally integrated with an institution's broader approach to quality and safety. Design/methodology/approach The authors describe how the fundamental principles of action learning have been applied to advancing quality and safety in health care at a large academic medical institution. The authors provide an academic contextualization of action learning in health care and then transition to how this concept can be practically applied to quality and safety by providing detailing examples at the unit, cross-functional and executive levels. Findings The authors describe three unique approaches to applying action learning in the comprehensive unit-based safety program, clinical communities and the quality management infrastructure. These examples, individually, provide discrete ways to integrate action learning in the advancement of quality and safety. However, more importantly when combined, they represent how action learning can form the basis of a learning health system around quality and safety. Originality/value This study represents the broadest description of action learning applied to the quality and safety literature in health care and provides detailed examples of its use in a real-world context.

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

    PubMed

    Van Scyoc, Karl

    2008-11-15

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

  4. Healthcare quality and safety: a review of policy, practice and research.

    PubMed

    Waring, Justin; Allen, Davina; Braithwaite, Jeffrey; Sandall, Jane

    2016-02-01

    Over the last two decades healthcare quality and safety have risen to the fore of health policy and research. This has largely been informed by theoretical and empirical ideas found in the fields of ergonomics and human factors. These have enabled significant advances in our understanding and management of quality and safety. However, a parallel and at time neglected sociological literature on clinical quality and safety is presented as offering additional, complementary, and at times critical insights on the problems of quality and safety. This review explores the development and contributions of both the mainstream and more sociological approaches to safety. It shows that where mainstream approaches often focus on the influence of human and local environment factors in shaping quality, a sociological perspective can deepen knowledge of the wider social, cultural and political factors that contextualise the clinical micro-system. It suggests these different perspectives can easily complement one another, offering a more developed and layered understanding of quality and safety. It also suggests that the sociological literature can bring to light important questions about the limits of the more mainstream approaches and ask critical questions about the role of social inequality, power and control in the framing of quality and safety.

  5. Patient Safety and Quality Metrics in Pediatric Hospital Medicine.

    PubMed

    Kumar, Bhanumathy

    2016-04-01

    Quality-based regulations, performance-based payouts, and open reporting have contributed to a growing focus on quality and safety metrics in health care. Medical errors are a well-known catastrophe in the field. Especially disturbing are estimates of pediatric safety issues, which hold a stronger capacity to cause serious issues than those found in adults. This article presents information collected in the past 2 decades pertaining to the issue of quality, and describes a preliminary list of potential solutions and methods of implementation. The beginning stages of a reconstructive journey of safety and quality in a Michigan pediatric hospital is introduced and discussed. Published by Elsevier Inc.

  6. The Effect of Line Maintenance Activity on Airline Safety Quality

    NASA Technical Reports Server (NTRS)

    Rhoades, Dawna L.; Reynolds, Rosemarie; Waguespack, Blaise, Jr.; Williams, Michael

    2005-01-01

    One of the arguments against deregulation of the airline industry has been the possibility that financially troubled carriers would be tempted to lower line maintenance spending, thus lowering maintenance quality and decreasing the overall safety of the carrier. Given the financial crisis triggered by the events of 9/11: it appears to be a good time to revisit this issue. This paper examines the quality of airline line maintenance activity and examines the impact of maintenance spending on maintenance quality and overall safety. Findings indicate that increased maintenance spending is associated with increased line maintenance activity and increased overall safety quality for the major U.S. carriers.

  7. Quality, Safety, and Value in Pediatric Orthopaedic Surgery.

    PubMed

    Glotzbecker, Michael P; Wang, Kevin; Waters, Peter M; McCarthy, James; Flynn, John M; Vitale, Michael G

    2016-09-01

    Enhancing patient safety and the quality of care continues to be a focus of considerable public and professional interest. We have made dramatic strides in our technical ability to care for children with pediatric orthopaedic problems, but it has become increasingly obvious that there are also significant opportunities to improve the quality, safety, and value of the care we deliver. The purpose of this article is to introduce pediatric orthopaedic surgeons to the rationale for and principles of quality improvement and to provide an update on quality, safety, and value projects within Pediatric Orthopaedic Society of North America.

  8. Worker safety and glutaraldehyde in the gastrointestinal lab environment.

    PubMed

    Cohen, Nancy L; Patton, Carol M

    2006-01-01

    Glutaraldehyde is considered a high-level surgical disinfectant commonly used in the United States in gastrointestinal lab environments. Glutaraldehyde requires proper ventilation when used as glutaraldehyde vapors are known irritants to the skin, eyes, nose, and lungs without proper ventilation in the work environment. Vapor concentration is the unit of measurement for the environmental presence of glutaraldehyde. Safe levels of glutaraldehyde vapor concentrations are a significant issue in the work environment. The American Conference of Governmental Hygienists has established and reported safe and allowable limits for vapor concentration of glutaraldehyde. Unfortunately, uncontrolled glutaraldehyde exposure in selected work environments is contributing to occupational asthma. Environmental exposure to glutaraldehyde has been linked to respiratory sensitization of the workers exposed and suggests the need for safe work environments anywhere glutaraldehyde is in use. Gastrointestinal labs use high-level disinfectants like glutaraldehyde to safely and thoroughly disinfect endoscopic instruments and accessories; however, there are worker-safety considerations relevant to glutaraldehyde use. The purpose of this article is to identify and describe clinical issues and challenges associated with worker safety and proper ventilation of glutaraldehyde in a gastrointestinal environment. A multidisciplinary problem-solving approach for use in identification and intervention for glutaraldehyde exposure and safety recommendations related to glutaraldehyde use as a high-level disinfectant in one gastroenterology lab environment will be highlighted.

  9. Quality and safety requirements for sustainable phage therapy products.

    PubMed

    Pirnay, Jean-Paul; Blasdel, Bob G; Bretaudeau, Laurent; Buckling, Angus; Chanishvili, Nina; Clark, Jason R; Corte-Real, Sofia; Debarbieux, Laurent; Dublanchet, Alain; De Vos, Daniel; Gabard, Jérôme; Garcia, Miguel; Goderdzishvili, Marina; Górski, Andrzej; Hardcastle, John; Huys, Isabelle; Kutter, Elizabeth; Lavigne, Rob; Merabishvili, Maia; Olchawa, Ewa; Parikka, Kaarle J; Patey, Olivier; Pouilot, Flavie; Resch, Gregory; Rohde, Christine; Scheres, Jacques; Skurnik, Mikael; Vaneechoutte, Mario; Van Parys, Luc; Verbeken, Gilbert; Zizi, Martin; Van den Eede, Guy

    2015-07-01

    The worldwide antibiotic crisis has led to a renewed interest in phage therapy. Since time immemorial phages control bacterial populations on Earth. Potent lytic phages against bacterial pathogens can be isolated from the environment or selected from a collection in a matter of days. In addition, phages have the capacity to rapidly overcome bacterial resistances, which will inevitably emerge. To maximally exploit these advantage phages have over conventional drugs such as antibiotics, it is important that sustainable phage products are not submitted to the conventional long medicinal product development and licensing pathway. There is a need for an adapted framework, including realistic production and quality and safety requirements, that allows a timely supplying of phage therapy products for 'personalized therapy' or for public health or medical emergencies. This paper enumerates all phage therapy product related quality and safety risks known to the authors, as well as the tests that can be performed to minimize these risks, only to the extent needed to protect the patients and to allow and advance responsible phage therapy and research.

  10. Drug safety and efficacy impaired by quality failure.

    PubMed

    Ekiert, R J

    2011-06-01

    The three main pillars of drug evaluation are quality, safety and efficacy. Each marketing authorization dossier has to demonstrate conformity with quality, safety and efficacy requirements separately. While this is justifiable, it may nevertheless lead to some important problems being overlooked. The relationship between these three aspects of a medicinal product can be of great importance. Little is said about how quality can affect safety or even efficacy. It is worth discussing these connections in order to assess side-effects appropriately and to distinguish between quality failures and real pharmacovigilance problems. Not every side-effect is a result of the drug's pharmacodynamic or pharmacokinetic properties or other therapy-related issues such as interactions. Sometimes a patient complaint is caused by substandard quality of the drug. This possibility should never be ignored in any assessment of side-effects. This paper presents a useful check-list of quality failures that can endanger drug safety.

  11. Evaluation of Safety, Quality and Productivity in Construction

    NASA Astrophysics Data System (ADS)

    Usmen, M. A.; Vilnitis, M.

    2015-11-01

    This paper examines the success indicators of construction projects, safety, quality and productivity, in terms of their implications and impacts during and after construction. First safety is considered during construction with a focus on hazard identification and the prevention of occupational accidents and injuries on worksites. The legislation mandating safety programs, training and compliance with safety standards is presented and discussed. Consideration of safety at the design stage is emphasized. Building safety and the roles of building codes in prevention of structural failures are also covered in the paper together with factors affecting building failures and methods for their prevention. Quality is introduced in the paper from the perspective of modern total quality management. Concepts of quality management, quality control, quality assurance and Six Sigma and how they relate to building quality and structural integrity are discussed with examples. Finally, productivity concepts are presented with emphasis on effective project management to minimize loss of productivity, complimented by lean construction and lean Six Sigma principles. The paper concludes by synthesizing the relationships between safety, quality and productivity.

  12. Hospital Nurses' Work Environment Characteristics and Patient Safety Outcomes.

    PubMed

    Lee, Seung Eun; Scott, Linda D

    2016-08-01

    This integrative literature review assesses the relationship between hospital nurses' work environment characteristics and patient safety outcomes and recommends directions for future research based on examination of the literature. Using an electronic search of five databases, 18 studies published in English between 1999 and 2016 were identified for review. All but one study used a cross-sectional design, and only four used a conceptual/theoretical framework to guide the research. No definition of work environment was provided in most studies. Differing variables and instruments were used to measure patient outcomes, and findings regarding the effects of work environment on patient outcomes were inconsistent. To clarify the relationship between nurses' work environment characteristics and patient safety outcomes, researchers should consider using a longitudinal study design, using a theoretical foundation, and providing clear operational definitions of concepts. Moreover, given the inconsistent findings of previous studies, they should choose their measurement methodologies with care.

  13. Quality Control: (Material) Safety Data Sheets.

    PubMed

    Allen, Loyd V

    2017-01-01

    Safety Data Sheets (formerly Material Safety Data Sheets) are a system for cataloging information on chemicals, chemical compounds, and chemical mixtures and include instructions for the safe use and potential hazards associated with a particular material or product. At present, there are 16 sections of Safety Data Sheets, and these sections are discussed in this article. Two United States Pharmacopeia compounding-related chapters (<795> and <800>) refer to Safety Data Sheets, and this article provides a brief discussion on the terminology contained within those chapters. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  14. Common predictors of nurse-reported quality of care and patient safety.

    PubMed

    Stimpfel, Amy Witkoski; Djukic, Maja; Brewer, Carol S; Kovner, Christine T

    2017-03-03

    In the era of the Patient Protection and Affordable Care Act, quality of care and patient safety in health care have never been more visible to patients or providers. Registered nurses (nurses) are key players not only in providing direct patient care but also in evaluating the quality and safety of care provided to patients and families. We had the opportunity to study a unique cohort of nurses to understand more about the common predictors of nurse-reported quality of care and patient safety across acute care settings. We analyzed cross-sectional survey data that were collected in 2015 from 731 nurses, as part of a national 10-year panel study of nurses. Variables selected for inclusion in regression analyses were chosen based on the Systems Engineering Initiative for Patient Safety model, which is composed of work system or structure, process, and outcomes. Our findings indicate that factors from three components of the Systems Engineering Initiative for Patient Safety model-Work System (person, environment, and organization) are predictive of quality of care and patient safety as reported by nurses. The main results from our multiple linear and logistic regression models suggest that significant predictors common to both quality and safety were job satisfaction and organizational constraints. In addition, unit type and procedural justice were associated with patient safety, whereas better nurse-physician relations were associated with quality of care. Increasing nurses' job satisfaction and reducing organizational constraints may be areas to focus on to improve quality of care and patient safety. Our results provide direction for hospitals and nurse managers as to how to allocate finite resources to achieve improvements in quality of care and patient safety alike.

  15. Soil quality under mixed grassland - Cropland environments

    USDA-ARS?s Scientific Manuscript database

    Native grassland environments (i.e. prairies) are typically characterized by soils with high quality. Historical cultivation of prairies has led to soil resources that are now in a compromised state of health. The loss of soil organic matter that led to large biopores and a favorable rooting envir...

  16. Human factors systems approach to healthcare quality and patient safety

    PubMed Central

    Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

    2013-01-01

    Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

  17. Implementation of Programmatic Quality and the Impact on Safety

    NASA Technical Reports Server (NTRS)

    Huls, Dale Thomas; Meehan, Kevin

    2005-01-01

    The purpose of this paper is to discuss the implementation of a programmatic quality assurance discipline within the International Space Station Program and the resulting impact on safety. NASA culture has continued to stress safety at the expense of quality when both are extremely important and both can equally influence the success or failure of a Program or Mission. Although safety was heavily criticized in the media after Colimbiaa, strong case can be made that it was the failure of quality processes and quality assurance in all processes that eventually led to the Columbia accident. Consequently, it is possible to have good quality processes without safety, but it is impossible to have good safety processes without quality. The ISS Program quality assurance function was analyzed as representative of the long-term manned missions that are consistent with the President s Vision for Space Exploration. Background topics are as follows: The quality assurance organizational structure within the ISS Program and the interrelationships between various internal and external organizations. ISS Program quality roles and responsibilities with respect to internal Program Offices and other external organizations such as the Shuttle Program, JSC Directorates, NASA Headquarters, NASA Contractors, other NASA Centers, and International Partner/participants will be addressed. A detailed analysis of implemented quality assurance responsibilities and functions with respect to NASA Headquarters, the JSC S&MA Directorate, and the ISS Program will be presented. Discussions topics are as follows: A comparison of quality and safety resources in terms of staffing, training, experience, and certifications. A benchmark assessment of the lessons learned from the Columbia Accident Investigation (CAB) Report (and follow-up reports and assessments), NASA Benchmarking, and traditional quality assurance activities against ISS quality procedures and practices. The lack of a coherent operational

  18. Implementation of Programmatic Quality and the Impact on Safety

    NASA Technical Reports Server (NTRS)

    Huls, Dale Thomas; Meehan, Kevin

    2005-01-01

    The purpose of this paper is to discuss the implementation of a programmatic quality assurance discipline within the International Space Station Program and the resulting impact on safety. NASA culture has continued to stress safety at the expense of quality when both are extremely important and both can equally influence the success or failure of a Program or Mission. Although safety was heavily criticized in the media after Colimbiaa, strong case can be made that it was the failure of quality processes and quality assurance in all processes that eventually led to the Columbia accident. Consequently, it is possible to have good quality processes without safety, but it is impossible to have good safety processes without quality. The ISS Program quality assurance function was analyzed as representative of the long-term manned missions that are consistent with the President s Vision for Space Exploration. Background topics are as follows: The quality assurance organizational structure within the ISS Program and the interrelationships between various internal and external organizations. ISS Program quality roles and responsibilities with respect to internal Program Offices and other external organizations such as the Shuttle Program, JSC Directorates, NASA Headquarters, NASA Contractors, other NASA Centers, and International Partner/participants will be addressed. A detailed analysis of implemented quality assurance responsibilities and functions with respect to NASA Headquarters, the JSC S&MA Directorate, and the ISS Program will be presented. Discussions topics are as follows: A comparison of quality and safety resources in terms of staffing, training, experience, and certifications. A benchmark assessment of the lessons learned from the Columbia Accident Investigation (CAB) Report (and follow-up reports and assessments), NASA Benchmarking, and traditional quality assurance activities against ISS quality procedures and practices. The lack of a coherent operational

  19. Nurses critical to quality, safety, and now financial performance.

    PubMed

    Kohlbrenner, Janis; Whitelaw, George; Cannaday, Denise

    2011-03-01

    Preventable hospital errors are the accepted impetus to the establishment of quality measures and served as a catalyst for the ongoing evolution of healthcare reform. Nurses are crucial members of the hospital quality team, and their actions are integral to the hospital's quality performance. The authors explore some of the practical challenges created by quality performance standards, specifically around venous thromboembolism, and the contribution nurses can make, to patient safety, quality of care, and the institutions financial performance.

  20. [Quality management and safety culture in medicine: context and concepts].

    PubMed

    Wischet, Werner; Eitzinger, Claudia

    2009-01-01

    The publication of the IOM report "To err is human: building a safer health system" in 1999 put spotlight on the primacy of the principle of primum non nocere and made patient safety a central topic of quality management. A key conclusion of the report was the need for a well-developed safety culture. While concepts of quality management have evolved along the lines of ISO and Total Quality Management over the last decades patient safety still has not got the same amount of attention (PubMed). Evidence from other safety-critical areas but also from the field of medicine itself suggests that an efficient culture of safety is a conditio sine qua non for the sustainable improvement of patient safety. Considering these arguments the present paper aims at emphasizing the importance of an efficient culture of safety for patient safety and quality management in healthcare. In addition, key instruments of safety culture as well as their limitations will be presented.

  1. Towards a sociology of healthcare safety and quality.

    PubMed

    Allen, Davina; Braithwaite, Jeffrey; Sandall, Jane; Waring, Justin

    2016-02-01

    The contributions to this collection address technologies, practices, experiences and the organisation of quality and safety across a wide range of healthcare contexts. Spanning three continents, from hospital to community, maternity to mental health, they shine a light into the boardrooms, back offices and front-lines of healthcare, offering sociological insights from the perspectives of managers, clinicians and patients. We review these articles and consider how they contribute to some of the dilemmas that confront mainstream approaches to quality and safety and then look ahead to outline future lines of sociological inquiry to progress the theory and practice of quality and safety.

  2. Creating a Fellowship Curriculum in Patient Safety and Quality.

    PubMed

    Abookire, Susan A; Gandhi, Tejal K; Kachalia, Allen; Sands, Kenneth; Mort, Elizabeth; Bommarito, Grace; Gagne, Jane; Sato, Luke; Weingart, Saul N

    2016-01-01

    The authors sought to create a curriculum suitable for a newly created clinical fellowship curriculum across Harvard Medical School-affiliated teaching hospitals as part of a newly created 2-year quality and safety fellowship program described in the companion article "Design and Implementation of the Harvard Fellowship in Patient Safety and Quality." The aim of the curriculum development process was to define, coordinate, design, and implement a set of essential skills for future physician-scholars of any specialty to lead operational quality and patient safety efforts. The process of curriculum development and the ultimate content are described in this article. © The Author(s) 2014.

  3. Good practice in health, environment and safety management in enterprise.

    PubMed

    Michalak, J

    2001-01-01

    Good practice in health, environment and safety management in enterprise (GP HESME) is a process that aims at continuous improvement in health, environment and safety performance, involving all stakeholders within and outside the enterprise. This WHO program is supported by other international organizations, and the declaration of Ministers of Health and Ministers of Environment adopted in 1999. The basic issues of the GP HESME concept are presented as well as its prerequisites, benefits and participants. The key partners in GP HESME are employers and their organizations, representatives of employees, governmental agencies, local authorities, financial and insurance institutions, occupational health services, environmental and social services, associations of professionals, research and training institutions. The HESME system is intended to function at different levels: international, national, local community, and enterprise settings. The lists of expected benefits for each group of stakeholders are discussed. Evaluation of GP HESME is based on the criteria and indicators, the most important of them are briefly presented.

  4. Creating a culture for health care quality and safety.

    PubMed

    Roberts, Velma; Perryman, Martha M

    2007-01-01

    Approximately 67% of hospital quality indicators require some type of laboratory testing to monitor compliance. Unfortunately, in many hospitals, laboratory data information systems remain an untapped resource in eliminating medical errors and improving patient safety. Using case scenarios, this article demonstrates potential consequences for patient safety and quality of care when information sharing between medical technologists and nurses is not a part of a hospital's culture. The outcome for this patient could have been avoided if a more inclusive health care quality and safety culture existed. Creating a culture for health care quality and safety requires consensus building by clinical and administrative leaders. Consensus building occurs by managing relationships among and between a team of independent, autonomous physicians, nurses, allied health professionals, and health care administrators. These relationships are built on mutual respect and effective communication. Creating a quality culture is a challenging but necessary prerequisite for eliminating medical errors and ensuring patient safety. Physician leaders promoting and advancing cultural change in clinical care from one of exclusive decision making authority to a culture that is based on shared decision making are a necessary first step. Shared decision making requires mutual respect, trust, confidentiality, responsiveness, empathy, effective listening, and communication among all clinical team members. Physician and administrative leaders with a focus on patient safety and a willingness to change will ensure a culture of health care quality and safety.

  5. Patient safety and quality improvement in rehabilitation medicine.

    PubMed

    Cristian, Adrian; Green, Jonah

    2012-05-01

    Patient safety in medical settings has become a major concern. As more and more individuals seek rehabilitative care for their medical conditions or are referred to rehabilitation specialists with increasingly complex medical conditions, the issue of patient safety in the rehabilitation setting takes on added importance. This article introduces the concepts of patient safety, cognitive biases, systems thinking, and quality improvement as they apply to the rehabilitation medicine.

  6. Maintaining Quality in a Decommissioning Environment

    SciTech Connect

    Attas, Michael

    2008-01-15

    The decommissioning of AECL's Whiteshell Laboratories is Canada's largest nuclear decommissioning project to date. This research laboratory has operated for forty years since it was set up in 1963 in eastern Manitoba as the Whiteshell Nuclear Research Establishment, complete with 60 MW(Th) test reactor, hot cells, particle accelerators, and multiple large-scale research programs. Returning the site to almost complete green state will require several decades of steady work in combination with periods of storage-with-surveillance. In this paper our approach to maintaining quality during the long decommissioning period is explained. In this context, 'quality' includes both regulatory aspects (compliance with required standards) and business aspects (meeting the customers' needs and exceeding their expectations). Both aspects are discussed, including examples and lessons learned. The five years of development and implementation of a quality assurance program for decommissioning the WL site have led to a number of lessons learned. Many of these are also relevant to other decommissioning projects, in Canada and elsewhere: - Early discussions with the regulator can save time and effort later in the process; - An iterative process in developing documentation allows for steady improvements and input throughout the process; - Consistent 2-way communication with staff regarding the benefits of a quality program assists greatly in adoption of the philosophy and procedures; - Top-level management must lead in promoting quality; - Field trials of procedures ('beta testing') ensures they are easy to use as well as useful. Success in decommissioning the Whiteshell Laboratories depends on the successful implementation of a rigorous quality program. This will help to ensure both safety and efficiency of all activities on site, from planning through execution and reporting. The many aspects of maintaining this program will continue to occupy quality practitioners in AECL, reaping

  7. 76 FR 7854 - Patient Safety Organizations: Voluntary Delisting From Quality Excellence, Inc./PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Medical Care, of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality... safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety...

  8. The Veterans Affairs National Quality Scholars program: a model for interprofessional education in quality and safety.

    PubMed

    Patrician, Patricia A; Dolansky, Mary A; Pair, Vincent; Bates, Mekeshia; Moore, Shirley M; Splaine, Mark; Gilman, Stuart C

    2013-01-01

    The Quality and Safety Education for Nurses (QSEN) project is enhancing the emphasis on quality care and patient safety content in nursing schools. A partnership between QSEN and the Veterans Affairs National Quality Scholars program resulted in a unique experiential, interdisciplinary fellowship for both nurses and physicians. This article introduces the Veterans Affairs National Quality Scholars program and provides examples of learning activities and fellows' accomplishments. Interprofessional quality and safety education at the doctoral and postdoctoral levels is germane to improving the quality of health care.

  9. Hyperspectral and multispectral imaging for evaluating food safety and quality

    USDA-ARS?s Scientific Manuscript database

    Spectral imaging technologies have been developed rapidly during the past decade. This paper presents hyperspectral and multispectral imaging technologies in the area of food safety and quality evaluation, with an introduction, demonstration, and summarization of the spectral imaging techniques avai...

  10. Bronson Methodist Hospital: journey to excellence in quality and safety.

    PubMed

    Knapp, Cheryl

    2006-10-01

    Bronson Healthcare Group, a 343-bed not-for-profit health care system serving all of southwest Michigan and northern Indiana, has as its flagship Bronson Methodist Hospital, the recipient of the 2005 Malcolm Baldrige National Quality Award. The Baldrige criteria were used to formalize Bronson's approach to performance excellence. The strategic plan is condensed and communicated via a "Plan for Excellence" focused on three strategies: clinical excellence, customer and service excellence, and corporate effectiveness. Initiatives include clinical scene investigation (a system for reporting and investigating sentinel and atypical events), a strategy for educating staff in the Situation-Background-Assessment-Recommendations (SBAR) communication technique, and mandatory influenza immunization for health care staff (safety), patient health literacy needs and a health information center (patient centeredness); methods to reduce bloodstream and ventilator-acquired pneumonia infections (effectiveness); a physician portal for access to forms, test results, and patient information (efficiency); restaurant-style pagers for patients and families while waiting (timeliness); and community outreach (equity). Bronson's journey to excellence continues with more accountability for hand-off communication and teamwork, enhancing a non-punitive environment for patient safety reporting, and further incorporating patient and family involvement.

  11. Key Principles in Quality and Safety in Radiology.

    PubMed

    Abujudeh, Hani; Kaewlai, Rathachai; Shaqdan, Khalid; Bruno, Michael A

    2017-03-01

    The purpose of this article is to introduce the reader to basic concepts of quality and safety in radiology. Concepts are introduced that are keys to identifying, understanding, and utilizing certain quality tools with the aim of making process improvements. Challenges, opportunities, and change drivers can be mapped from the radiology quality perspective. Best practices, informatics, and benchmarks can profoundly affect the outcome of the quality improvement initiative we all aim to achieve.

  12. Communication and psychological safety in veterans health administration work environments.

    PubMed

    Yanchus, Nancy J; Derickson, Ryan; Moore, Scott C; Bologna, Daniele; Osatuke, Katerine

    2014-01-01

    The purpose of this paper is to explore employee perceptions of communication in psychologically safe and unsafe clinical care environments. Clinical providers at the USA Veterans Health Administration were interviewed as part of planning organizational interventions. They discussed strengths, weaknesses, and desired changes in their workplaces. A subset of respondents also discussed workplace psychological safety (i.e. employee perceptions of being able to speak up or report errors without retaliation or ostracism--Edmondson, 1999). Two trained coders analysed the interview data using a grounded theory-based method. They excerpted passages that discussed job-related communication and summarized specific themes. Subsequent analyses compared frequencies of themes across workgroups defined as having psychologically safe vs unsafe climate based upon an independently administered employee survey. Perceptions of work-related communication differed across clinical provider groups with high vs low psychological safety. The differences in frequencies of communication-related themes across the compared groups matched the expected pattern of problem-laden communication characterizing psychologically unsafe workplaces. Previous research implied the existence of a connection between communication and psychological safety whereas this study offers substantive evidence of it. The paper summarized the differences in perceptions of communication in high vs low psychological safety environments drawing from qualitative data that reflected clinical providers' direct experience on the job. The paper also illustrated the conclusions with multiple specific examples. The findings are informative to health care providers seeking to improve communication within care delivery teams.

  13. Quality and strength of patient safety climate on medical-surgical units.

    PubMed

    Hughes, Linda C; Chang, Yunkyung; Mark, Barbara A

    2009-01-01

    Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units. Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate. Data came from a larger organizational study to investigate hospital and unit characteristics associated with organizational, nurse, and patient outcomes. The sample for this study was 3,689 RNs on 286 medical-surgical units in 146 hospitals. Nursing workgroup and managerial commitment to safety were the two most strongly positive attributes of the patient safety climate. However, issues surrounding the balance between job duties and safety compliance and nurses' reluctance to reveal errors continue to be problematic. Nurses in Magnet hospitals were more likely to communicate about errors and participate in error-related problem solving. Nurses on smaller units and units with lower work complexity reported greater safety compliance and were more likely to communicate about and reveal errors. Nurses on smaller units also reported greater commitment to patient safety and participation in error-related problem solving. Nursing workgroup commitment to safety is a valuable resource that can be leveraged to promote a sense of personal responsibility for and shared ownership of patient safety. Managers can capitalize on this commitment by promoting a work environment in which control over nursing practice and active participation in unit decisions are encouraged and by developing channels of communication that increase staff nurse involvement in identifying patient safety issues, prioritizing unit-level safety goals, and resolving day-to-day operational problems the have the potential to jeopardize patient safety.

  14. Produce safety and quality research at ERRC

    USDA-ARS?s Scientific Manuscript database

    There are many reports of disease due to consumption of fruits and vegetables that were contaminated on the surface with enteric pathogens. Therefore, the safety of fresh-cut melons and other produce available in salad-bar operations and supermarkets is a concern. Physical and chemical treatments ...

  15. Tank safety screening data quality objective. Revision 1

    SciTech Connect

    Hunt, J.W.

    1995-04-27

    The Tank Safety Screening Data Quality Objective (DQO) will be used to classify 149 single shell tanks and 28 double shell tanks containing high-level radioactive waste into safety categories for safety issues dealing with the presence of ferrocyanide, organics, flammable gases, and criticality. Decision rules used to classify a tank as ``safe`` or ``not safe`` are presented. Primary and secondary decision variables used for safety status classification are discussed. The number and type of samples required are presented. A tabular identification of each analyte to be measured to support the safety classification, the analytical method to be used, the type of sample, the decision threshold for each analyte that would, if violated, place the tank on the safety issue watch list, and the assumed (desired) analytical uncertainty are provided. This is a living document that should be evaluated for updates on a semiannual basis. Evaluation areas consist of: identification of tanks that have been added or deleted from the specific safety issue watch lists, changes in primary and secondary decision variables, changes in decision rules used for the safety status classification, and changes in analytical requirements. This document directly supports all safety issue specific DQOs and additional characterization DQO efforts associated with pretreatment and retrieval. Additionally, information obtained during implementation can assist in resolving assumptions for revised safety strategies, and in addition, obtaining information which will support the determination of error tolerances, confidence levels, and optimization schemes for later revised safety strategy documentation.

  16. Patient Safety and Quality Improvement Act of 2005.

    PubMed

    Fassett, William E

    2006-05-01

    To review Public Law (PL) 109-41-the Patient Safety and Quality Improvement Act of 2005 (PSQIA)-and summarize key medication error research that contributed to congressional recognition of the need for this legislation. Relevant publications related to medication error research, patient safety programs, and the legislative history of and commentary on PL 109-41, published in English, were identified by MEDLINE, PREMEDLINE, Thomas (Library of Congress), and Internet search engine-assisted searches using the terms healthcare quality, medication error, patient safety, PL 109-41, and quality improvement. Additional citations were identified from references cited in related publications. All relevant publications were reviewed. Summarization of the PSQIA was carried out by legal textual analysis. PL 109-41 provides privilege and confidentiality for patient safety work product (PSWP) developed for reporting to patient safety organizations (PSOs). It does not establish federal mandatory reporting of significant errors; rather, it relies on existing state reporting systems. The Act does not preempt stronger state protections for PSWP. The Agency for Healthcare Research and Quality is directed to certify PSOs and promote the establishment of a national network of patient safety databases. Whistleblower protection and penalties for unauthorized disclosure of PSWP are among its enforcement mechanisms. The Act protects clinicians who report minor errors to PSOs and protects the information from disclosure, but providers must increasingly embrace a culture of interdisciplinary concern for patient safety if this protection is to have real impact on patient care.

  17. Environment, safety and health progress assessment manual. Volume 2, Appendices

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES&H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ``more focused, concentrating on ES&H management, ES&H corrective actions, self-assessment programs, and root-cause related issues.`` In July 1991, the Secretary approved the initiation of ES&H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES&H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual.

  18. Quality, Safety, and Value: The Current AAOS Initiatives.

    PubMed

    Sanders, James O

    2015-01-01

    The AAOS is committed to helping orthopaedists provide safe, effective, and high-quality care for their patients. There are a number of very active initiatives focused on patient safety, team performance, and evidence-based quality and value including clinical practice guidelines and appropriate use criteria. This article describes those initiatives.

  19. Quality and safety of broiler meat in various chilling systems

    USDA-ARS?s Scientific Manuscript database

    Chilling is a critical step in poultry processing to attain high quality meat and to meet the USDA-FSIS temperature standards. This study was conducted to determine the effects of commercially available chilling systems on quality and safety of broiler meat. A total of 300 carcasses in two replica...

  20. Peer Review in Nursing: Essential Components of a Model Supporting Safety and Quality.

    PubMed

    George, Vicki; Haag-Heitman, Barb

    2015-01-01

    This article introduces an accountability-focused nursing framework to systematically organize and promote quality and safety nursing outcomes. The 4 essential components of this framework include a responsive environment; shared decision making, personal empowerment, and transformational management. These elements promote a professional practice environment that supports clinical nurses to practice at their highest level of autonomy and promotes accountability for patient outcomes. The often-misunderstood concept of peer review is foundational to 2 of the model components.

  1. Architectural approach for quality and safety aware healthcare social networks.

    PubMed

    López, Diego M; Blobel, Bernd; González, Carolina

    2012-01-01

    Quality of information and privacy and safety issues are frequently identified as main limitations to make most benefit from social media in healthcare. The objective of the paper is to contribute to the analysis of healthcare social networks (SN), and online healthcare social network services (SNS) by proposing a formal architectural analysis of healthcare SN and SNS, considering the complexity of both systems, but stressing on quality, safety and usability aspects. Quality policies are necessary to control the quality of content published by experts and consumers. Privacy and safety policies protect against inappropriate use of information and users responsibility for sharing information. After the policies are established and documented, a proof of concept online SNS supporting primary healthcare promotion is presented in the paper.

  2. Quality management, a directive approach to patient safety.

    PubMed

    Ayuso-Murillo, Diego; de Andrés-Gimeno, Begoña; Noriega-Matanza, Concha; López-Suárez, Rafael Jesús; Herrera-Peco, Ivan

    Nowadays the implementation of effective quality management systems and external evaluation in healthcare is a necessity to ensure not only transparency in activities related to health but also access to health and patient safety. The key to correctly implementing a quality management system is support from the managers of health facilities, since it is managers who design and communicate to health professionals the strategies of action involved in quality management systems. This article focuses on nursing managers' approach to quality management through the implementation of cycles of continuous improvement, participation of improvement groups, monitoring systems and external evaluation quality models (EFQM, ISO). The implementation of a quality management system will enable preventable adverse effects to be minimized or eliminated, and promote patient safety and safe practice by health professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. Environment quality at Maitri station in Antarctica.

    PubMed

    Tiwari, Anoop Kumar; Kulkarni, Sunil; Ramteke, D S; Nayak, G N

    2006-07-01

    A comprehensive study of air, water and soil quality was undertaken during the austral summer of 1999-2000 at the Indian Polar Research Station "Maitri" in compliance with the statutory requirements of the article 3 of Protocol on Environmental Protection to the Antarctic Treaty. The main objective of the study was to assess the impacts of various scientific programs and their associated logistic support facilities on the fragile ecosystem of Antarctica. Identification of major sources of pollution and quantification of pollutants in different environmental components were carried out through an extensive environmental monitoring program spread over a period of 5-7 weeks. Preliminary studies reveal that the levels of pollution are not alarming but there is scope for concern looking into the critical aspects of Antarctic environment and the carrying capacity of the environment surrounding Maitri station.

  4. The Quality and Safety Track: Training Future Physician Leaders.

    PubMed

    Vinci, Lisa M; Oyler, Julie; Arora, Vineet M

    2014-01-01

    Future physician leaders will need the knowledge and skills necessary to improve systems of care. To address this need, Pritzker School of Medicine implemented a 4-year scholarly track in quality and patient safety for medical students. The Quality and Safety Track (QST) includes an intensive elective that teaches basic quality-improvement skills, an individual mentored scholarly project, and engagement in the Institute for Healthcare Improvement Open School. The first-year elective incorporates a group project that allows students to apply basic process improvement skills. Institutional quality and safety leaders also present their work, giving students context for how these skills are used. To date, 23 students have completed the elective, and 11 chose to pursue QST throughout their medical school experience. Students who completed the elective reported improved confidence in using core quality improvement skills. QST is a feasible and innovative program to develop future health care leaders in quality and safety. © 2013 by the American College of Medical Quality.

  5. Food Labeling and Consumer Associations with Health, Safety, and Environment.

    PubMed

    Sax, Joanna K; Doran, Neal

    2016-12-01

    The food supply is complicated and consumers are increasingly calling for labeling on food to be more informative. In particular, consumers are asking for the labeling of food derived from genetically modified organisms (GMO) based on health, safety, and environmental concerns. At issue is whether the labels that are sought would accurately provide the information desired. The present study examined consumer (n = 181) perceptions of health, safety and the environment for foods labeled organic, natural, fat free or low fat, GMO, or non-GMO. Findings indicated that respondents consistently believed that foods labeled GMO are less healthy, safe and environmentally-friendly compared to all other labels (ps < .05). These results suggest that labels mean something to consumers, but that a disconnect may exist between the meaning associated with the label and the scientific consensus for GMO food. These findings may provide insight for the development of labels that provide information that consumers seek.

  6. The impact of different housing systems on egg safety and quality.

    PubMed

    Holt, P S; Davies, R H; Dewulf, J; Gast, R K; Huwe, J K; Jones, D R; Waltman, D; Willian, K R

    2011-01-01

    A move from conventional cages to either an enriched cage or a noncage system may affect the safety or quality, or both, of the eggs laid by hens raised in this new environment. The safety of the eggs may be altered either microbiologically through contamination of internal contents with Salmonella enterica serovar Enteritidis (Salmonella Enteritidis) or other pathogens, or both, or chemically due to contamination of internal contents with dioxins, pesticides, or heavy metals. Quality may be affected through changes in the integrity of the shell, yolk, or albumen along with changes in function, composition, or nutrition. Season, hen breed, flock age, and flock disease-vaccination status also interact to affect egg safety and quality and must be taken into account. An understanding of these different effects is prudent before any large-scale move to an alternative housing system is undertaken.

  7. The Role of Age-Friendly Environments on Quality of Life among Thai Older Adults

    PubMed Central

    Tiraphat, Sariyamon; Peltzer, Karl; Thamma-Aphiphol, Kriengsak; Suthisukon, Kawinarat

    2017-01-01

    Studies on the significance of age-friendly environments towards quality of life among older adults have been limited. This study aimed to examine the association between age-friendly environments and quality of life among Thai older adults. Cross-sectional interview survey data were collected from 4183 older adults (≥60 years) using multistage stratified systematic sampling from all four regions in Thailand. The outcome variable was the World Health Organization Quality of Life (WHOQOL-BREF) scale, while independent variables included sociodemographic factors, having a health problem, and neighbourhood age-friendly environment variables. In multivariable logistic regression, significant age-friendly environments predictors of quality of life included walkable neighbourhood, neighbourhood aesthetics, neighbourhood service accessibility, neighbourhood criminal safety, neighbourhood social trust, neighbourhood social support, and neighbourhood social cohesion. The present study confirms the important role of age-friendly neighbourhoods in terms of physical and social environments towards the quality of life of older adults. PMID:28282942

  8. [Assuring food safety and nutritional quality].

    PubMed

    E, Alonzo; V, Pontieri; V, Cannizzaro; R, La Carrubba; P, Pisana; M, Raiti; M, Fardella

    2014-01-01

    Nutrition needs increasingly integration between Food Safety and Nutritional Prevention, duties, in Italy, since I 998 the Food Hygiene and Nutrition services (SIAN) do. Furthermore, working in Evidence Based Prevention (EBP) is necessary to improve the prevention and make it more useful to people health, so it must be used tested efficacy methods, above all in a unsuitable economic and human sources contest. In order to improve the prevention and working in EBP, SIAN have devised and achieved some Nutritional Prevention Projects, interregional, regional and local wide net-working, by using process and efficacy indicators, in some projects also user's satisfaction indicators are used. Project's results will be used to work in EBP ever more in order to improve the prevention and make it repeatable and sustainable to prevent the gradual and constant increase of chronic-degenerative diseases an consequently health costs.

  9. Improving safety and quality: how can education help?

    PubMed

    Walton, Merrilyn M; Elliott, Susan L

    2006-05-15

    National efforts to improve the quality and safety of health care present challenges for medical education and training. Today's doctors need to be skilled communicators who know how to identify, prevent and manage adverse events and near misses, how to use evidence and information, how to work safely in a team, how to practise ethically, and how to be workplace teachers and learners. These competencies (knowledge, skills and attitudes) are set out in the National Patient Safety Education Framework (NPSF) of the Australian Council for Safety and Quality in Health Care. The NPSF is designed to help medical schools, vocational colleges, health organisations and private practitioners develop curricula to enable health professionals to work safely. The NPSF describes what doctors (depending on their level of knowledge and experience) can do to demonstrate competencies in a range of quality and safety activities. Medical schools, vocational colleges, health organisations and private practitioners need to work collaboratively with one another and with other health professionals to ensure that patient safety and quality curricula are implemented and evaluated, and that valid and reliable assessments of learning outcomes are developed. Interdisciplinary and vertically integrated education and training are needed, incorporating innovative methods, to create a safer health care system.

  10. Safety and mission assurance in a better, faster, cheaper environment

    NASA Astrophysics Data System (ADS)

    Gregory, Frederick D.

    1996-09-01

    To provide the American people with an exciting aeronautics and space program that provides more tangible value in products and services and more relevance to the public, NASA has developed a philosophy that emphasizes better, faster, and cheaper ways of conducting business. The integration of safety, reliability and quality assurance (SR&QA) products and services into all NASA's programs and projects, from beginning to end, and the implementation of progressive quality management and contracting practices are direct applications of this philosophy. NASA's new test effectiveness program integrates the oribital performance and reliability experience of prior spacecraft with new design processes and improved telemetry to achieve higher performance and reliability, faster, and at reduced cost. As United States government leaders for ISO 9000 implementation, NASA is promoting single quality systems for contractors, the use of advanced quality practices, and methods for the implementation of baseline quality systems with the appropriate oversight to further low cost, high performance programs in the future. To remain vital in today's era of fiscal constraint, NASA must be efficient, effective, and relevant. The innovative integration and application of SR&QA tools, techniques, and management approaches in all NASA's programs and projects will play an integral role in achieving this end.

  11. Case study: reconciling the quality and safety gap through strategic planning.

    PubMed

    Jeffs, Lianne; Merkley, Jane; Jeffrey, Jana; Ferris, Ella; Dusek, Janice; Hunter, Catherine

    2006-05-01

    An essential outcome of professional practice environments is the provision of high-quality, safe nursing care. To mitigate the quality and safety chasm, nursing leadership at St. Michael's Hospital undertook a strategic plan to enhance the nursing professional practice environment. This case study outlines the development of the strategic planning process: the driving forces (platform); key stakeholders (process and players); vision, guiding principles, strategic directions, framework for action and accountability (plan); lessons learned (pearls); and next steps to moving forward the vision, strategic directions and accountability mechanisms (passion and perseverance).

  12. Visualising differences in professionals' perspectives on quality and safety.

    PubMed

    Travaglia, Joanne Francis; Nugus, Peter Ivan; Greenfield, David; Westbrook, Johanna Irene; Braithwaite, Jeffrey

    2012-09-01

    The safety-and-quality movement is now two decades old. Errors persist despite best efforts, indicating that there are entrenched overt and perhaps less explicit barriers limiting the success of improvement efforts. OBJECTIVES AND HYPOTHESES: To examine the perspectives of five groups of healthcare workers (administrative staff, nurses, medical practitioners, allied health and managers) and to compare and contrast their descriptions of quality-and-safety activities within their organisation. Differences in perspectives can be an indicator of divergence in the conceptualisation of, and impetus for, quality-improvement strategies which are intended to engage healthcare professions and staff. Study data were collected in a defined geographical healthcare jurisdiction in Australia, via individual and group interviews held across four service streams (aged care and rehabilitation; mental health; community health; and cancer services). Data were collected in 2008 and analysed, using data-mining software, in 2009. Clear differences in the perspectives of professional groups were evident, suggesting variations in the perceptions of, and priorities for, quality and safety. The visual representation of quality and safety perspectives provides insights into the conceptual maps currently utilised by healthcare workers. Understanding the similarity and differences in these maps may enable more effective targeting of interprofessional improvement strategies.

  13. The AMA clinical quality improvement forum on addressing patient safety.

    PubMed

    Berman, S

    2000-07-01

    More than 200 health care policy makers and researchers, clinicians, quality professionals, and other representatives of health care organizations, government, and academia attended the Division of American Medical Association Clinical Quality Improvement's conference, "Addressing Patient Safety," April 28, 2000, in Chicago--the first national conference to respond to the recent Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System. ADDRESSING PATIENT SAFETY--PUBLIC AND PRIVATE PERSPECTIVES: John M. Eisenberg, MD, stated that research on errors is needed to describe the scope and nature of the problem, understand the barriers to and benefits of improvement, and develop and test strategies for improvement. Kenneth W. Kizer, MD, MPH, stated that the National Quality Forum will develop a compendium of best practices and will develop core measures for serious adverse events, and health care organizations and government health programs should act now to make a clear organizational commitment to patient safety, create a nonpunitive health care culture of safety, and implement known safe medication practices. Alan R. Nelson, MD, stated that the IOM report places its emphasis on continuous quality improvement and technology that can be used to mitigate the risks in a complex health system. Donald M. Nielsen, MD, discussed the American Hospital Association's (AHA's) Medication Safety Initiative, which promised to provide its members with successful practices, tools, and resources and to track progress of implementation of the recommended successful practices. Dennis S. O'Leary, MD, stated that when a hospital reports a sentinel event, the hospital is expected to implement improvements to reduce risk and monitor their effectiveness. The National Committee for Quality Assurance is considering changes to its accreditation standards to further address patient safety.

  14. Environment, safety and health progress assessment manual. Volume 1

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES&H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ``more focused, concentrating on ES&H management, ES&H corrective actions, self-assessment programs, and root-cause related issues.`` In July 1991, the Secretary approved the initiation of ES&H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES&H areas. This manual documents the processes to be used to perform the ES&H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy.

  15. Environment, Safety and Health Progress Assessment of the Hanford Site

    SciTech Connect

    Not Available

    1992-05-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES&H) Progress Assessment of the Hanford Site, in Richland, Washington. The assessment, which was conducted from May 11 through May 22, 1992, included a selective-review of the ES&H management systems and programs of the responsible DOE Headquarters Program Offices the DOE Richland Field Office, and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the Hanford Site ES&H Progress Assessment is to provide the Secretary with an independent assessment of the adequacy and effectiveness of the DOE and contractor management structures, resources, and systems to address ES&H problems and requirements. They are not intended to be comprehensive compliance assessments of ES&H activities. The point of reference for assessing programs at the Hanford Site was, for the most part, the Tiger Team Assessment of the Hanford Site, which was conducted from May 21 through July 18, 1990. A summary of issues and progress in the areas of environment, safety and health, and management is included.

  16. Work environment and safety climate in the Swedish merchant fleet.

    PubMed

    Forsell, Karl; Eriksson, Helena; Järvholm, Bengt; Lundh, Monica; Andersson, Eva; Nilsson, Ralph

    2017-02-01

    To get knowledge of the work environment for seafarers sailing under the Swedish flag, in terms of safety climate, ergonomical, chemical and psychosocial exposures, and the seafarers self-rated health and work ability. A Web-based questionnaire was sent to all seafarers with a personal e-mail address in the Swedish Maritime Registry (N = 5608). Comparisons were made mainly within the study population, using Student's t test, prevalence odds ratios and logistic regressions with 95% confidence intervals. The response rate was 35% (N = 1972; 10% women, 90% men), with 61% of the respondents working on deck, 31% in the engine room and 7% in the catering/service department (1% not classifiable). Strain on neck, arm or back and heavy lifting were associated with female gender (p = 0.0001) and younger age (below or above 30 years of age, p < 0.0001). Exposures to exhausts, oils and dust were commonly reported. Major work problems were noise, risk of an accident and vibrations from the hull of the ship. The safety climate was high in comparison with that in land-based occupations. One-fourth had experienced personal harassment or bullying during last year of service. Noise, risk of accidents, hand/arm and whole-body vibrations and psychosocial factors such as harassment were commonly reported work environment problems among seafarers within the Swedish merchant fleet.

  17. Quality and Safety Aspects of Cereals (Wheat) and Their Products.

    PubMed

    Varzakas, Theo

    2016-11-17

    Cereals and, most specifically, wheat are described in this chapter highlighting on their safety and quality aspects. Moreover, wheat quality aspects are adequately addressed since they are used to characterize dough properties and baking quality. Determination of dough properties is also mentioned and pasta quality is also described in this chapter. Chemometrics-multivariate analysis is one of the analyses carried out. Regarding production weighing/mixing of flours, kneading, extruded wheat flours, and sodium chloride are important processing steps/raw materials used in the manufacturing of pastry products. Staling of cereal-based products is also taken into account. Finally, safety aspects of cereal-based products are well documented with special emphasis on mycotoxins, acrylamide, and near infrared methodology.

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

    SciTech Connect

    Ford, E; Ezzell, G; Miller, B; Yorke, E

    2014-06-15

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

  19. Perinatal staff perceptions of safety and quality in their service.

    PubMed

    Sinni, Suzanne V; Wallace, Euan M; Cross, Wendy M

    2014-11-28

    Ensuring safe and appropriate service delivery is central to a high quality maternity service. With this in mind, over recent years much attention has been given to the development of evidence-based clinical guidelines, staff education and risk reporting systems. Less attention has been given to assessing staff perceptions of a service's safety and quality and what factors may influence that. In this study we set out to assess staff perceptions of safety and quality of a maternity service and to explore potential influences on service safety. The study was undertaken within a new low risk metropolitan maternity service in Victoria, Australia with a staffing profile comprising midwives (including students), neonatal nurses, specialist obstetricians, junior medical staff and clerical staff. In depth open-ended interviews using a semi-structured questionnaire were conducted with 23 staff involved in the delivery of perinatal care, including doctors, midwives, nurses, nursing and midwifery students, and clerical staff. Data were analyzed using naturalistic interpretive inquiry to identify emergent themes. Staff unanimously reported that there were robust systems and processes in place to maintain safety and quality. Three major themes were apparent: (1) clinical governance, (2) dominance of midwives, (3) inter-professional relationships. Overall, there was a strong sense that, at least in this midwifery-led service, midwives had the greatest opportunity to be an influence, both positively and negatively, on the safe delivery of perinatal care. The importance of understanding team dynamics, particularly mutual respect, trust and staff cohesion, were identified as key issues for potential future service improvement. Senior staff, particularly midwives and neonatal nurses, play central roles in shaping team behaviors and attitudes that may affect the safety and quality of service delivery. We suggest that strategies targeting senior staff to enhance their performance in

  20. Propofol sedation Quality and safety. Failure mode and effects analysis.

    PubMed

    Huergo Fernández, Adrián; Amor Martín, Pedro; Fernández Cadenas, Fernando

    2017-08-01

    Sedation is a key component of digestive endoscopy. While ensuring procedural safety and quality represents a primary goal, a detailed assessment of patient-focused risks and improvements is lacking on most occasions. Failure mode and effect analysis (FMEA) is a useful tool in this context as a means of raising barriers and defense mechanisms to prevent adverse events from developing.

  1. Raman chemical imaging technology for food safety and quality evaluation

    USDA-ARS?s Scientific Manuscript database

    Raman chemical imaging combines Raman spectroscopy and digital imaging to visualize composition and morphology of a target. This technique offers great potential for food safety and quality research. Most commercial Raman instruments perform measurement at microscopic level, and the spatial range ca...

  2. Raman chemical imaging system for food safety and quality inspection

    USDA-ARS?s Scientific Manuscript database

    Raman chemical imaging technique combines Raman spectroscopy and digital imaging to visualize composition and structure of a target, and it offers great potential for food safety and quality research. In this study, a laboratory-based Raman chemical imaging platform was designed and developed. The i...

  3. Quality improvement initiative to reduce serious safety events and improve patient safety culture.

    PubMed

    Muething, Stephen E; Goudie, Anthony; Schoettker, Pamela J; Donnelly, Lane F; Goodfriend, Martha A; Bracke, Tracey M; Brady, Patrick W; Wheeler, Derek S; Anderson, James M; Kotagal, Uma R

    2012-08-01

    Many thousands of patients die every year in the United States as a result of serious and largely preventable safety events or medical errors. Safety events are common in hospitalized children. We conducted a quality improvement initiative to implement cultural and system changes with the goal of reducing serious safety events (SSEs) by 80% within 4 years at our large, urban pediatric hospital. A multidisciplinary SSE reduction team reviewed the safety literature, examined recent SSEs, interviewed internal leaders, and visited other leading organizations. Senior hospital leaders provided oversight, monitored progress, and helped to overcome barriers. Interventions focused on: (1) error prevention; (2) restructuring patient safety governance; (3) a new root cause analysis process and a common cause database; (4) a highly visible lessons learned program; and (5) specific tactical interventions for high-risk areas. Our outcome measures were the rate of SSEs and the change in patient safety culture. SSEs per 10000 adjusted patient-days decreased from a mean of 0.9 at baseline to 0.3 (P < .0001). The days between SSEs increased from a mean of 19.4 at baseline to 55.2 (P < .0001). After a worsening of patient safety culture outcomes in the first year of intervention, significant improvements were observed between 2007 and 2009. Our multifaceted approach was associated with a significant and sustained reduction of SSEs and improvements in patient safety culture. Multisite studies are needed to better understand contextual factors and the significance of specific interventions.

  4. [Work environment and patient safety: data comparison between Seneca and RN4CAST projects].

    PubMed

    Escobar-Aguilar, Gema; Gómez-García, Teresa; Ignacio-García, Emilio; Rodríguez-Escobar, José; Moreno-Casbas, Teresa; Fuentelsaz-Gallego, Carmen; González-María, Esther; Contreras-Moreira, Mónica

    2013-01-01

    To analyze the relationship between the work environment and burnout of nurses and the quality of care for patient safety at the Spanish National Health System Hospitals included in SENECA and RN4CAST studies. Descriptive study with a secondary analysis that compares data of 984 patient records, 1469 patient, and 1886 professional surveys from SENECA project, with 2139 nurses' surveys from RN4CAST study, in 24 hospitals. Adverse events data related to care, and patient's and professional's perception of safety were compared with work environment (measured by the Nursing Work Index) and burnout (measured by Maslach Burnout Inventory). There was a statistically significant relation of pain with «Staffing and resource adequacy» (r=-0,435, p=0,03) and nosocomial infection with «Nursing foundations for quality of care» (r=-0,424; p=0,04) and «Nurse participation in hospital affairs» (r=-0,516, p=0,01) of the Nursing Work Index. The hospital classification obtained from the Nursing Work Index was associated with the patients' perception of safety (r=0,66, p<0,01). Professionals' perception of participation in patient safety issues was associated with the five factors of the Nursing Work Index (r ∈ [|0,41|-|0,78 |], p<0,046) and with Maslach emotional exhaustion (r=-0,518, p=0,01). The organizations that foster a supportive work environment will have patients that perceive safer care. In addition, proper resource management could decrease the occurrence of adverse events such as pain. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. Sampling the food processing environment: taking up the cudgel for preventive quality management in food processing environments.

    PubMed

    Wagner, Martin; Stessl, Beatrix

    2014-01-01

    The Listeria monitoring program for Austrian cheese factories was established in 1988. The basic idea is to control the introduction of L. monocytogenes into the food processing environment, preventing the pathogen from contaminating the food under processing. The Austrian Listeria monitoring program comprises four levels of investigation, dealing with routine monitoring of samples and consequences of finding a positive sample. Preventive quality control concepts attempt to detect a foodborne hazard along the food processing chain, prior to food delivery, retailing, and consumption. The implementation of a preventive food safety concept provokes a deepened insight by the manufacturers into problems concerning food safety. The development of preventive quality assurance strategies contributes to the national food safety status and protects public health.

  6. Factors affecting quality and safety of fresh-cut produce.

    PubMed

    Francis, G A; Gallone, A; Nychas, G J; Sofos, J N; Colelli, G; Amodio, M L; Spano, G

    2012-01-01

    The quality of fresh-cut fruit and vegetable products includes a combination of attributes, such as appearance, texture, and flavor, as well as nutritional and safety aspects that determine their value to the consumer. Nutritionally, fruit and vegetables represent a good source of vitamins, minerals, and dietary fiber, and fresh-cut produce satisfies consumer demand for freshly prepared, convenient, healthy food. However, fresh-cut produce deteriorates faster than corresponding intact produce, as a result of damage caused by minimal processing, which accelerates many physiological changes that lead to a reduction in produce quality and shelf-life. The symptoms of produce deterioration include discoloration, increased oxidative browning at cut surfaces, flaccidity as a result of loss of water, and decreased nutritional value. Damaged plant tissues also represent a better substrate for growth of microorganisms, including spoilage microorganisms and foodborne pathogens. The risk of pathogen contamination and growth is one of the main safety concerns associated with fresh-cut produce, as highlighted by the increasing number of produce-linked foodborne outbreaks in recent years. The pathogens of major concern in fresh-cut produce are Listeria monocytogenes, pathogenic Escherichia coli mainly O157:H7, and Salmonella spp. This article describes the quality of fresh-cut produce, factors affecting quality, and various techniques for evaluating quality. In addition, the microbiological safety of fresh-cut produce and factors affecting pathogen survival and growth on fresh-cut produce are discussed in detail.

  7. Environment, safety, and health considerations for a new accelerator facility

    SciTech Connect

    J. Donald Cossairt

    2001-04-23

    A study of siting considerations for possible future accelerators at Fermilab is underway. Each candidate presents important challenges in environment, safety, and health (ES&H) that are reviewed generically in this paper. Some of these considerations are similar to those that have been encountered and solved during the construction and operation of other accelerator facilities. Others have not been encountered previously on the same scale. The novel issues will require particular attention coincident with project design efforts to assure their timely cost-effective resolution. It is concluded that with adequate planning, the issues can be addressed in a manner that merits the support of the Laboratory, the US Department of Energy (DOE), and the public.

  8. The prioritization of environment, safety, and health activities

    SciTech Connect

    Otway, H.; Puckett, J.M.; von Winterfeldt, D.

    1991-09-01

    Federal facilities, including the national laboratories, must bring existing operations into compliance with environment, safety, and health (ES H) regulations while restoring sites of past operations to conform with today's more rigorous standards. The need for ES H resources is increasing while overall budgets are decreasing, and the resulting staffing and financial constraints often make it impossible to carry out all necessary activities simultaneously. This stimulated interest in formal methods to prioritize ES H activities. We describe the development of an approach called MAPP (Multi-Attribute Prioritization Process), which features expert judgment, user values, and intensive user participation in the system design process. We present results of its application to the prioritization of 41 ES H activities having a total cost of over $25 million. We conclude that the insights gained from user participation in the design process and the formal prioritization results are probably of comparable value. 19 refs., 3 figs., 9 tabs.

  9. The Italian Society for Safety and Quality in Transplantation (SISQT).

    PubMed

    Filipponi, F

    2010-01-01

    The Italian Society for Safety and Quality in Transplantation (La Societâ Italiana per Ia Sicurezza e la Qualità nei Trapianti, SISQT) was founded in 2008 to bring quality and safety issues at the center of donation and transplantation practice. In doing so, the SISQT seeks to involve, all health care professionals across the continuum of donation and transplantation, championing a collaborative, inclusive, inter-disciplinary, inter-professional, and multi-stakeholder approach, in order to ease translation of the results of research into clinical practice. The program of the SISQT aims to (1) set a patient safety agenda with all professionals and stakeholders; (2) design and implement patient-centered care processes and procedures; 3) help professionals harmonize and integrate operational practice with policy and regulatory mandates of the European union; (3) lay the scientific evidence on management of complex care across the continuum of donation and transplantation; (4) promote behaviors and cultural attributes in light of quality and safety. Accomplishment of these results requires cooperation of each care provider at all levels, from hospital to home to achieve integration of patient expectations within the scope of current transplant practice.

  10. Examining quality function deployment in safety promotion in Sweden.

    PubMed

    Kullberg, Agneta; Nordqvist, Cecilia; Lindqvist, Kent; Timpka, Toomas

    2014-09-01

    The first-hand needs and demands of laypersons are not always considered when safety promotion programmes are being developed. We compared focal areas for interventions identified from residents' statements of safety needs with focal areas for interventions identified by local government professionals in a Swedish urban community certified by the international Safe Community movement supported by the World Health Organization. Quantitative and qualitative data on self-expressed safety needs from 787 housing residents were transformed into an intervention design, using the quality function deployment (QFD) technique and compared with the safety intervention programme developed by professionals at the municipality administrative office. The outcome of the comparison was investigated with regard to implications for the Safe Community movement. The QFD analysis identified the initiation and maintenance of social integrative processes in housing areas as the most highly prioritized interventions among the residents, but failed to highlight the safety needs of several vulnerable groups (the elderly, infants and persons with disabilities). The intervention programme designed by the public health professionals did not address the social integrative processes, but it did highlight the vulnerable groups. This study indicates that the QFD technique is suitable for providing residential safety promotion efforts with a quality orientation from the layperson's perspective. Views of public health professionals have to be included to ascertain that the needs of socially deprived residents are adequately taken into account. QFD can augment the methodological toolbox for safety promotion programmes, including interventions in residential areas. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Implementation Science: A Neglected Opportunity to Accelerate Improvements in the Safety and Quality of Surgical Care.

    PubMed

    Hull, Louise; Athanasiou, Thanos; Russ, Stephanie

    2017-06-01

    The aim of this review was to emphasize the importance of implementation science in understanding why efforts to integrate evidence-based interventions into surgical practice frequently fail to replicate the improvements reported in early research studies. Over the past 2 decades, numerous patient safety initiatives have been developed to improve the quality and safety of surgical care. The surgical community is now faced with translating "promising" initiatives from the research environment into clinical practice-the World Health Organization (WHO) has described this task as one of the greatest challenges facing the global health community and has identified the importance of implementation science in scaling up evidence-based interventions. Using the WHO surgical safety checklist, a prominent example of a rapidly and widely implemented surgical safety intervention of the past decade, a review of literature, spanning surgery, and implementation science, was conducted to identify and describe a broad range of factors affecting implementation success, including contextual factors, implementation strategies, and implementation outcomes. Our current approach to conceptualizing and measuring the "effectiveness" of interventions has resulted in factors critical to implementing surgical safety interventions successfully being neglected. Improvements in the safety and quality of surgical care can be accelerated by drawing more heavily upon implementation science and that until this rapidly evolving field becomes more firmly embedded into surgical research and implementation efforts, our understanding of why interventions such as the checklist "work" in some settings and appear "not to work" in other settings will be limited.

  12. EH&S annual report: Summary of activities Environment, Health and Safety Division, 1992

    SciTech Connect

    Not Available

    1994-03-01

    This report presents an overview of the environment, safety, and health program in operation at the Lawrence Berkeley Laboratory. description of research in environmental science, remediation, waste management, safety, health services, radiation assessment, and emergency plans are provided.

  13. Safety and performance of TCI pumps in a magnetic resonance imaging environment.

    PubMed

    Adapa, R M; Axell, R G; Mangat, J S; Carpenter, T A; Absalom, A R

    2012-01-01

    Target controlled infusion (TCI) devices can be associated with significant safety concerns when used during magnetic resonance imaging (MRI). We tested the safety and compatibility of newer TCI systems in a 3-Tesla MRI environment. Two Asena PK and two Agilia TCI pumps were used to administer TCI propofol (at target blood concentrations of 0.5 and 6.0 μg.ml⁻¹) using the Marsh model under magnetic fields of up to 50 G with a T2-weighted sequence. We assessed the devices for projectile risk, accuracy of drug delivery, alarm function and effects on MR image quality. Both devices did not demonstrate any significant deflection at the tested field strengths, and performed within acceptable limits (cumulative error in total delivered volume < 3%; maximum 10-min interval error < 10%). The Asena pump caused minor artefacts on MR images. The TCI pumps tested perform well and safely implement pharmacokinetic software in a high magnetic field.

  14. Surgical robotics for patient safety in the perioperative environment: realizing the promise.

    PubMed

    Fuji Lai; Louw, Deon

    2007-06-01

    Surgery is at a crossroads of complexity. However, there is a potential path toward patient safety. One such course is to leverage computer and robotic assist techniques in the reduction and interception of error in the perioperative environment. This white paper attempts to facilitate the road toward realizing that promise by outlining a research agenda. The paper will briefly review the current status of surgical robotics and summarize any conclusions that can be reached to date based on existing research. It will then lay out a roadmap for future research to determine how surgical robots should be optimally designed and integrated into the perioperative workflow and process. Successful movement down this path would involve focused efforts and multiagency collaboration to address the research priorities outlined, thereby realizing the full potential of surgical robotics to augment human capabilities, enhance task performance, extend the reach of surgical care, improve health care quality, and ultimately enhance patient safety.

  15. Leveraging Trainees to Improve Quality and Safety at the Point of Care: Three Models for Engagement.

    PubMed

    Johnson Faherty, Laura; Mate, Kedar S; Moses, James M

    2016-04-01

    Trainees, as frontline providers who are acutely aware of quality improvement (QI) opportunities and patient safety (PS) issues, are key partners in achieving institutional quality and safety goals. However, as academic medical centers accelerate their initiatives to prioritize QI and PS, trainees have not always been engaged in these efforts. This article describes the development of an organizing framework with three suggested models of varying scopes and time horizons to effectively involve trainees in the quality and safety work of their training institutions. The proposed models, which were developed through a literature review, expert interviews with key stakeholders, and iterative testing, are (1) short-term, team-based, rapid-cycle initiatives; (2) medium-term, unit-based initiatives; and (3) long-term, health-system-wide initiatives. For each, the authors describe the objective, scope, duration, role of faculty leaders, steps for implementation in the clinical setting, pros and cons, and examples in the clinical setting. There are many barriers to designing the ideal training environments that fully engage trainees in QI/PS efforts, including lack of protected time for faculty mentors, time restrictions due to rotation-based training, and structural challenges. However, one of the most promising strategies for overcoming these barriers is integrating QI/PS principles into routine clinical care. These models provide opportunities for trainees to successfully learn and apply quality and safety principles to routine clinical care at the team, unit, and system level.

  16. Taking ownership of safety. What are the active ingredients of safety coaching and how do they impact safety outcomes in critical offshore working environments?

    PubMed

    Krauesslar, Victoria; Avery, Rachel E; Passmore, Jonathan

    2015-01-01

    Safety coaching interventions have become a common feature in the safety critical offshore working environments of the North Sea. Whilst the beneficial impact of coaching as an organizational tool has been evidenced, there remains a question specifically over the use of safety coaching and its impact on behavioural change and producing safe working practices. A series of 24 semi-structured interviews were conducted with three groups of experts in the offshore industry: safety coaches, offshore managers and HSE directors. Using a thematic analysis approach, several significant themes were identified across the three expert groups including connecting with and creating safety ownership in the individual, personal significance and humanisation, ingraining safety and assessing and measuring a safety coach's competence. Results suggest clear utility of safety coaching when applied by safety coaches with appropriate coach training and understanding of safety issues in an offshore environment. The current work has found that the use of safety coaching in the safety critical offshore oil and gas industry is a powerful tool in managing and promoting a culture of safety and care.

  17. Active and Intelligent Packaging: The Indication of Quality and Safety.

    PubMed

    Janjarasskul, Theeranun; Suppakul, Panuwat

    2016-09-19

    The food industry has been under growing pressure to feed an exponentially increasing world population and challenged to meet rigorous food safety law and regulation. The plethora of media consumption has provoked consumer demand for safe, sustainable, organic, and wholesome products with "clean" labels. The application of active and intelligent packaging has been commercially adopted by food and pharmaceutical industries as a solution for the future for extending shelf life and simplifying production processes; facilitating complex distribution logistics; reducing, if not eliminating the need for preservatives in food formulations; enabling restricted food packaging applications; providing convenience, improving quality, variety and marketing features; as well as providing essential information to ensure consumer safety. This chapter reviews innovations of active and intelligent packaging which advance packaging technology through both scavenging and releasing systems for shelf life extension, and through diagnostic and identification systems for communicating quality, tracking and brand protection.

  18. "Keeping each patient safe": quality safety teaching/learning packets.

    PubMed

    Benezo, Chris; Gaudy, Doris; White, T Michael

    2004-12-01

    University of Pittsburgh Medical Center (UPMC) McKeesport developed a tool, the UPMC McKeesport Quality Safety Teaching/Learning Packet, to provide physicians, nurses, and therapists with a common language to address complex safety issues. Teaching/learning packets were developed to "keep each patient safe": by calling for help early; from falls and confusion; and from hospital-acquired infections (http://McKeesport.upmc.com/KeepingPatientsSafe.htm). In July 2002, the concept of calling for help early became a requirement at UPMC McKeesport. The code team was to be called for any significant change in status and for traditional code arrests. In 2004, a teaching/learning packet addressed the concepts of fall risk and acute (delirium) and chronic (dementia) confusion. Strategies were implemented to reduce the rate of falls through risk screening and interventions for falls and delirium. In April 2004, a teaching/learning packet was introduced to reduce hospital-acquired infections, and professionals were positioned to better address isolation, hand hygiene, central-line-associated bacteremia, Clostridium difficile, and appropriate antibiotic usage. Three quality safety teaching/learning packets, which provided the professionals in the organization with the common language (culture) to advance patient safety, accomplished rapid change and were well accepted by staff and physicians.

  19. Building a Culture of Safety: Camp Safety Director Ensures Safe Environment.

    ERIC Educational Resources Information Center

    Friedman, Norman

    2001-01-01

    Having a designated safety expert at camp creates a culture of safety. The Gene Ezersky Camp Safety College, which certifies safety directors, has identified seven areas of camp that should be the focus of the safety director: kitchen and food services, health and sanitation, emergency preparation and management, leadership training, facility…

  20. The CCLM contribution to improvements in quality and patient safety.

    PubMed

    Plebani, Mario

    2013-01-01

    Clinical laboratories play an important role in improving patient care. The past decades have seen unbelievable, often unpredictable improvements in analytical performance. Although the seminal concept of the brain-to-brain laboratory loop has been described more than four decades ago, there is now a growing awareness about the importance of extra-analytical aspects in laboratory quality. According to this concept, all phases and activities of the testing cycle should be assessed, monitored and improved in order to decrease the total error rates thereby improving patients' safety. Clinical Chemistry and Laboratory Medicine (CCLM) not only has followed the shift in perception of quality in the discipline, but has been the catalyst for promoting a large debate on this topic, underlining the value of papers dealing with errors in clinical laboratories and possible remedies, as well as new approaches to the definition of quality in pre-, intra-, and post-analytical steps. The celebration of the 50th anniversary of the CCLM journal offers the opportunity to recall and mention some milestones in the approach to quality and patient safety and to inform our readers, as well as laboratory professionals, clinicians and all the stakeholders of the willingness of the journal to maintain quality issues as central to its interest even in the future.

  1. Quality Improvement Initiative to Reduce Serious Safety Events and Improve Patient Safety Culture

    PubMed Central

    Goudie, Anthony; Schoettker, Pamela J.; Donnelly, Lane F.; Goodfriend, Martha A.; Bracke, Tracey M.; Brady, Patrick W.; Wheeler, Derek S.; Kotagal, Uma R.

    2012-01-01

    BACKGROUND AND OBJECTIVE: Many thousands of patients die every year in the United States as a result of serious and largely preventable safety events or medical errors. Safety events are common in hospitalized children. We conducted a quality improvement initiative to implement cultural and system changes with the goal of reducing serious safety events (SSEs) by 80% within 4 years at our large, urban pediatric hospital. METHODS: A multidisciplinary SSE reduction team reviewed the safety literature, examined recent SSEs, interviewed internal leaders, and visited other leading organizations. Senior hospital leaders provided oversight, monitored progress, and helped to overcome barriers. Interventions focused on: (1) error prevention; (2) restructuring patient safety governance; (3) a new root cause analysis process and a common cause database; (4) a highly visible lessons learned program; and (5) specific tactical interventions for high-risk areas. Our outcome measures were the rate of SSEs and the change in patient safety culture. RESULTS: SSEs per 10 000 adjusted patient-days decreased from a mean of 0.9 at baseline to 0.3 (P < .0001). The days between SSEs increased from a mean of 19.4 at baseline to 55.2 (P < .0001). After a worsening of patient safety culture outcomes in the first year of intervention, significant improvements were observed between 2007 and 2009. CONCLUSIONS: Our multifaceted approach was associated with a significant and sustained reduction of SSEs and improvements in patient safety culture. Multisite studies are needed to better understand contextual factors and the significance of specific interventions. PMID:22802607

  2. Safety in urban environment and emergency notice boards

    SciTech Connect

    Confortini, Claudia; Tira, Maurizio

    2008-07-08

    Reliable and safe urban system conditions have to be a crucial goal of ordinary planning activities. Among planning goals, priority must be given to indications relating to the safety levels to be achieved and to the amount of resources to be directed towards reducing the vulnerability of urban systems and therefore of the measures to be taken. Uban vulnerability cannot in fact be reduced to the sum of the vulnerability of single buildings or to the physical vulnerability of its various components. This research work consists of identifying those urban sub-areas that are important for safety in relation to natural risks, ambits that should be highlighted by means of permanent emergency notice boards/billboards. What are the hazard notices relating to all natural hazards and related risks? Where are they located? Are they clear and straightforward so that all residents and visitors are able to understand them, as it is already the case for road signs (or at least it should be)? What urban sub-areas are worth highlighting in relation to natural risks, acting for example as escape routes or meeting points? How is information for the public managed in order that people are immediately, easily and regularly notified? What is the relation of such signals to ordinary traffic signals? Research into the state of the art of permanent notice boards/billboards of this type, currently distinguished only by sporadic and local initiatives, aims at carrying out a census of and recognizing urban elements already considered as important for reducing the vulnerability of the urban system to different natural calamities and at providing new highlights as regards the identification of new ones. The next step is to work out a decision and common-language strategy for planning these elements and for their adequate signposting, so as to be able to live in the urban environment with awareness, safety and confidence, including with respect to more remote and therefore often neglected

  3. Safety in Urban Environment and Emergency Notice Boards

    NASA Astrophysics Data System (ADS)

    Confortini, Claudia; Tira, Maurizio

    2008-07-01

    Reliable and safe urban system conditions have to be a crucial goal of ordinary planning activities. Among planning goals, priority must be given to indications relating to the safety levels to be achieved and to the amount of resources to be directed towards reducing the vulnerability of urban systems and therefore of the measures to be taken. Uban vulnerability cannot in fact be reduced to the sum of the vulnerability of single buildings or to the physical vulnerability of its various components. This research work consists of identifying those urban sub-areas that are important for safety in relation to natural risks, ambits that should be highlighted by means of permanent emergency notice boards/billboards. What are the hazard notices relating to all natural hazards and related risks? Where are they located? Are they clear and straightforward so that all residents and visitors are able to understand them, as it is already the case for road signs (or at least it should be)? What urban sub-areas are worth highlighting in relation to natural risks, acting for example as escape routes or meeting points? How is information for the public managed in order that people are immediately, easily and regularly notified? What is the relation of such signals to ordinary traffic signals? Research into the state of the art of permanent notice boards/billboards of this type, currently distinguished only by sporadic and local initiatives, aims at carrying out a census of and recognizing urban elements already considered as important for reducing the vulnerability of the urban system to different natural calamities and at providing new highlights as regards the identification of new ones. The next step is to work out a decision and common-language strategy for planning these elements and for their adequate signposting, so as to be able to live in the urban environment with awareness, safety and confidence, including with respect to more remote and therefore often neglected

  4. Environment, Safety and Health progress assessment of the Idaho National Engineering Laboratory (INEL)

    SciTech Connect

    Not Available

    1993-08-01

    The ES&H Progress Assessments are part of the Department`s continuous improvement process throughout DOE and its contractor organizations. The purpose of the INEL ES&H Progress Assessment is to provide the Department with concise independent information on the following: (1) change in culture and attitude related to ES&H activities; (2) progress and effectiveness of the ES&H corrective actions resulting from previous Tiger Team Assessments; (3) adequacy and effectiveness of the ES&H self-assessment programs of the DOE line organizations and the site management and operating contractor; and (4) effectiveness of DOE and contractor management structures, resources, and systems to effectively address ES&H problems. It is not intended that this Progress Assessment be a comprehensive compliance assessments of ES&H activities. The points of reference for assessing programs at the INEL were, for the most part, the 1991 INEL Tiger Team Assessment, the INEL Corrective Action Plan, and recent appraisals and self-assessments of INEL. Horizontal and vertical reviews of the following programmatic areas were conducted: Management: Corrective action program; self-assessment; oversight; directives, policies, and procedures; human resources management; and planning, budgeting, and resource allocation. Environment: Air quality management, surface water management, groundwater protection, and environmental radiation. Safety and Health: Construction safety, worker safety and OSHA, maintenance, packaging and transportation, site/facility safety review, and industrial hygiene.

  5. The safety climate and its relationship to safety practices, safety of the work environment and occupational accidents in eight wood-processing companies.

    PubMed

    Varonen, U; Mattila, M

    2000-11-01

    Employees continuously observe their work environment and the actions of their fellow workers and superiors, and they use such observations as a basis for the creation of cognitive models associated with safety. These models regulate their actions in the workplace and thus have an influence on safety. This study attempts to define the structure of the safety climate as perceived by workers and the correlations between the safety climate, on the one hand, and the safety practices of the company, the safety level of the work environment and occupational accidents on the other. The variables used in this study were the same as those employed in two previous Finnish safety climate studies carried out in the plywood industry, shipyards, the forestry industry, building construction and stevedoring. The safety climate was measured by means of a questionnaire. Workers from four sawmills, two plywood factories and two parquet plants participated. The total number of participants was 508 in 1990 and 548 in 1993. The variables formed four factors, whose contents and reliabilities closely resembled the results obtained in the earlier studies. These results indicate that the structure of the safety climate among Finnish workers is quite stable. The safety climate correlated both with the safety level of the work environment and with the safety practices of the company, but the correlation between the safety climate and the safety of the work environment was stronger. This result differs from those of the previous studies, in which the safety climate was defined specifically in terms of an individual's perceptions of the safety practices of the company and of the behavior of other employees. The two safety climate factors that described a company's attitudes to safety and its safety precautions correlated with the accident rates. The better the safety climate of the company was, the lower was the accident rate. Four companies with an accident rate below the average for the wood

  6. Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions

    PubMed Central

    Jarrar, Mu’taman; Rahman, Hamzah Abdul; Don, Mohammad Sobri

    2016-01-01

    Background and Objective: Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Design: Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. Results: The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme “1 Care for 1 Malaysia” in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. Conclusions: There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia. PMID:26755459

  7. Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions.

    PubMed

    Jarrar, Mu'taman; Abdul Rahman, Hamzah; Don, Mohammad Sobri

    2015-10-20

    Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme "1 Care for 1 Malaysia" in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.

  8. 77 FR 42738 - Patient Safety Organizations: Voluntary Relinquishment From the Coalition for Quality and Patient...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From the Coalition for Quality and Patient Safety of Chicagoland (CQPS PSO) AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Delisting. SUMMARY: The Patient Safety and...

  9. 24 CFR 1005.111 - What safety and quality standards apply?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What safety and quality standards... URBAN DEVELOPMENT LOAN GUARANTEES FOR INDIAN HOUSING § 1005.111 What safety and quality standards apply? (a) Loans guaranteed under section 184 must be for dwelling units which meet the safety and quality...

  10. NAVIGATING A QUALITY ROUTE TO A NATIONAL SAFETY AWARD

    SciTech Connect

    PREVETTE SS

    2009-05-26

    Deming quality methodologies applied to safety are recognized with the National Safety Council's annual Robert W. Campbell Award. Over the last ten years, the implementation of Statistical Process Control and quality methodologies at the U.S. Department of Energy's Hanford Site have contributed to improved safety. Improvements attributed to Statistical Process Control are evidenced in Occupational Safety and Health records and documented through several articles in Quality Progress and the American Society of Safety Engineers publication, Professional Safety. Statistical trending of safety, quality, and occurrence data continues to playa key role in improving safety and quality at what has been called the world's largest environmental cleanup project. DOE's Hanford Site played a pivotal role in the nation's defense beginning in the 1940s, when it was established as part of the Manhattan Project. After more than 50 years of producing material for nuclear weapons, Hanford, which covers 586 square miles in southeastern Washington state, is now focused on three outcomes: (1) Restoring the Columbia River corridor for multiple uses; (2) Transitioning the central plateau to support long-term waste management; and (3) Putting DOE assets to work for the future. The current environmental cleanup mission faces challenges of overlapping technical, political, regulatory, environmental, and cultural interests. From Oct. 1, 1996 through Sept. 30, 2008, Fluor Hanford was a prime contractor to the Department of Energy's Richland Operations Office. In this role, Fluor Hanford managed several major cleanup activities that included dismantling former nuclear-processing facilities, cleaning up the Site's contaminated groundwater, retrieving and processing transuranic waste for shipment and disposal off-site, maintaining the Site's infrastructure, providing security and fire protection, and operating the Volpentest HAMMER Training and Education Center. On October 1,2008, a transition

  11. Occupational Safety and Related Impacts on Health and the Environment

    PubMed Central

    Watterson, Andrew

    2016-01-01

    The inter-relationship between safety, health and the ‘environment’ is a complex and at times a relatively neglected topic. In this issue, ‘safety’ is often viewed by contributors as ‘health and safety’ and includes occupationally-related ill health as well as injury or harm to employees and the wider public. ‘Environment’ is also interpreted in the widest sense covering both physical and work environments with upstream work hazards presenting risks to downstream communities. The focus is very much on exploring and where possible addressing the challenges, some old and some facing workers in a range of public and private settings and also at times their nearby communities. The 19 papers in the issue cover public and private sectors, global and very local populations, macro-theoretical perspectives, large epidemiological and some single factory or hospital site small case studies. A number of the papers are just beginning to explore and draw out for the first time the risks from hazards in their part of the world. The methodologies adopted also range from lab-based studies through ergonomic assessments and interventions to therapeutic approaches. PMID:27782047

  12. Microbiological quality and safety assessment of lettuce production in Brazil.

    PubMed

    Ceuppens, Siele; Hessel, Claudia Titze; de Quadros Rodrigues, Rochele; Bartz, Sabrina; Tondo, Eduardo César; Uyttendaele, Mieke

    2014-07-02

    The microbiological quality and safety of lettuce during primary production in Brazil were determined by enumeration of hygiene indicators Escherichia coli, coliforms and enterococci and detection of enteric pathogens Salmonella and E. coli O157:H7 in organic fertilizers, soil, irrigation water, lettuce crops, harvest boxes and worker's hands taken from six different lettuce farms throughout the crop growth cycle. Generic E. coli was a suitable indicator for the presence of Salmonella and E. coli O157:H7, while coliforms and enterococci were not. Few pathogens were detected: 5 salmonellae and 2 E. coli O157:H7 from 260 samples, of which only one was lettuce and the others were manure, soil and water. Most (5/7) pathogens were isolated from the same farm and all were from organic production. Statistical analysis revealed the following environmental and agro-technical risk factors for increased microbial load and pathogen prevalence in lettuce production: high temperature, flooding of lettuce fields, application of contaminated organic fertilizer, irrigation with water of inferior quality and large distances between the field and toilets. Control of the composting process of organic fertilizers and the irrigation water quality appear most crucial to improve and/or maintain the microbiological quality and safety during the primary production of lettuce. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Enhancement of drilling safety and quality using online sensors and artificial neural networks.

    PubMed

    Liu, Tien-I; Kumagai, Akihiko; Lee, Chongchan

    2003-01-01

    Cutting force sensors and neural networks have been used for the occupational safety of the drilling process. The drill conditions have been online classified into 3 categories: safe, caution, and danger. This approach can change the drill just before its failure. The inputs to neural networks include drill size, feed rate, spindle speed, and features that were extracted from drilling force measurements. The outputs indicate the safety states. This detection system can reach a success rate of over 95%. Furthermore, the one misclassification during online tests was a one-step ahead pre-alarm that is acceptable from the safety and quality viewpoint. The developed online detection system is very robust and can be used in very complex manufacturing environments.

  14. A sustainable city environment through child safety and mobility-a challenge based on ITS?

    PubMed

    Leden, Lars; Gårder, Per; Schirokoff, Anna; Monterde-i-Bort, Hector; Johansson, Charlotta; Basbas, Socrates

    2014-01-01

    Our cities should be designed to accommodate everybody, including children. We will not move toward a more sustainable society unless we accept that children are people with transportation needs, and 'bussing' them around, or providing parental limousine services at all times, will not lead to sustainability. Rather, we will need to make our cities walkable for children, at least those above a certain age. Safety has two main aspects, traffic safety and personal safety (risk of assault). Besides being safe, children will also need an urban environment with reasonable mobility, where they themselves can reach destinations with reasonable effort; else they will still need to be driven. This paper presents the results of two expert questionnaires focusing on the potential safety and mobility benefits to child pedestrians of targeted types of intelligent transportation systems (ITS). Five different types of functional requests for children were identified based on previous work. The first expert questionnaire was structured to collect expert opinions on which ITS solutions or devices would be, and why, the most relevant ones to satisfy the five different functional requests of child pedestrians. Based on the first questionnaire, fifteen problem areas were defined. In the second questionnaire, the experts ranked the fifteen areas, and prioritized related ITS services, according to their potential for developing ITS services beneficial to children. Several ITS systems for improving pedestrian quality are discussed. ITS services can be used when a pedestrian route takes them to a dangerous street, dangerous crossing point or through a dangerous neighborhood. An improvement of safety and other qualities would lead to increased mobility and a more sustainable way of living. Children would learn how to live to support their own health and a sustainable city environment. But it will be up to national, regional and local governments, through their ministries and agencies and

  15. Beyond metrics? Utilizing 'soft intelligence' for healthcare quality and safety.

    PubMed

    Martin, Graham P; McKee, Lorna; Dixon-Woods, Mary

    2015-10-01

    Formal metrics for monitoring the quality and safety of healthcare have a valuable role, but may not, by themselves, yield full insight into the range of fallibilities in organizations. 'Soft intelligence' is usefully understood as the processes and behaviours associated with seeking and interpreting soft data-of the kind that evade easy capture, straightforward classification and simple quantification-to produce forms of knowledge that can provide the basis for intervention. With the aim of examining current and potential practice in relation to soft intelligence, we conducted and analysed 107 in-depth qualitative interviews with senior leaders, including managers and clinicians, involved in healthcare quality and safety in the English National Health Service. We found that participants were in little doubt about the value of softer forms of data, especially for their role in revealing troubling issues that might be obscured by conventional metrics. Their struggles lay in how to access softer data and turn them into a useful form of knowing. Some of the dominant approaches they used risked replicating the limitations of hard, quantitative data. They relied on processes of aggregation and triangulation that prioritised reliability, or on instrumental use of soft data to animate the metrics. The unpredictable, untameable, spontaneous quality of soft data could be lost in efforts to systematize their collection and interpretation to render them more tractable. A more challenging but potentially rewarding approach involved processes and behaviours aimed at disrupting taken-for-granted assumptions about quality, safety, and organizational performance. This approach, which explicitly values the seeking out and the hearing of multiple voices, is consistent with conceptual frameworks of organizational sensemaking and dialogical understandings of knowledge. Using soft intelligence this way can be challenging and discomfiting, but may offer a critical defence against the

  16. Proteomics in food: Quality, safety, microbes, and allergens.

    PubMed

    Piras, Cristian; Roncada, Paola; Rodrigues, Pedro M; Bonizzi, Luigi; Soggiu, Alessio

    2016-03-01

    Food safety and quality and their associated risks pose a major concern worldwide regarding not only the relative economical losses but also the potential danger to consumer's health. Customer's confidence in the integrity of the food supply could be hampered by inappropriate food safety measures. A lack of measures and reliable assays to evaluate and maintain a good control of food characteristics may affect the food industry economy and shatter consumer confidence. It is imperative to create and to establish fast and reliable analytical methods that allow a good and rapid analysis of food products during the whole food chain. Proteomics can represent a powerful tool to address this issue, due to its proven excellent quantitative and qualitative drawbacks in protein analysis. This review illustrates the applications of proteomics in the past few years in food science focusing on food of animal origin with some brief hints on other types. Aim of this review is to highlight the importance of this science as a valuable tool to assess food quality and safety. Emphasis is also posed in food processing, allergies, and possible contaminants like bacteria, fungi, and other pathogens.

  17. Nanotechnology to the rescue: using nano-enabled approaches in microbiological food safety and quality.

    PubMed

    Eleftheriadou, Mary; Pyrgiotakis, Georgios; Demokritou, Philip

    2017-04-01

    Food safety and quality assurance is entering a new era. Interventions along the food supply chain must become more efficient in safeguarding public health and the environment and must address numerous challenges and new consumption trends. Current methods of microbial control to assure the safety of food and minimize microbial spoilage have each shown inefficiencies. Nanotechnology is a rapidly expanding area in the agri/feed/food sector. Nano-enabled approaches such as antimicrobial food-contact surfaces/packaging, nano-enabled sensors for rapid pathogen/contaminant detection and nano-delivered biocidal methods, currently on the market or at a developmental stage, show great potential for the food industry. Concerns on potential risks to human health and the environment posed by use of engineered nanomaterials (ENMs) in food applications must, however, be adequately evaluated at the developmental stage to ensure consumer's acceptance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Students' Perceptions of School Safety: Effects by Community, School Environment, and Substance Use Variables

    ERIC Educational Resources Information Center

    Kitsantas, Anastasia; Ware, Herbert W.; Martinez-Arias, Rosario

    2004-01-01

    An important element of the context in which children are educated is the safety in their schools. The purpose of the present study was to examine the relationships among student perceptions of community safety, school environment, substance use, and school safety with a total of 3,092 sixth, seventh, and eighth graders. Data were used from the…

  19. Classroom Air Quality: Exploring the Indoor Environment.

    ERIC Educational Resources Information Center

    Borst, Richard

    1997-01-01

    Describes a teacher's experiences with Global Lab, which is depicted as a real-world networked science laboratory connecting individuals investigating global and local environmental change. Focuses on techniques to monitor indoor air quality. (DDR)

  20. Quality and Safety in Orthopaedics: Learning and Teaching at the Same Time: AOA Critical Issues.

    PubMed

    Black, Kevin P; Armstrong, April D; Hutzler, Lorraine; Egol, Kenneth A

    2015-11-04

    Increasing attention has been placed on providing higher quality and safer patient care. This requires the development of a new set of competencies to better understand and navigate the system and lead the orthopaedic team. While still trying to learn and develop these competencies, the academic orthopaedist is also expected to model and teach them.The orthopaedic surgeon must understand what is being measured and why, both for purposes of providing better care and to eliminate unnecessary expense in the system. Metrics currently include hospital-acquired conditions, "never events," and thirty-day readmission rates. More will undoubtedly follow.Although commitment and excellence at the individual level are essential, the orthopaedist must think at the systems level to provide the highest value of care. A work culture characterized by respect and trust is essential to improved communication, teamwork, and confidential peer review. An increasing number of resources, both in print and electronic format, are available for us to understand what we can do now to improve quality and safety.Resident education in quality and safety is a fundamental component of the systems-based practice competency, the Next Accreditation System, and the Clinical Learning Environment Review. This needs to be longitudinally integrated into the curriculum and applied parallel to the development of resident knowledge and skill, and will be best learned if resident learning is experiential and taught within a genuine culture of quality and safety.

  1. Maintaining Corrosion Protection by Anticipating Increased Environment, Safety and Health Requirements

    DTIC Science & Technology

    2009-02-01

    4. TITLE AND SUBTITLE Maintaining Corrosion Protection by Anticipating Increased Environment, Safety and Health Requirements 5a. CONTRACT NUMBER 5b...responding? Environment, Safety and Health (ESH) Corrosion Prevention and Control (CPC) RDECOM  Often competing requirements  Many CPC...2001, Environmental Protection Agency: “highly likely” to be carcinogenic in humans  2006, National Research Council: “potential human carcinogen

  2. The History of Infant Formula: Quality, Safety, and Standard Methods.

    PubMed

    Wargo, Wayne F

    2016-01-01

    Food-related laws and regulations have existed since ancient times. Egyptian scrolls prescribed the labeling needed for certain foods. In ancient Athens, beer and wines were inspected for purity and soundness, and the Romans had a well-organized state food control system to protect consumers from fraud or bad produce. In Europe during the Middle Ages, individual countries passed laws concerning the quality and safety of eggs, sausages, cheese, beer, wine, and bread; some of these laws still exist today. But more modern dietary guidelines and food regulations have their origins in the latter half of the 19th century when the first general food laws were adopted and basic food control systems were implemented to monitor compliance. Around this time, science and food chemistry began to provide the tools to determine "purity" of food based primarily on chemical composition and to determine whether it had been adulterated in any way. Since the key chemical components of mammalian milk were first understood, infant formulas have steadily advanced in complexity as manufacturers attempt to close the compositional gap with human breast milk. To verify these compositional innovations and ensure product quality and safety, infant formula has become one of the most regulated foods in the world. The present paper examines the historical development of nutritional alternatives to breastfeeding, focusing on efforts undertaken to ensure the quality and safety from antiquity to present day. The impact of commercial infant formulas on global regulations is addressed, along with the resulting need for harmonized, fit-for-purpose, voluntary consensus standard methods.

  3. Role of QA in total quality management environment

    SciTech Connect

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

    1992-01-01

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

  4. Quality and Safety Education for Nurses Implementation: Is It Sustainable?

    PubMed

    Cooper, Elizabeth

    Is the Quality and Safety Education for Nurses (QSEN) initiative still advancing in prelicensure nursing education? The purpose of this article is to report a 2-part evaluation regarding QSEN within the curricula. The evaluation included an online survey and conference for faculty in the San Francisco Bay Area (SFBA). This article discusses survey results and the ideas and suggestions of SFBA faculty that were made at the conference. The results were positive. Most schools continue to advance QSEN into their curricula. Ten ways to strengthen integration of QSEN in the curriculum and barriers are identified.

  5. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges

    PubMed Central

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W.

    2017-01-01

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products’ quality, availability, safety, as well as challenges related to a GFD are discussed. PMID:28786929

  6. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges.

    PubMed

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W

    2017-08-08

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products' quality, availability, safety, as well as challenges related to a GFD are discussed.

  7. Physical Environment and Student Safety in South Georgia Schools.

    ERIC Educational Resources Information Center

    Chan, Tak Cheung; Morgan, P. Lena

    The preservation of school safety should be a primary commitment of all educators. This paper presents findings of a study that examined school facility safety in 27 Georgia schools. Data were gathered from a survey of 9 elementary, 11 middle, and 7 high schools in south Georgia. The surveys elicited information related to both school-site safety…

  8. Effects of ventilated safety helmets in a hot environment

    Treesearch

    G.A. Davis; E.D. Edmisten; R.E. Thomas; R.B. Rummer; D.D. Pascoe

    2001-01-01

    Forest workers are likely to remove head protection in hot and humid conditions because of thermal discomfort. However, a recent Occupational Safety and Health Administration (OSHA) regulation revision requires all workers in logging operations to wear safety helmets, thus creating a compliance problem. To determine which factors contribute to forest workers’ thermal...

  9. A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

    PubMed

    O'Heron, Colette T; Jarman, Benjamin T

    2014-01-01

    To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  10. Leisure, environment, and the quality of life

    Treesearch

    Daniel R. Williams

    2006-01-01

    The environment is omnipresent. It is everything and anything external to us that might have an impact on how we think, feel, and act. It is physical and social, natural and human made. It includes not just our immediate surroundings but also a kind of mental shell of spatially and temporally nested situations and contexts we carry around with us in the form of...

  11. Evaluating Water Quality in a Suburban Environment

    NASA Astrophysics Data System (ADS)

    Thomas, S. M.; Garza, N.

    2008-12-01

    A water quality analysis and modeling study is currently being conducted on the Martinez Creek, a small catchment within Cibolo watershed, a sub-basin of the San Antonio River, Texas. Several other major creeks, such as Salatrillo, Escondido, and Woman Hollering merge with Martinez Creek. Land use and land cover analysis shows that the major portion of the watershed is dominated by residential development with average impervious cover percentage of approximately 40% along with a some of agricultural areas and brushlands. This catchment is characterized by the presence of three small wastewater treatment plants. Previous site visits and sampling of water quality indicate the presence of algae and fecal coliform bacteria at levels well above state standards at several locations in the catchment throughout the year. Due to the presence of livestock, residential development and wastewater treatment plants, a comprehensive understanding of water quality is important to evaluate the sources and find means to control pollution. As part of the study, a spatial and temporal water quality analyses of conventional parameters as well as emerging contaminants, such as veterinary pharmaceuticals and microbial pathogens is being conducted to identify critical locations and sources. Additionally, the Hydrologic Simulation Program FORTRAN (HSPF) will be used to identify best management practices that can be incorporated given the projected growth and development and feasibility.

  12. Ensuring Quality in a Virtual Reference Environment

    ERIC Educational Resources Information Center

    Barbier, Pat; Ward, Joyce

    2004-01-01

    Soon after AskALibrarian, Florida's Statewide Virtual Reference Desk, began to offer Chat Reference to the public in 2003, a Quality Assurance Workgroup was established to ensure that the service patrons received would be friendly, accurate, and adequate. To make certain that best practices were used in answering the real time questions, two…

  13. Ensuring Quality in a Virtual Reference Environment

    ERIC Educational Resources Information Center

    Barbier, Pat; Ward, Joyce

    2004-01-01

    Soon after AskALibrarian, Florida's Statewide Virtual Reference Desk, began to offer Chat Reference to the public in 2003, a Quality Assurance Workgroup was established to ensure that the service patrons received would be friendly, accurate, and adequate. To make certain that best practices were used in answering the real time questions, two…

  14. Better medical office safety culture is not associated with better scores on quality measures.

    PubMed

    Hagopian, Benjamin; Singer, Mendel E; Curry-Smith, Anne C; Nottingham, Kelly; Hickner, John

    2012-03-01

    A strong safety culture is an essential element of safe medical practice. Few studies, however, have studied the link between safety culture and clinical quality outcomes. In this study, we examined the association between safety culture and quality measures in primary care offices. A total of 24 primary care offices in Cleveland, Ohio. The Medical Office Survey on Patient Safety was administered to clinicians and support staff to rate 12 dimensions of safety culture and a single overall patient safety rating. An average of the 12 safety culture dimension scores was calculated to produce an aggregated patient safety score. Using linear correlation, we calculated the association between the 2 summary safety measures (overall patient safety rating and aggregated patient safety score) and 2 composite quality measures, a chronic disease score, and a prevention score. The survey response rate was 79% (387/492). There was considerable variation in both safety culture scores and quality scores from office to office. There was no association between the chronic disease score and either summary measure of safety culture. There were small but statistically significant negative associations between the prevention score and the overall patient safety rating (β = -0.087, P = 0.002) as well as the aggregated patient safety score (β = -0.004, P = 0.007). Although safety theory predicts a positive association between safety culture and quality, we found no meaningful associations between safety culture and currently accepted measures of primary care clinical quality. Larger studies across several health care organizations are needed to determine whether these findings are reproducible. If so, it may be necessary to reconsider the dimensions of safety culture in primary care as well as the relationship between safety culture and primary care clinical quality.

  15. Patient safety and quality improvement: a 'CLER' time to move beyond peripheral participation.

    PubMed

    Schumacher, Daniel J; Frohna, John G

    2016-01-01

    In the United States, the Accreditation Council for Graduate Medical Education (ACGME) has instituted a new program, the Clinical Learning Environment Review (CLER), that places focus in six important areas of the resident and fellow working and learning environment. Two of these areas are patient safety and quality improvement (QI). In their early CLER reviews of institutions housing ACGME-accredited training programs, ACGME has found that despite significant progress in patient safety and QI to date much work remains, especially when it comes to meaningful engagement of medical trainees in this work. In this article, the authors argue that peripheral involvement of trainees in patient safety and QI work does not allow the experiential learning that is necessary for professional development and the ultimate ability to execute performance that meets the needs of patients in contemporary clinical practice. Rather, as leaders in patient safety and QI have advocated since early in this movement, embedded and immersed experiences are necessary for learning and success.

  16. Seafood Safety and Quality: The Consumer’s Role

    PubMed Central

    Hicks, Doris T.

    2016-01-01

    All the good news about seafood—the health and nutritional benefits, the wide varieties and flavors—has had a positive effect on consumption: people are eating more seafood (http://www.seagrant.sunysb.edu/seafood/pdfs/SeafoodSavvy.pdf). Yet consumers want to be assured that seafood is as safe as, or safer to eat than, other foods. When you hear “seafood safety”, think of a safety net designed to protect you, the consumer, from food-borne illness. Every facet of the seafood industry, from harvester to consumer, plays a role in holding up the safety net. The role of state and federal agencies, fishermen, aquaculturists, retailers, processors, restaurants, and scientists is to provide, update, and carry out the necessary handling, processing, and inspection procedures to give consumers the safest seafood possible. The consumer’s responsibility is to follow through with proper handling techniques, from purchase to preparation. It doesn’t matter how many regulations and inspection procedures are set up; the final edge of the safety net is held by the consumer. This article will give you the information you need to educate yourself and be assured that the fish and shellfish you consume are safe. The most common food-borne illnesses are caused by a combination of bacteria naturally present in our environment and food handling errors made in commercial settings, food service institutions, or at home. PMID:28231165

  17. The possible effects on health, comfort and safety of aircraft cabin environments.

    PubMed

    Brown, T P; Shuker, L K; Rushton, L; Warren, F; Stevens, J

    2001-09-01

    A consultation was undertaken to investigate the views and concerns of stakeholders in the aircraft industry about the possible harmful effects on personal health, comfort and safety of aircraft cabin environments. Stakeholders were identified from a variety of sources including Government agencies, the Internet, House of Lords inquiry, and suggestions of interviewees. They represented: aircraft crews, aircraft constructors and engineers, government departments and authorities, holiday/flight companies, insurance companies, non-governmental organisations, occupational health physicians, passenger representatives, and independent researchers and consultants. Eighty-seven were contacted of which 57 were interviewed over the telephone using a semi-structured questionnaire. Their concerns were transcribed into a standard format and analysed qualitatively. Key stakeholders, along with Government officials, were invited to a workshop to discuss and prioritize the issues raised during the interviews. The main concerns expressed by the participants fell into five main areas: deep vein thrombosis, air quality, infection, cosmic radiation, and jet lag and work patterns. In addition, a number of safety concerns were raised as well as comments on the provision of appropriate advice to passengers. It was generally felt that further research was required on each of these subjects, as well as an improvement in the quality, quantity and availability of information provided for passengers prior to boarding a flight.

  18. The Implementation of Payload Safety in an Operational Environment

    NASA Technical Reports Server (NTRS)

    Cissom, R. D.; Horvath, Tim J.; Watson, Kristi S.; Rogers, Mark N. (Technical Monitor); Vanhooser, T. (Technical Monitor)

    2002-01-01

    The objective of this paper is to define the safety life-cycle process for a payload beginning with the output of the Payload Safety Review Panel and continuing through the life of the payload on-orbit. It focuses on the processes and products of the operations safety implementation through the increment preparations and real-time operations processes. In addition, the paper addresses the role of the Payload Operations and Integration Center and the interfaces to the International Partner Payload Control Centers.

  19. Quality of Chemical Safety Information in Printing Industry

    PubMed Central

    Tsai, Chung-Jung; Mao, I-Fang; Ting, Jo-Yu; Young, Chi-Hsien; Lin, Jhih-Sian; Li, Wei-Lun

    2016-01-01

    Objectives: Employees in printing industries can be exposed to multiple solvents in their work environment. The objectives of this study were to investigate the critical components of chemical solvents by analyzing the components of the solvents and collecting the Safety data sheets (SDSs), and to evaluate the hazard communication implementation status in printing industries. Method: About 152 printing-related industries were recruited by area-stratified random sampling and included 23 plate-making, 102 printing and 27 printing-assistance companies in Taiwan. We analyzed company questionnaires (n = 152), SDSs (n = 180), and solvents (n = 20) collected from this sample of printing-related companies. Results: Analytical results indicated that benzene and ethylbenzene, which were carcinogen and possibly carcinogen, were detectable in the cleaning solvents, and the detection rate were 54.5% (concentrations: <0.011–0.035 wt%) and 63.6% (concentrations: <0.011–6.22 wt%), respectively; however, neither compound was disclosed in the SDS for the solvents. Several other undisclosed components, including methanol, isopropanol and n-butanol, were also identified in the printing inks, fountain solutions and dilution solvents. We noted that, of the companies we surveyed, only 57.2% had a hazard communication program, 61.8% had SDSs on file and 59.9% provided employee safety and health training. We note that hazard communication programs were missing or ineffective in almost half of the 152 printing industries surveyed. Conclusions: Current safety information of solvents components in printing industries was inadequate, and many hazardous compounds were undisclosed in the SDSs of the solvents or the labels of the containers. The implementation of hazard communications in printing industries was still not enough for protecting the employees’ safety and health. PMID:26568584

  20. Quality of Chemical Safety Information in Printing Industry.

    PubMed

    Tsai, Chung-Jung; Mao, I-Fang; Ting, Jo-Yu; Young, Chi-Hsien; Lin, Jhih-Sian; Li, Wei-Lun

    2016-04-01

    Employees in printing industries can be exposed to multiple solvents in their work environment. The objectives of this study were to investigate the critical components of chemical solvents by analyzing the components of the solvents and collecting the Safety data sheets (SDSs), and to evaluate the hazard communication implementation status in printing industries. About 152 printing-related industries were recruited by area-stratified random sampling and included 23 plate-making, 102 printing and 27 printing-assistance companies in Taiwan. We analyzed company questionnaires (n = 152), SDSs (n = 180), and solvents (n = 20) collected from this sample of printing-related companies. Analytical results indicated that benzene and ethylbenzene, which were carcinogen and possibly carcinogen, were detectable in the cleaning solvents, and the detection rate were 54.5% (concentrations: <0.011-0.035 wt%) and 63.6% (concentrations: <0.011-6.22 wt%), respectively; however, neither compound was disclosed in the SDS for the solvents. Several other undisclosed components, including methanol, isopropanol and n-butanol, were also identified in the printing inks, fountain solutions and dilution solvents. We noted that, of the companies we surveyed, only 57.2% had a hazard communication program, 61.8% had SDSs on file and 59.9% provided employee safety and health training. We note that hazard communication programs were missing or ineffective in almost half of the 152 printing industries surveyed. Current safety information of solvents components in printing industries was inadequate, and many hazardous compounds were undisclosed in the SDSs of the solvents or the labels of the containers. The implementation of hazard communications in printing industries was still not enough for protecting the employees' safety and health. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  1. Quality characteristics and safety of smoke-flavoured water.

    PubMed

    Tano-Debrah, Kwaku; Amamoo-Otchere, Joanne; Karikari, A Y; Diako, Charles

    2007-06-01

    Smoke-flavoured water is produced in Ghana by filling a previously smoked container with potable water and allowing the water to condition with the smoke to attain a characteristic rain water flavour. Owing to the current knowledge on the toxicity, carcinogenicity and other safety issues of some smoke-constituents, the commercial production of the product is becoming a public health concern. This study sought to determine the effects of the smoke-flavouring process on the quality characteristics of smoke-flavoured water to predict the safety of the product. A traditional and a commercial protocol for the production of smoke-flavoured water were simulated in the laboratory and at the site of a company which used to produce the product, respectively. Samples of the flavoured water produced were analyzed for pH, colour, turbidity, conductivity, total hardness, dissolved oxygen content (DO), biochemical oxygen demand (BOD), the polycyclic aromatic hydrocarbon constituents (PAHs), coliform count, and flavour acceptability. Data obtained were evaluated in reference to data on control samples prepared during the investigations. The results obtained suggested that the smoke-flavouring process may not significantly change most of the physico-chemical and microbiological characteristics of the water processed, and thus not affect the drinking quality characteristics of the water. The process however has the potential of adding some organic compounds, which could include polycyclic aromatic hydrocarbons (PAHs), the group that may have the toxicity and carcinogenic effects. The types of PAHs and their concentrations are expected to vary with the process characteristics, but could be insignificantly low to affect the safety of the water. The results suggest a need for some standardization of the process.

  2. Road safety control: Application in urban environment in Greece

    NASA Astrophysics Data System (ADS)

    Charisoudis, A.; Mintsis, G.; Basbas, S.; Taxiltaris, Ch.

    2013-01-01

    The purpose of this paper is to determine what is and what is not a "road safety control" on the one hand and on the other hand to examine the procedure of the realization of this control in different countries in the level of the organization as well as in the level of the praxis through the Road Safety Manuals of each country. The countries under examination are: The United Kinghdom, Danish, U.S.A, Australia and New Zeeland. The Road Safety Manual of the International Organization World Road Association-PIARC is also mentioned. Finally examples of the application of road safety control, which were realized in the frame of the research programs of the research team of the Department of Transportation Engineering, School of Rural and Surveing, Aristotle University of Thessaloniki in the town of Aridea, are given.(in Greeks)

  3. Organizational culture and a safety-conscious work environment: The mediating role of employee communication satisfaction.

    PubMed

    Silla, Inmaculada; Navajas, Joaquin; Koves, G Kenneth

    2017-06-01

    A safety-conscious work environment allows high-reliability organizations to be proactive regarding safety and enables employees to feel free to report any concern without fear of retaliation. Currently, research on the antecedents to safety-conscious work environments is scarce. Structural equation modeling was applied to test the mediating role of employee communication satisfaction in the relationship between constructive culture and a safety-conscious work environment in several nuclear power plants. Employee communication satisfaction partially mediated the positive relationships between a constructive culture and a safety-conscious work environment. Constructive cultures in which cooperation, supportive relationships, individual growth and high performance are encouraged facilitate the establishment of a safety-conscious work environment. This influence is partially explained by increased employee communication satisfaction. Constructive cultures should be encouraged within organizations. In addition, managers should promote communication policies and practices that support a safety-conscious work environment. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

  4. 30 CFR 250.806 - Safety and pollution prevention equipment quality assurance requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Safety and pollution prevention equipment... Gas Production Safety Systems § 250.806 Safety and pollution prevention equipment quality assurance... install only certified safety and pollution prevention equipment (SPPE) in wells located on the OCS. SPPE...

  5. MISSION: Mission and Safety Critical Support Environment. Executive overview

    NASA Technical Reports Server (NTRS)

    Mckay, Charles; Atkinson, Colin

    1992-01-01

    For mission and safety critical systems it is necessary to: improve definition, evolution and sustenance techniques; lower development and maintenance costs; support safe, timely and affordable system modifications; and support fault tolerance and survivability. The goal of the MISSION project is to lay the foundation for a new generation of integrated systems software providing a unified infrastructure for mission and safety critical applications and systems. This will involve the definition of a common, modular target architecture and a supporting infrastructure.

  6. Patients' perceptions of safety and quality of maternity clinical handover.

    PubMed

    Chin, Georgiana S M; Warren, Narelle; Kornman, Louise; Cameron, Peter

    2011-08-10

    Maternity clinical handover serves to address the gaps in knowledge existing when transitions between individuals or groups of clinicians occur throughout the antenatal, intra-partum and postnatal period. There are limited published studies on maternity handover and a paucity of information about patients' perceptions of the same. This paper reports postnatal patients' perceptions of how maternity handover contributes to the quality and safety of maternity care. This paper reports on a mixed-methods study consisting of qualitative interviews and quantitative medical record analysis. Thirty English-speaking postnatal patients who gave birth at an Australian tertiary maternity hospital participated in a semi-structured interview prior to discharge from hospital. Interview data were coded thematically using the constant comparative method and managed via NVivo software; this data set was supplemented by medical record data analysed using STATA. Almost half of the women were aware of a handover process. Clinician awareness of patient information was seen as evidence that handover had taken place and was seen as representing positive aspects of teamwork, care and communication by participants, all important factors in the perception of quality health care. Collaborative cross-checking, including the use of cognitive artefacts such as hand held antenatal records and patient-authored birth plans, and the involvement of patients and their support people in handover were behaviours described by participants to be protective mechanisms that enhanced quality and safety of care. These human factors also facilitated team situational awareness (TSA), shared decision making and patient motivation in labour. This study illustrates that many patients are aware of handover processes. For some patients, evidence of handover, through clinician awareness of information, represented positive aspects of teamwork, care and communication. Cross-checking and cognitive artefacts were

  7. Patients' perceptions of safety and quality of maternity clinical handover

    PubMed Central

    2011-01-01

    Background Maternity clinical handover serves to address the gaps in knowledge existing when transitions between individuals or groups of clinicians occur throughout the antenatal, intra-partum and postnatal period. There are limited published studies on maternity handover and a paucity of information about patients' perceptions of the same. This paper reports postnatal patients' perceptions of how maternity handover contributes to the quality and safety of maternity care. Methods This paper reports on a mixed-methods study consisting of qualitative interviews and quantitative medical record analysis. Thirty English-speaking postnatal patients who gave birth at an Australian tertiary maternity hospital participated in a semi-structured interview prior to discharge from hospital. Interview data were coded thematically using the constant comparative method and managed via NVivo software; this data set was supplemented by medical record data analysed using STATA. Results Almost half of the women were aware of a handover process. Clinician awareness of patient information was seen as evidence that handover had taken place and was seen as representing positive aspects of teamwork, care and communication by participants, all important factors in the perception of quality health care. Collaborative cross-checking, including the use of cognitive artefacts such as hand held antenatal records and patient-authored birth plans, and the involvement of patients and their support people in handover were behaviours described by participants to be protective mechanisms that enhanced quality and safety of care. These human factors also facilitated team situational awareness (TSA), shared decision making and patient motivation in labour. Conclusions This study illustrates that many patients are aware of handover processes. For some patients, evidence of handover, through clinician awareness of information, represented positive aspects of teamwork, care and communication. Cross

  8. Environment, safety and health compliance assessment, Feed Materials Production Center, Fernald, Ohio

    SciTech Connect

    Not Available

    1989-09-01

    The Secretary of Energy established independent Tiger Teams to conduct environment, safety, and health (ES H) compliance assessments at US Department of Energy (DOE) facilities. This report presents the assessment of the Feed Materials Production Center (FMPC) at Fernald, Ohio. The purpose of the assessment at FMPC is to provide the Secretary with information regarding current ES H compliance status, specific ES H noncompliance items, evaluation of the adequacy of the ES H organizations and resources (DOE and contractor), and root causes for noncompliance items. Areas reviewed included performance under Federal, state, and local agreements and permits; compliance with Federal, state and DOE orders and requirements; adequacy of operations and other site activities, such as training, procedures, document control, quality assurance, and emergency preparedness; and management and staff, including resources, planning, and interactions with outside agencies.

  9. Environment, Safety and Health Progress Assessment of the Morgantown Energy Technology Center (METC)

    SciTech Connect

    Not Available

    1993-08-01

    This report documents the result of the US Department of Energy`s (DOE) Environment, Safety and Health (ES&H) Progress Assessment of the Morgantown Energy Technology Center (METC) in Morgantown, West Virginia. METC is currently a research and development facility, managed by DOE`s Office of Fossil Energy. Its goal is to focus energy research and development to develop engineered fossil fuel systems, that are economically viable and environmentally sound, for commercial application. There is clear evidence that, since the 1991 Tiger Team Assessment, substantial progress has been made by both FE and METC in most aspects of their ES&H program. The array of new and restructured organizations, systems, and programs at FE and METC; increased assignments of staff to support these initiatives; extensive training activities; and the maturing planning processes, all reflect a discernable, continuous improvement in the quality of the ES&H performance.

  10. [Establishment and application of pollutant discharge-environment quality model].

    PubMed

    Li, Ming-Sheng; Sun, Yuan; Chen, Yuan-Hang; Zhang, Jian-Hui

    2014-03-01

    In order to explore the mutual influence between pollutant discharge and environment quality, relation models of pollutant discharge and environmental quality were established, and the relationship was divided into four types, low pollutant discharge-high environmental quality, high pollutant discharge-high environmental quality, high pollutant discharge-low environmental quality, and low pollutant discharge-low environmental quality. The evolution paths from one type into another were also discussed. The regional data in 2005 and 2010 was used to validate the pollutant discharge-environmental quality models. The results showed that most regions of China belonged to the high pollutant discharge-low environmental quality type, and the pollutant discharge- environmental quality type didn't vary too much during the 2005-2010 period. In the majority of provinces, the environmental quality index was higher than the pollutant discharge index, and the pollutant discharge quantity overflowed the environmental capacity. The reduction of pollutant discharge quantity should be the most important environmental problem in China. At present, China is in a critical period of environmental governance, and excessive disturbance from economic system to the environment system should be prevented. The results should be helpful for understanding the regional environmental quality situation, on the implementation of pollutant discharge reduction, and the improvement of environmental quality.

  11. The Quality of Home Environment in Brazil: An Ecological Model

    ERIC Educational Resources Information Center

    de Oliveira, Ebenezer A.; Barros, Fernando C.; Anselmi, Luciana D. da Silva; Piccinini, Cesar A.

    2006-01-01

    Based on Bronfenbrenner's (1999) ecological perspective, a longitudinal, prospective model of individual differences in the quality of home environment (Home Observation for Measurement of the Environment--HOME) was tested in a sample of 179 Brazilian children and their families. Perinatal measures of family socioeconomic status (SES) and child…

  12. Light, Colour & Air Quality: Important Elements of the Learning Environment?

    ERIC Educational Resources Information Center

    Hathaway, Warren E.

    1987-01-01

    Reviews and evaluates studies of the effects of light, color, and air quality on the learning environment. Concludes that studies suggest a role for light in establishing and maintaining physiological functions and balances and a need for improved air quality in airtight, energy efficient buildings. (JHZ)

  13. Light, Colour & Air Quality: Important Elements of the Learning Environment?

    ERIC Educational Resources Information Center

    Hathaway, Warren E.

    1987-01-01

    Reviews and evaluates studies of the effects of light, color, and air quality on the learning environment. Concludes that studies suggest a role for light in establishing and maintaining physiological functions and balances and a need for improved air quality in airtight, energy efficient buildings. (JHZ)

  14. Hygiene and Safety in the Meat Processing Environment from Butcher Shops: Microbiological Contamination and Listeria monocytogenes.

    PubMed

    Silva, Danilo Augusto Lopes da; Dias, Mariane Rezende; Cossi, Marcus Vinícius Coutinho; Castilho, Natália Parma Augusto de; Camargo, Anderson Carlos; Nero, Lúis Augusto

    2016-04-01

    The quality and safety of meat products can be estimated by assessing their contamination by hygiene indicator microorganisms and some foodborne pathogens, with Listeria monocytogenes as a major concern. To identify the main sources of microbiological contamination in the processing environment of three butcher shops, surface samples were obtained from the hands of employees, tables, knives, inside butcher displays, grinders, and meat tenderizers (24 samples per point). All samples were subjected to enumeration of hygiene indicator microorganisms and detection of L. monocytogenes, and the obtained isolates were characterized by their serogroups and virulence genes. The results demonstrated the absence of relevant differences in the levels of microbiological contamination among butcher shops; samples with counts higher than reference values indicated inefficiency in adopted hygiene procedures. A total of 87 samples were positive for Listeria spp. (60.4%): 22 from tables, 20 from grinders, 16 from knives, 13 from hands, 9 from meat tenderizers, and 7 from butcher shop displays. Thirty-one samples (21.5%) were positive for L. monocytogenes, indicating the presence of the pathogen in meat processing environments. Seventy-four L. monocytogenes isolates were identified, with 52 from serogroups 1/2c or 3c and 22 from serogroups 4b, 4d, 4a, or 4c. All 74 isolates were positive for hlyA, iap, plcA, actA, and internalins (inlA, inlB, inlC, and inlJ). The establishment of appropriate procedures to reduce microbial counts and control the spread of L. monocytogenes in the final steps of the meat production chain is of utmost importance, with obvious effects on the quality and safety of meat products for human consumption.

  15. Food Safety and Quality. Uniform, Risk-Based Inspection System Needed to Ensure Safe Food Supply,

    DTIC Science & Technology

    1992-06-01

    Concerned about the effectiveness of the federal food safety inspection system, the Chairman, Subcommittee on Oversight and Investigations, House...federal resources for inspection, and (3) agencies are effectively coordinating their food safety and quality inspection efforts.

  16. Getting boards on board: engaging governing boards in quality and safety.

    PubMed

    Conway, James

    2008-04-01

    As hospitals seek to drive rapid quality improvement, boards have an opportunity-and a significant responsibility--to make better quality of care the organization's top priority. "Six things all boards should do to improve quality and reduce harm" are recommended: (1) setting aims--set a specific aim to reduce harm this year; make an explicit, public commitment to measurable quality improvement; (2) getting data and hearing stories--select and review progress toward safer care as the first agenda item at every board meeting, grounded in transparency--and putting a "human face" on harm data; (3) establishing and monitoring system-level measures--identify a small group of organizationwide "roll-up" measures of patient safety that are continually updated and are made transparent to the entire organization and its customers; (4) changing the environment, policies, and culture--commit to establish and maintain an environment that is respectful, fair, and just for all who experience the pain and loss as a result of avoidable harm and adverse outcomes: the patients, their families, and the staff at the sharp end of error; (5) learning, starting with the board--develop the board's capability and learn about how "best-in-the-world" boards work with executive and medical staff leaders to reduce harm; (6) establishing executive accountability--oversee the effective execution of a plan to achieve aims to reduce harm, including executive team accountability for clear quality improvement targets.

  17. Graduate medical education's new focus on resident engagement in quality and safety: will it transform the culture of teaching hospitals?

    PubMed

    Myers, Jennifer S; Nash, David B

    2014-10-01

    The Accreditation Council for Graduate Medical Education recently announced its Clinical Learning Environment Review (CLER) program, which is designed to catalyze and promote the engagement of physician trainees in health care quality and patient safety activities that are essential to the delivery of high-quality patient care in U.S. teaching hospitals. In this Commentary, the authors argue that a strong organizational culture in quality improvement and patient safety is a necessary foundation for resident engagement in these areas. They describe residents' influence via their social networks on the behaviors and attitudes of peers and other health care providers and highlight this as a powerful driver for culture change in teaching hospitals. They also consider some of the potential unintended consequences of the CLER program and offer strategies to avoid them. The authors suggest that the CLER program provides an opportunity for health care and graduate medical education leaders to closely examine organizational quality and safety culture and the degree to which their residents are integrated in these efforts. They highlight the importance of developing collaborative interprofessional strategies to reach common goals to improve patient care. By sharpening the focus on patient safety, supervision, professionalism, patient care transitions, and the overall quality of health care delivery in the clinical learning environment during residents' formative training years, the hope is that the CLER program will inspire a new generation of physicians who possess and value these skills.

  18. The US Agency for Healthcare Research and Quality's activities in patient safety research.

    PubMed

    Meyer, Gregg S; Battles, James; Hart, James C; Tang, Ning

    2003-12-01

    To update the international community on the US Agency for Healthcare Research and Quality's (AHRQ) recent and current activities in improving patient safety. Review of the literature concerning the importance of patient safety as a health care quality issue, international perspectives on patient safety, a review of research solicitations, and early results of funded studies. A representative sample of patient safety studies from those currently being funded by AHRQ. In response to a growing interest in patient safety in general and a recent US Institute of Medicine report on patient safety in particular, the US Agency for Healthcare Research and Quality has refocused its quality research mission. In the fiscal year 2002, AHRQ spent US$55 million on patient safety research. This investment was spread across six complementary research areas: (1) health systems error reporting, analysis, and safety improvement research demonstrations; (2) Clinical Informatics to Promote Patient Safety (CLIPS); (3) Centers of Excellence for patient safety research and practice (COE); (4) Developmental Centers for Evaluation and Research in Patient Safety (DCERPS); (5) The Effect of Health Care Working Conditions on Quality of Care; and (6) Partnerships for Quality: Patient Safety Research Dissemination and Education. Internal teams of researchers at AHRQ have published studies on patient safety, such as documenting the impact of medication errors. In addition to funding research on patient safety, AHRQ is an integral partner in several national and international collaborations to form strategic synergies that build upon each member organization's strengths, reduce redundant efforts, and benefit from each other's successes. As evidence on patient safety is generated, AHRQ also serves the important mission of disseminating information to the public. The patient safety research field has undergone a period of rapid evolution. It is now incumbent upon the international health care quality

  19. Roadmap to an effective quality improvement and patient safety program implementation in a rural hospital setting.

    PubMed

    Ingabire, Willy; Reine, Petera M; Hedt-Gauthier, Bethany L; Hirschhorn, Lisa R; Kirk, Catherine M; Nahimana, Evrard; Nepomscene Uwiringiyemungu, Jean; Ndayisaba, Aphrodis; Manzi, Anatole

    2015-12-01

    Implementation lessons: (1) implementation of an effective quality improvement and patient safety program in a rural hospital setting requires collaboration between hospital leadership, Ministry of Health and other stakeholders. (2) Building Quality Improvement (QI) capacity to develop engaged QI teams supported by mentoring can improve quality and patient safety.

  20. Quality control in a deterministic manufacturing environment

    SciTech Connect

    Barkman, W.E.; Babelay, E.F.; De Mint, P.D.; Lewis, J.C.; Woodard, L.M.

    1985-01-24

    An approach for establishing quality control in processes which exhibit undesired continual or intermittent excursions in key process parameters is discussed. The method is called deterministic manufacturing, and it is designed to employ automatic monitoring of the key process variables for process certification, but utilizes only sample certification of the process output to verify the validity of the measurement process. The system utilizes a local minicomputer to sample the appropriate process parameters that describe the condition of the machine tool, the cutting process, and the computer numerical control system. Sampled data are pre-processed by the minicomputer and then sent to a host computer that maintains a permanent data base describing the manufacturing conditions for each work piece. Parts are accepted if the various parameters remain within the required limits during the machining cycle. The need for additional actions is flagged if limits are exceeded. With this system it is possible to retrospectively examine the process status just prior to the occurrence of a problem. (LEW)

  1. Codex Alimentarius: food quality and safety standards for international trade.

    PubMed

    Randell, A W; Whitehead, A J

    1997-08-01

    Since 1962, the Codex Alimentarius Commission (CAC) of the Food and Agriculture Organisation/World Health Organisation has been responsible for developing standards, guidelines and other recommendations on the quality and safety of food to protect the health of consumers and to ensure fair practices in food trade. The mission of the CAC remains relevant, but a number of factors have shown the need for new techniques to form the basis of food standards, the most important of which is risk analysis. The authors give a brief description of the role and work of the CAC and the efforts deployed by the Commission to respond to the challenges posed by new approaches to government regulation, harmonisation of national requirements based on international standards and the role of civil society.

  2. Improving packaged food quality and safety. Part 2: nanocomposites.

    PubMed

    Lagarón, J M; Cabedo, L; Cava, D; Feijoo, J L; Gavara, R; Gimenez, E

    2005-10-01

    This paper gathers a number of significant results where nanotechnology was satisfactorily applied to improve packaged food quality and safety by increasing the barrier properties to oxygen of an ethylene-vinyl alcohol copolymer (EVOH) in dry and under humid conditions and of a poly(lactic acid) (PLA) biopolymer. The nanodispersion in the polymer matrix of modified monolayers of clays included in positive lists for food-contact applications is an adequate methodology to increase packaged food shelf-life. In spite of the fact that, in principle, there is no reason to believe that 'adequately' modified nanocomposites making use of substances in positive lists can impose any immediate risk threat for food-contact applications, further studies concerning potential migration issues and life-cycle analysis have to still emerge within the overall field of nanotechnology to corroborate the fact.

  3. Organising a manuscript reporting quality improvement or patient safety research.

    PubMed

    Holzmueller, Christine G; Pronovost, Peter J

    2013-09-01

    Peer-reviewed publication plays important roles in disseminating research findings, developing generalisable knowledge and garnering recognition for authors and institutions. Nonetheless, many bemoan the whole manuscript writing process, intimidated by the arbitrary and somewhat opaque conventions. This paper offers practical advice about organising and writing a manuscript reporting quality improvement or patient safety research for submission to a peer-reviewed journal. Each section of the paper discusses a specific manuscript component-from title, abstract and each section of the manuscript body, through to reference list and tables and figures-explaining key principles, offering content organisation tips and providing an example of how this section may read. The paper also offers a checklist of common mistakes to avoid in a manuscript.

  4. Insomnia risks and costs: health, safety, and quality of life.

    PubMed

    Rosekind, Mark R; Gregory, Kevin B

    2010-08-01

    The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia. However, emerging data have shown links with several common and costly medical conditions such as heart disease and diabetes. Furthermore, studies show that patients who have insomnia have more emergency department and physician visits, laboratory tests, and prescription drug use than those who do not have insomnia, increasing direct and indirect consumption of healthcare resources. Insomnia also has been shown to negatively affect daytime functioning, including workplace productivity, as well as workplace and public safety. These daytime effects of insomnia are translated into indirect costs that are reportedly higher than the direct costs of this disorder. These observations have significant implications for managed care organizations and healthcare providers. Improvements in diagnosing and treating insomnia can significantly reduce the healthcare cost of insomnia and its comorbid disorders, while providing additional economic benefits from improved daytime functioning and from increased productivity.

  5. Safety pharmacology methods and models in an evolving regulatory environment.

    PubMed

    Pugsley, Michael K; de Korte, Tessa; Authier, Simon; Huang, Hai; Accardi, Michael V; Curtis, Michael J

    2017-09-01

    This editorial prefaces the annual themed issue on safety pharmacology (SP) methods published in the Journal of Pharmacological and Toxicological Methods (JPTM). We highlight here the content derived from the recent 2016 Safety Pharmacology Society (SPS), Canadian Society of Pharmacology and Therapeutics (CSPT), and Japanese Safety Pharmacology Society (JSPS) joint meeting held in Vancouver, B.C., Canada. This issue of JPTM continues the tradition of providing a publication summary of articles primarily presented at the joint meeting with direct bearing on the discipline of SP. As the regulatory landscape is expected to evolve with revision announced for the existing guidance document on non-clinical proarrhythmia risk assessment (ICHS7B) there is also imminent inception of the Comprehensive in vitro Proarrhythmia Assay (CiPA) initiative. Thus, the field of SP is dynamically progressing with characterization and implementation of numerous alternative non-clinical safety models. Novel method development and refinement in all areas of the discipline are reflected in the content. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. [Audits of the quality management system and safety in radiotherapy: Lessons learned and future prospects].

    PubMed

    Leroy, E; Marque, A

    2016-10-01

    The external audit of the management system of quality and safety in radiotherapy by quality managers of the French Association of Quality and Safety in Radiotherapy (AFQSR) is an opportunity to exchange good practices, returns of experience, effectiveness and weaknesses of the quality system, and its perceptions by all the teams. We present the results of the first audits conducted, and the results of a survey on the perception of quality at national level. Copyright © 2016. Published by Elsevier SAS.

  7. TU-EF-BRD-04: Summing It Up: The Future of Quality and Safety Research

    SciTech Connect

    Ford, E.

    2015-06-15

    Research related to quality and safety has been a staple of medical physics academic activities for a long time. From very early on, medical physicists have developed new radiation measurement equipment and analysis techniques, created ever increasingly accurate dose calculation models, and have vastly improved imaging, planning, and delivery techniques. These and other areas of interest have improved the quality and safety of radiotherapy for our patients. With the advent of TG-100, quality and safety is an area that will garner even more research interest in the future. As medical physicists pursue quality and safety research in greater numbers, it is worthwhile to consider what actually constitutes research on quality and safety. For example, should the development of algorithms for real-time EPID-based in-vivo dosimetry be defined as “quality and safety” research? How about the clinical implementation of such as system? Surely the application of failure modes and effects analysis to a clinical process would be considered quality and safety research, but is this type of research that should be included in the medical physics peer-reviewed literature? The answers to such questions are of critical importance to set researchers in a direction that will provide the greatest benefit to our field and the patients we serve. The purpose of this symposium is to consider what constitutes research in the arena of quality and safety and differentiate it from other research directions. The key distinction here is developing the tool itself (e.g. algorithms for EPID dosimetry) vs. studying the impact of the tool with some quantitative metric. Only the latter would I call quality and safety research. Issues of ‘basic’ versus ‘applied’ quality and safety research will be covered as well as how the research results should be structured to provide increasing levels of support that a quality and safety intervention is effective and sustainable. Examples from existing

  8. TU-EF-BRD-01: Topics in Quality and Safety Research and Level of Evidence

    SciTech Connect

    Pawlicki, T.

    2015-06-15

    Research related to quality and safety has been a staple of medical physics academic activities for a long time. From very early on, medical physicists have developed new radiation measurement equipment and analysis techniques, created ever increasingly accurate dose calculation models, and have vastly improved imaging, planning, and delivery techniques. These and other areas of interest have improved the quality and safety of radiotherapy for our patients. With the advent of TG-100, quality and safety is an area that will garner even more research interest in the future. As medical physicists pursue quality and safety research in greater numbers, it is worthwhile to consider what actually constitutes research on quality and safety. For example, should the development of algorithms for real-time EPID-based in-vivo dosimetry be defined as “quality and safety” research? How about the clinical implementation of such as system? Surely the application of failure modes and effects analysis to a clinical process would be considered quality and safety research, but is this type of research that should be included in the medical physics peer-reviewed literature? The answers to such questions are of critical importance to set researchers in a direction that will provide the greatest benefit to our field and the patients we serve. The purpose of this symposium is to consider what constitutes research in the arena of quality and safety and differentiate it from other research directions. The key distinction here is developing the tool itself (e.g. algorithms for EPID dosimetry) vs. studying the impact of the tool with some quantitative metric. Only the latter would I call quality and safety research. Issues of ‘basic’ versus ‘applied’ quality and safety research will be covered as well as how the research results should be structured to provide increasing levels of support that a quality and safety intervention is effective and sustainable. Examples from existing

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

    PubMed

    Ishikura, Satoshi

    2008-11-01

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

  10. Defining quality metrics and improving safety and outcome in allergy care.

    PubMed

    Lee, Stella; Stachler, Robert J; Ferguson, Berrylin J

    2014-04-01

    The delivery of allergy immunotherapy in the otolaryngology office is variable and lacks standardization. Quality metrics encompasses the measurement of factors associated with good patient-centered care. These factors have yet to be defined in the delivery of allergy immunotherapy. We developed and applied quality metrics to 6 allergy practices affiliated with an academic otolaryngic allergy center. This work was conducted at a tertiary academic center providing care to over 1500 patients. We evaluated methods and variability between 6 sites. Tracking of errors and anaphylaxis was initiated across all sites. A nationwide survey of academic and private allergists was used to collect data on current practice and use of quality metrics. The most common types of errors recorded were patient identification errors (n = 4), followed by vial mixing errors (n = 3), and dosing errors (n = 2). There were 7 episodes of anaphylaxis of which 2 were secondary to dosing errors for a rate of 0.01% or 1 in every 10,000 injection visits/year. Site visits showed that 86% of key safety measures were followed. Analysis of nationwide survey responses revealed that quality metrics are still not well defined by either medical or otolaryngic allergy practices. Academic practices were statistically more likely to use quality metrics (p = 0.021) and perform systems reviews and audits in comparison to private practices (p = 0.005). Quality metrics in allergy delivery can help improve safety and quality care. These metrics need to be further defined by otolaryngic allergists in the changing health care environment. © 2014 ARS-AAOA, LLC.

  11. Implementation Science: New Approaches to Integrating Quality and Safety Education for Nurses Competencies in Nursing Education.

    PubMed

    Dolansky, Mary A; Schexnayder, Julie; Patrician, Patricia A; Sales, Anne

    Although quality and safety competencies were developed and disseminated nearly a decade ago by the Quality and Safety Education for Nurses (QSEN) project, the uptake in schools of nursing has been slow. The use of implementation science methods may be useful to accelerate quality and safety competency integration in nursing education. The article includes a definition and description of implementation science methods and practical implementation strategies for nurse educators to consider when integrating the QSEN competencies into nursing curriculum.

  12. Food Safety and Quality: Who Does What in the Federal Government, Volume 1

    DTIC Science & Technology

    1990-12-01

    information labels should contain and what packaging is a(ceptable: and * monitor state and local inspection programs for food retail and service...program information relating to food safety and quality. Although other federal agencies are involved with food safety and quality activities, we...presents information on the size and makeup of the industry, federal legislative responsibilities, federal food safety and quality activities, federal

  13. Key Performance Indicators in the Evaluation of the Quality of Radiation Safety Programs.

    PubMed

    Schultz, Cheryl Culver; Shaffer, Sheila; Fink-Bennett, Darlene; Winokur, Kay

    2016-08-01

    Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal). Each year, in the annual report, data is analyzed and then tracked and trended. While any summary report will, by nature, include items such as the number of pieces of equipment, inspections performed, staff monitored and educated and other similar parameters, not all include an objective review of the quality and effectiveness of the program. Through objective numerical data Beaumont adopted seven key performance indicators. The assertion made is that key performance indicators can be used to establish benchmarks for evaluation and comparison of the effectiveness and quality of radiation safety programs. Based on over a decade of data collection, and adoption of key performance indicators, this paper demonstrates one way to establish objective benchmarking for radiation safety programs in the health care environment.

  14. Environment Health & Safety Research Program. Organization and 1979-1980 Publications

    SciTech Connect

    1981-01-01

    This document was prepared to assist readers in understanding the organization of Pacific Northwest Laboratory, and the organization and functions of the Environment, Health and Safety Research Program Office. Telephone numbers of the principal management staff are provided. Also included is a list of 1979 and 1980 publications reporting on work performed in the Environment, Health and Safety Research Program, as well as a list of papers submitted for publication.

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

    PubMed

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

    2015-10-01

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

  16. Multifactorial influences on and deviations from medication administration safety and quality in the acute medical/surgical context.

    PubMed

    Popescu, Andrea; Currey, Judy; Botti, Mari

    2011-03-01

    Although numerous factors influence medication administration, our understanding of the interplay of these factors on medication quality and safety is limited. The aim of this study was to explore the multifactorial influences on medication quality and safety in the context of a single checking policy for medication administration in acute care. An exploratory/descriptive study using non-participant observation and follow-up interview was used to identify factors influencing medication quality and safety in medication administration episodes (n=30). Observations focused on nurses' interactions with patients during medication administration, and the characteristics of the environment in which these took place. Confirmation of observed data occurred on completion of the observation period during short semi-structured interviews with participant nurses. Findings showed nurses developed therapeutic relationships with patients in terms of assessing patients before administering medications and educating patients about drugs during medication administration. Nurses experienced more frequent distractions when medications were stored and prepared in a communal drug room according to ward design. Nurses deviated from best-practice guidelines during medication administration. Nurses' abilities and readiness to develop therapeutic relationships with patients increased medication quality and safety, thereby protecting patients from potential adverse events. Deviations from best-practice medication administration had the potential to decrease medication safety. System factors such as ward design determining medication storage areas can be readily addressed to minimise potential error. Nurses displayed behaviours that increased medication administration quality and safety; however, violations of practice standards were observed. These findings will inform future intervention studies to improve medication quality and safety. Copyright ©2011 Sigma Theta Tau International.

  17. Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

    PubMed Central

    2011-01-01

    system is associated with lower rates of adjusted hospital complications. A number of methodological and logistic hurdles remain to link hospital quality improvement systems to outcomes. Further research should aim at identifying the latent dimensions of quality improvement systems that predict quality and safety outcomes. Such research would add pertinent knowledge regarding the implementation of organizational strategies related with quality of care outcomes. PMID:22185479

  18. Effects of gamma radiation on raspberries: safety and quality issues.

    PubMed

    Verde, S Cabo; Trigo, M J; Sousa, M B; Ferreira, A; Ramos, A C; Nunes, I; Junqueira, C; Melo, R; Santos, P M P; Botelho, M L

    2013-01-01

    There is an ever-increasing global demand from consumers for high-quality foods with major emphasis placed on quality and safety attributes. One of the main demands that consumers display is for minimally processed, high-nutrition/low-energy natural foods with no or minimal chemical preservatives. The nutritional value of raspberry fruit is widely recognized. In particular, red raspberries are known to demonstrate a strong antioxidant capacity that might prove beneficial to human health by preventing free radical-induced oxidative stress. However, food products that are consumed raw, are increasingly being recognized as important vehicles for transmission of human pathogens. Food irradiation is one of the few technologies that address both food quality and safety by virtue of its ability to control spoilage and foodborne pathogenic microorganisms without significantly affecting sensory or other organoleptic attributes of the food. Food irradiation is well established as a physical, nonthermal treatment (cold pasteurization) that processes foods at or nearly at ambient temperature in the final packaging, reducing the possibility of cross contamination until the food is actually used by the consumer. The aim of this study was to evaluate effects of gamma radiation on raspberries in order to assess consequences of irradiation. Freshly packed raspberries (Rubus idaeus L.) were irradiated in a (60)Co source at several doses (0.5, 1, or 1.5 kGy). Bioburden, total phenolic content, antioxidant activity, physicochemical properties such as texture, color, pH, soluble solids content, and acidity, and sensorial parameters were assessed before and after irradiation and during storage time up to 14 d at 4°C. Characterization of raspberries microbiota showed an average bioburden value of 10(4) colony-forming units (CFU)/g and a diverse microbial population predominantly composed of two morphological types (gram-negative, oxidase-negative rods, 35%, and filamentous fungi, 41

  19. [Agricultural environment quality of China and its improving countermeasures].

    PubMed

    Zeng, Xibai; Yang, Zhengli

    2006-01-01

    This paper analyzed the present status of China agricultural water and soil environment. It was indicated that the agricultural water environment in this country was more serious, with the affected area being approximately 20% of the total farmland, and 5% of it being severely affected. More attention should be paid to the pollution of agricultural chemicals in soil environment. The impacts of industrial wastes, urban sewage and garbage, agricultural chemicals, and soil erosion on agro-environment were discussed, with the impact degree of these factors analyzed. The major problems in China agricultural environment melioration were presented, related researches and major countermeasures in this country and developed countries were reviewed, and relevant measures and suggestions on improving the agricultural environment quality of China were put forward.

  20. A cross-sectional study to identify organisational processes associated with nurse-reported quality and patient safety

    PubMed Central

    Tvedt, Christine; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir

    2012-01-01

    Objectives The purpose of this study was to identify organisational processes and structures that are associated with nurse-reported patient safety and quality of nursing. Design This is an observational cross-sectional study using survey methods. Setting Respondents from 31 Norwegian hospitals with more than 85 beds were included in the survey. Participants All registered nurses working in direct patient care in a position of 20% or more were invited to answer the survey. In this study, 3618 nurses from surgical and medical wards responded (response rate 58.9). Nurses' practice environment was defined as organisational processes and measured by the Nursing Work Index Revised and items from Hospital Survey on Patient Safety Culture. Outcome measures Nurses' assessments of patient safety, quality of nursing, confidence in how their patients manage after discharge and frequency of adverse events were used as outcome measures. Results Quality system, nurse–physician relation, patient safety management and staff adequacy were process measures associated with nurse-reported work-related and patient-related outcomes, but we found no associations with nurse participation, education and career and ward leadership. Most organisational structures were non-significant in the multilevel model except for nurses’ affiliations to medical department and hospital type. Conclusions Organisational structures may have minor impact on how nurses perceive work-related and patient-related outcomes, but the findings in this study indicate that there is a considerable potential to address organisational design in improvement of patient safety and quality of care. PMID:23263021

  1. 2011 John M. Eisenberg Patient Safety and Quality Awards. Individual Achievement. Interview by Eric J. Thomas.

    PubMed

    Shine, Kenneth

    2012-07-01

    Dr. Shine, who, as president, led the Institute of Medicine's focus on quality and patient safety, describes initiatives at the University of Texas System, including quality improvement training, systems engineering, assessment of projects' economic impact, and dissemination of good practices.

  2. Health, safety, and productivity in a manufacturing environment.

    PubMed

    Bunn, W B; Pikelny, D B; Slavin, T J; Paralkar, S

    2001-01-01

    The Health and Productivity Management model at International Truck and Engine Corporation includes the measurement, analysis, and management of the individual component programs affecting employee safety, health, and productivity. The key to the success of the program was the iterative approach used to identify the opportunities, develop interventions, and achieve targets through continuous measurement and management. In addition, the integration of multiple disciplines and the overall emphasis on employee productivity and its cost are key foci of the International Model. The program was instituted after economic and clinical services' analyses of data on International employees showed significant excess costs and a high potential for health care cost reductions based on several modifiable health risk factors. The company also faced significant challenges in the safety, workers' compensation, and disability areas. The program includes safety, workers' compensation, short-term disability, long-term disability, health care, and absenteeism. Monthly reports/analyses are sent to senior management, and annual goals are set with the board of directors. Economic impact has been documented in the categories after intervention. For example, a comprehensive corporate wellness effort has had a significant impact in terms of reducing both direct health care cost and improving productivity, measured as absenteeism. Workers' compensation and disability program interventions have had an impact on current costs, resulting in a significant reduction of financial liability. In the final phase of the program, all direct and indirect productivity costs will be quantified. The impact of the coordinated program on costs associated with employee health will be analyzed initially and compared with a "silo" approach.

  3. NEAMS Nuclear Waste Management IPSC : evaluation and selection of tools for the quality environment.

    SciTech Connect

    Bouchard, Julie F.; Stubblefield, William Anthony; Vigil, Dena M.; Edwards, Harold Carter

    2011-05-01

    The objective of the U.S. Department of Energy Office of Nuclear Energy Advanced Modeling and Simulation Nuclear Waste Management Integrated Performance and Safety Codes (NEAMS Nuclear Waste Management IPSC) is to provide an integrated suite of computational modeling and simulation (M&S) capabilities to quantitatively assess the long-term performance of waste forms in the engineered and geologic environments of a radioactive-waste storage facility or disposal repository. These M&S capabilities are to be managed, verified, and validated within the NEAMS Nuclear Waste Management IPSC quality environment. M&S capabilities and the supporting analysis workflow and simulation data management tools will be distributed to end-users from this same quality environment. The same analysis workflow and simulation data management tools that are to be distributed to end-users will be used for verification and validation (V&V) activities within the quality environment. This strategic decision reduces the number of tools to be supported, and increases the quality of tools distributed to end users due to rigorous use by V&V activities. This report documents an evaluation of the needs, options, and tools selected for the NEAMS Nuclear Waste Management IPSC quality environment. The objective of the U.S. Department of Energy (DOE) Office of Nuclear Energy Advanced Modeling and Simulation Nuclear Waste Management Integrated Performance and Safety Codes (NEAMS Nuclear Waste Management IPSC) program element is to provide an integrated suite of computational modeling and simulation (M&S) capabilities to assess quantitatively the long-term performance of waste forms in the engineered and geologic environments of a radioactive-waste storage facility or disposal repository. This objective will be fulfilled by acquiring and developing M&S capabilities, and establishing a defensible level of confidence in these M&S capabilities. The foundation for assessing the level of confidence is based upon

  4. [Construction and implementation of quality control index for clinical safety of Chinese medicine injection].

    PubMed

    Jiang, Jun-jie; Xie, Yan-ming

    2015-12-01

    In order to ensure the authenticity and accuracy of traditional Chinese medicine injection safety monitoring data, Chinese medicine injection safety monitoring quality control indicators, including the monitoring center, monitoring personnel, hardware conditions, monitoring progress and the number of patients into the group, original documents and archives management, electronic data, adverse events, quality management were constructed. Its application in the creation of major new drugs technology major projects, 10 kinds of traditional Chinese medicine injections clinical safety monitoring quality control work, found the missing case surveillance, not reported adverse events, only reported adverse reactions, electronic data reporting lag, lack of level of efforts to control the problem, and corrected, the traditional Chinese medicine injection safety monitoring of quality control and quality assurance, and subsequent Chinese medicine safety monitoring quality control to provide the reference.

  5. Work environment characteristics of high-quality home health agencies.

    PubMed

    Tullai-McGuinness, Susan; Riggs, Jennifer S; Farag, Amany A

    2011-10-01

    This concurrent mixed-method study examines the nurse work environment of high-quality Medicare-certified home health agencies. High-quality (n=6) and low-quality (n=6) home health agencies were recruited using agency-level publicly reported patient outcomes. Direct care registered nurses (RNs) from each agency participated in a focus group and completed the Practice Environment Scale of the Nurse Work Index (PES-NWI). No significant differences were found in the PES-NWI results between nurses working in high- and low-quality agencies, though nurses in high-quality agencies scored higher on all subscales. Nurses working in all the high-quality agencies identified themes of adequate staffing, supportive managers, and team work. These themes were not consistently identified in low-quality agencies. Themes of supportive managers and team work are reflective of effective leadership at the manager level. Agencies struggling to improve quality of care might consider developing their managers' leadership skills.

  6. Assessment of Contributions to Patient Safety Knowledge by the Agency for Healthcare Research and Quality-Funded Patient Safety Projects

    PubMed Central

    Sorbero, Melony E S; Ricci, Karen A; Lovejoy, Susan; Haviland, Amelia M; Smith, Linda; Bradley, Lily A; Hiatt, Liisa; Farley, Donna O

    2009-01-01

    Objective To characterize the activities of projects funded in Agency for Healthcare Research and Quality (AHRQ)' patient safety portfolio and assess their aggregate potential to contribute to knowledge development. Data Sources Information abstracted from proposals for projects funded in AHRQ' patient safety portfolio, information on safety practices from the AHRQ Evidence Report on Patient Safety Practices, and products produced by the projects. Study Design This represented one part of the process evaluation conducted as part of a longitudinal evaluation based on the Context–Input–Process–Product model. Principal Findings The 234 projects funded through AHRQ' patient safety portfolio examined a wide variety of patient safety issues and extended their work beyond the hospital setting to less studied parts of the health care system. Many of the projects implemented and tested practices for which the patient safety evidence report identified a need for additional evidence. The funded projects also generated a substantial body of new patient safety knowledge through a growing number of journal articles and other products. Conclusions The projects funded in AHRQ' patient safety portfolio have the potential to make substantial contributions to the knowledge base on patient safety. The full value of this new knowledge remains to be confirmed through the synthesis of results. PMID:21456108

  7. Assessment of contributions to patient safety knowledge by the Agency for Healthcare Research and Quality-funded patient safety projects.

    PubMed

    Sorbero, Melony E S; Ricci, Karen A; Lovejoy, Susan; Haviland, Amelia M; Smith, Linda; Bradley, Lily A; Hiatt, Liisa; Farley, Donna O

    2009-04-01

    To characterize the activities of projects funded in Agency for Healthcare Research and Quality (AHRQ)'s patient safety portfolio and assess their aggregate potential to contribute to knowledge development. Information abstracted from proposals for projects funded in AHRQ's patient safety portfolio, information on safety practices from the AHRQ Evidence Report on Patient Safety Practices, and products produced by the projects. This represented one part of the process evaluation conducted as part of a longitudinal evaluation based on the Context–Input–Process–Product model. The 234 projects funded through AHRQ's patient safety portfolio examined a wide variety of patient safety issues and extended their work beyond the hospital setting to less studied parts of the health care system. Many of the projects implemented and tested practices for which the patient safety evidence report identified a need for additional evidence. The funded projects also generated a substantial body of new patient safety knowledge through a growing number of journal articles and other products. The projects funded in AHRQ's patient safety portfolio have the potential to make substantial contributions to the knowledge base on patient safety. The full value of this new knowledge remains to be confirmed through the synthesis of results

  8. Improving Safety, Quality and Efficiency through the Management of Emerging Processes: The TenarisDalmine Experience

    ERIC Educational Resources Information Center

    Bonometti, Patrizia

    2012-01-01

    Purpose: The aim of this contribution is to describe a new complexity-science-based approach for improving safety, quality and efficiency and the way it was implemented by TenarisDalmine. Design/methodology/approach: This methodology is called "a safety-building community". It consists of a safety-behaviour social self-construction…

  9. Improving Safety, Quality and Efficiency through the Management of Emerging Processes: The TenarisDalmine Experience

    ERIC Educational Resources Information Center

    Bonometti, Patrizia

    2012-01-01

    Purpose: The aim of this contribution is to describe a new complexity-science-based approach for improving safety, quality and efficiency and the way it was implemented by TenarisDalmine. Design/methodology/approach: This methodology is called "a safety-building community". It consists of a safety-behaviour social self-construction…

  10. 30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., property, and the environment? 250.107 Section 250.107 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT..., property, and the environment? (a) You must protect health, safety, property, and the environment by: (1... would have a significant effect on safety, health, or the environment; (2) If it is economically...

  11. [Unintentional injuries in the home environment: home safety].

    PubMed

    Paes, Carlos E N; Gaspar, Vera L V

    2005-11-01

    To review the characteristics of unintentional injuries and their impact on children and adolescents. Articles published between 2000 and 2005 in the MEDLINE, EBSCO, Proquest, SciELO, BVS and Google Scholar databases were selected. The authors used the keywords unintentional injuries, injuries, safe home, burns, falls, drowning, scorpions, snakes, poisoning, child, adolescent, mortality, injury control, and hospitalization. Some articles were evaluated based on the selected publications. Unintentional injuries in the world and in Brazil are analyzed, and so are the behaviors currently adopted for injury prevention and control. The impact on mortality, on physical damage, and the economic burden of injuries are evaluated. Special emphasis is placed on home environment, approaching the effects of child development, social disparities and contextualization of home environment on children's world and vulnerabilities. The main types of events that cause physical damage to the child and adolescent in the home environment are described. The prevention of injuries in the home environment is possible. In this case, health professionals have the challenge to reduce the consequences of unintentional injuries on the morbidity and mortality of children and young people in Brazil and in the whole world.

  12. Integrating environment, safety and health training at a national laboratory

    SciTech Connect

    Larson, D.R.

    1993-01-01

    In a multi-purpose research laboratory, innovation and creativity are required to satisfy the training requirements for hazards to people and the environment. A climate that encourages excellence in research and enhances hazard minimization skills is created by combining technical expertise with instructional design talent.

  13. Integrating environment, safety and health training at a national laboratory

    SciTech Connect

    Larson, D.R.

    1993-03-01

    In a multi-purpose research laboratory, innovation and creativity are required to satisfy the training requirements for hazards to people and the environment. A climate that encourages excellence in research and enhances hazard minimization skills is created by combining technical expertise with instructional design talent.

  14. Ion mobility spectrometry for food quality and safety.

    PubMed

    Vautz, W; Zimmermann, D; Hartmann, M; Baumbach, J I; Nolte, J; Jung, J

    2006-11-01

    Ion mobility spectrometry is known to be a fast and sensitive technique for the detection of trace substances, and it is increasingly in demand not only for protection against explosives and chemical warfare agents, but also for new applications in medical diagnosis or process control. Generally, a gas phase sample is ionized by help of ultraviolet light, ss-radiation or partial discharges. The ions move in a weak electrical field towards a detector. During their drift they collide with a drift gas flowing in the opposite direction and, therefore, are slowed down depending on their size, shape and charge. As a result, different ions reach the detector at different drift times, which are characteristic for the ions considered. The number of ions reaching the detector are a measure of the concentration of the analyte. The method enables the identification and quantification of analytes with high sensitivity (ng l(-1) range). The selectivity can even be increased - as necessary for the analyses of complex mixtures - using pre-separation techniques such as gas chromatography or multi-capillary columns. No pre-concentration of the sample is necessary. Those characteristics of the method are preserved even in air with up to a 100% relative humidity rate. The suitability of the method for application in the field of food quality and safety - including storage, process and quality control as well as the characterization of food stuffs - was investigated in recent years for a number of representative examples, which are summarized in the following, including new studies as well: (1) the detection of metabolites from bacteria for the identification and control of their growth; (2) process control in food production - beer fermentation being an example; (3) the detection of the metabolites of mould for process control during cheese production, for quality control of raw materials or for the control of storage conditions; (4) the quality control of packaging materials during

  15. [State surveillance and control of food quality and safety in USA].

    PubMed

    Berman, V A

    2003-01-01

    The article is dealt with organization of agencies of U.S. federal government responsible for control of food safety and quality. An organizational chart of the Food and Drug Administration (FDA) of Department of Health and Human services is shown in great details. The U.S. federal legislation on food safety and quality is also described. Legal terms and definitions set by Federal Food, Drug and Safety Act for food safety and quality as well as basis requirements set in U.S.A. for food operation facilities are also discussed.

  16. A quality and safety framework for point-of-care clinical guidelines.

    PubMed Central

    Fox, J.; Bury, J.

    2000-01-01

    The electronic dissemination of medical knowledge in the form of executable clinical guidelines and decision support systems must be accompanied by comprehensive methods for ensuring the quality of their knowledge content and their safety in use. This paper outlines a set of quality and safety requirements, and reviews three current guideline technologies, the Arden Syntax, GLIF and PROforma, against these requirements. The approaches used in these technologies have different strengths, and we propose a general framework for ensuring quality and safety that combines them. This framework brings together the normal documentation standards of medical publishing, rigorous design methods from software engineering, and active safety management techniques from artificial intelligence. PMID:11079882

  17. Maintaining space shuttle safety within an environment of change

    NASA Astrophysics Data System (ADS)

    Greenfield, Michael A.

    1999-09-01

    In the 10 years since the Challenger accident, NASA has developed a set of stable and capable processes to prepare the Space Shuttle for safe launch and return. Capitalizing on the extensive experience gained from a string of over 50 successful flights, NASA today is changing the way it does business in an effort to reduce cost. A single Shuttle Flight Operations Contractor (SFOC) has been chosen to operate the Shuttle. The Government role will change from direct "oversight" to "insight" gained through understanding and measuring the contractor's processes. This paper describes the program management changes underway and the NASA Safety and Mission Assurance (S&MA) organization's philosophy, role, and methodology for pursuing this new approach. It describes how audit and surveillance will replace direct oversight and how meaningful performance metrics will be implemented.

  18. Developing a quality and safety curriculum for fellows: lessons learned from a neonatology fellowship program.

    PubMed

    Gupta, Munish; Ringer, Steve; Tess, Anjala; Hansen, Anne; Zupancic, John

    2014-01-01

    Formal training in health care quality and safety has become an important component of medical education at all levels, and quality and safety are core concepts within the practice-based learning and system-based practice medical education competencies. Residency and fellowship programs are rapidly attempting to incorporate quality and safety curriculum into their training programs but have encountered numerous challenges and barriers. Many program directors have questioned the feasibility and utility of quality and safety education during this stage of training. In 2010, we adopted a quality and safety educational module in our neonatal fellowship program that sought to provide a robust and practical introduction to quality improvement and patient safety through a combination of didactic and experiential activities. Our module has been successfully integrated into the fellowship program's curriculum and has been beneficial to trainees, faculty, and our clinical services, and our experience suggests that fellowship may be particularly well suited to incorporation of quality and safety training. We describe our module and share tools and lessons learned during our experience; we believe these resources will be useful to other fellowship programs seeking to improve the quality and safety education of their trainees. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. 38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

  20. 38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

  1. 38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

  2. 38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary...

  3. 38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

  4. Investigating and improving pedestrian safety in an urban environment.

    PubMed

    Pollack, Keshia M; Gielen, Andrea C; Mohd Ismail, Mohd Nasir; Mitzner, Molly; Wu, Michael; Links, Jonathan M

    2014-12-01

    Prompted by a series of fatal and nonfatal pedestrian-vehicle collisions, university leadership from one urban institution collaborated with its academic injury research center to investigate traffic-related hazards facing pedestrians. This descriptive epidemiologic study used multiple data collection strategies to determine the burden of pedestrian injury in the target area. Data were collected in 2011 through a review of university crash reports from campus police; a systematic environmental audit and direct observations using a validated instrument and trained raters; and focus groups with faculty, students, and staff. Study findings were synthesized and evidence-informed recommendations were developed and disseminated to university leadership. Crash reports provided some indication of the risks on the streets adjacent to the campus. The environmental audit identified a lack of signage posting the speed limit, faded crosswalks, issues with traffic light and walk sign synchronization, and limited formal pedestrian crossings, which led to jaywalking. Focus groups participants described dangerous locations and times, signal controls and signage, enforcement of traffic laws, use of cell phones and iPods, and awareness of pedestrian safety. Recommendations to improve pedestrian safety were developed in accordance with the three E's of injury prevention (education, enforcement, and engineering), and along with plans for implementation and evaluation, were presented to university leadership. These results underscore the importance of using multiple methods to understand fully the problem, developing pragmatic recommendations that align with the three E's of injury prevention, and collaborating with leadership who have the authority to implement recommended injury countermeasures. These lessons are relevant for the many colleges and universities in urban settings where a majority of travel to offices, classrooms, and surrounding amenities are by foot.

  5. Measuring Safety Levels in Playgrounds Using Environment Assessment Scales: The Issue of Playground Safety in Greece

    ERIC Educational Resources Information Center

    Botsoglou, Kafenia; Hrisikou, Spyridoula; Kakana, Domna Mika

    2011-01-01

    Playgrounds beget an unrivalled context which, through play activity, can foster children's growth. The foremost function of all playgrounds is to provide for safety. In the present study, our primary focus is to determine the degree of adequacy as far as playground equipment is concerned, including estimates of imminent dangers and the level of…

  6. Measuring Safety Levels in Playgrounds Using Environment Assessment Scales: The Issue of Playground Safety in Greece

    ERIC Educational Resources Information Center

    Botsoglou, Kafenia; Hrisikou, Spyridoula; Kakana, Domna Mika

    2011-01-01

    Playgrounds beget an unrivalled context which, through play activity, can foster children's growth. The foremost function of all playgrounds is to provide for safety. In the present study, our primary focus is to determine the degree of adequacy as far as playground equipment is concerned, including estimates of imminent dangers and the level of…

  7. Best practices: an electronic drug alert program to improve safety in an accountable care environment.

    PubMed

    Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

    2015-04-01

    The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total

  8. Creating a Total Quality Environment (TQE) for Learning

    ERIC Educational Resources Information Center

    Freed, Jann E.

    2005-01-01

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

  9. Assessing the Quality of Early Years Learning Environments

    ERIC Educational Resources Information Center

    Walsh, Glenda; Gardner, John

    2005-01-01

    This article describes a means of evaluating early years classrooms from the perspective of the child's experience. Nine key themes, such as motivation and independence, are identified as representing significant aspects of a high-quality environment for learning. The manner in which these manifest themselves in relation to the three elements of…

  10. Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

    PubMed

    Pfeiffer, Yvonne; Schwappach, David

    2016-01-01

    National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

  11. Impact of Virtual Environments on Sensorimotor Coordination and User Safety

    NASA Technical Reports Server (NTRS)

    Harm, Deborah L.; Taylor, Laura C.; Kennedy, Robert S.; Reschke, Millard F.

    2011-01-01

    One critical unresolved issue related to the safe use of virtual environments (VEs) is maladaptive sensorimotor coordination following exposure to VEs. Moving visual displays used in VEs, especially in the absence of concordant vestibular signals leads to adaptive responses during VE exposure, but maladaptive responses following return to the normal environment. In the current set of investigations, we examined the effect of HMD and dome VE displays on eye-head-hand coordination, gaze holding and postural equilibrium. Subjects (61) performed a navigation and a pick and place task. Further, we compared 30 min and 60 min exposures across 3 days (each separated by 1 day). A subset of these results will be presented. In general, we found significant decrements in all three measures following exposure to the VEs. In addition, we found that these disturbances generally recovered within 1-2 hrs and decreased across days. These findings suggest the need for post-VE monitoring of sensorimotor coordination and for developing a set of recommendations for users concerning activities that are safe to engage in following use of a VE.

  12. Promoting safer home environments for persons with Alzheimer's disease. The Home Safety/Injury Model.

    PubMed

    Hurley, Ann C; Gauthier, Mary Anne; Horvath, Kathy J; Harvey, Rose; Smith, Sally J; Trudeau, Scott; Cipolloni, P B; Hendricks, Ann; Duffy, Mary

    2004-06-01

    This article describes a Home Safety/Injury Model derived from Social Cognitive Theory. The model's three components are safety platform, the person with dementia, and risky behaviors. The person with dementia is in the center, located on the safety platform composed of the physical environment and caregiver competence. The interaction between the underlying dementia and indicators of frailty can lead to the person with dementia performing risky behaviors that can overcome the safety platform's resources and lead to an accident or injury, and result in negative consequences. Through education and research, the model guides proactive actions to prevent risky behaviors of individuals with dementia by promoting safer home environments and increased caregiver competence.

  13. Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey.

    PubMed

    Gauld, Robin; Horsburgh, Simon

    2014-02-01

    Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance. Three previously used questions were adapted. A total of 41040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient. A 25% response rate delivered 10303 surveys. Fifty-seven percent of respondents (95% CI: 56-58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69-70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68-70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics. The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement. WHAT IS KNOWN ABOUT THE TOPIC? Various studies have explored aspects of healthcare quality and safety, generally within a hospital or

  14. ADSA Foundation Scholar Award: Trends in culture-independent methods for assessing dairy food quality and safety: emerging metagenomic tools.

    PubMed

    Yeung, Marie

    2012-12-01

    Enhancing the quality and safety of dairy food is critical to maintaining the competitiveness of dairy products in the food and beverage market and in reinforcing consumer confidence in the dairy industry. Raw milk quality has a significant effect on finished product quality. Several microbial groups found in raw milk have been shown to adversely affect the shelf life of pasteurized milk. Current microbiological criteria used to define milk quality are based primarily on culture-dependent methods, some of which are perceived to lack the desired sensitivity and specificity. To supplement traditional methods, culture-independent methods are increasingly being used to identify specific species or microbial groups, and to detect indicator genes or proteins in raw milk or dairy products. Some molecular subtyping techniques have been developed to track the transmission of microbes in dairy environments. The burgeoning "-omics" technologies offer new and exciting opportunities to enhance our understanding of food quality and safety in relation to microbes. Metagenomics has the potential to characterize microbial diversity, detect nonculturable microbes, and identify unique sequences or other factors associated with dairy product quality and safety. In this review, fluid milk will be used as the primary example to examine the adequacy and validity of conventional methods, the current trend of culture-independent methods, and the potential applications of metagenomics in dairy food research.

  15. Fostering Future Leadership in Quality and Safety in Health Care through Systems Thinking.

    PubMed

    Phillips, Janet M; Stalter, Ann M; Dolansky, Mary A; Lopez, Gloria McKee

    2016-01-01

    There is a critical need for leadership in quality and safety to reform today's disparate spectrum of health services to serve patients in complex health care environments. Nurse graduates of degree completion programs (registered nurse-bachelor of science in nursing [RN-BSN]) are poised for leadership due to their recent education and nursing practice experience. The authors propose that integration of systems thinking into RN-BSN curricula is essential for developing these much needed leadership skills. The purpose of this article is to introduce progressive teaching strategies to help nurse educators achieve the student competencies described in the second essential of the BSN Essentials document (American Association of Colleges of Nursing, 2009), linking them with the competencies in Quality and Safety Education for Nurses (QSEN; L. Cronenwett et al., 2007) using an author-created model for curricular design, the Systems-level Awareness Model. The Systems Thinking Tool (M. A. Dolansky & S. M. Moore, 2013) can be used to evaluate systems thinking in the RN-BSN curriculum.

  16. Decision support environment for medical product safety surveillance.

    PubMed

    Botsis, Taxiarchis; Jankosky, Christopher; Arya, Deepa; Kreimeyer, Kory; Foster, Matthew; Pandey, Abhishek; Wang, Wei; Zhang, Guangfan; Forshee, Richard; Goud, Ravi; Menschik, David; Walderhaug, Mark; Woo, Emily Jane; Scott, John

    2016-12-01

    We have developed a Decision Support Environment (DSE) for medical experts at the US Food and Drug Administration (FDA). The DSE contains two integrated systems: The Event-based Text-mining of Health Electronic Records (ETHER) and the Pattern-based and Advanced Network Analyzer for Clinical Evaluation and Assessment (PANACEA). These systems assist medical experts in reviewing reports submitted to the Vaccine Adverse Event Reporting System (VAERS) and the FDA Adverse Event Reporting System (FAERS). In this manuscript, we describe the DSE architecture and key functionalities, and examine its potential contributions to the signal management process by focusing on four use cases: the identification of missing cases from a case series, the identification of duplicate case reports, retrieving cases for a case series analysis, and community detection for signal identification and characterization.

  17. Fuzzy-algebra uncertainty analysis for abnormal-environment safety assessment

    SciTech Connect

    Cooper, J.A.

    1994-01-01

    Many safety (risk) analyses depend on uncertain inputs and on mathematical models chosen from various alternatives, but give fixed results (implying no uncertainty). Conventional uncertainty analyses help, but are also based on assumptions and models, the accuracy of which may be difficult to assure. Some of the models and assumptions that on cursory examination seem reasonable can be misleading. As a result, quantitative assessments, even those accompanied by uncertainty measures, can give unwarranted impressions of accuracy. Since analysis results can be a major contributor to a safety-measure decision process, risk management depends on relating uncertainty to only the information available. The uncertainties due to abnormal environments are even more challenging than those in normal-environment safety assessments, and therefore require an even more cautious approach. A fuzzy algebra analysis is proposed in this report that has the potential to appropriately reflect the information available and portray uncertainties well, especially for abnormal environments.

  18. Computer programming: quality and safety for neonatal parenteral nutrition orders.

    PubMed

    Huston, Robert K; Markell, Andrea M; McCulley, Elizabeth A; Marcus, Matthew J; Cohen, Howard S

    2013-08-01

    Computerized software programs reduce errors and increase consistency when ordering parenteral nutrition (PN). The purpose of this study was to evaluate the effectiveness of our computerized neonatal PN calculator ordering program in reducing errors and optimizing nutrient intake. This was a retrospective study of infants requiring PN during the first 2-3 weeks of life. Caloric, protein, calcium, and phosphorus intakes; days above and below amino acid (AA) goals; and PN ordering errors were recorded. Infants were divided into 3 groups by birth weight for analysis: ≤1000 g, 1001-1500 g, and >1500 g. Intakes and outcomes of infants before (2007) vs after (2009) implementation of the calculator for each group were compared. There were no differences in caloric, protein, or phosphorus intakes in 2007 vs 2009 in any group. Mean protein intakes were 97%-99% of goal for ≤1000-g and 1001- to 1500-g infants in 2009 vs 87% of goal for each group in 2007. In 2007, 7.6 per 100 orders were above and 11.5 per 100 were below recommended AA intakes. Calcium intakes were higher in 2009 vs 2007 in ≤1000-g (46.6 ± 6.1 vs 39.5 ± 8.0 mg/kg/d, P < .001) and >1500-g infants (50.6 ± 7.4 vs 39.9 ± 8.3 mg/kg/d, P < .001). Ordering errors were reduced from 4.6 per 100 in 2007 to 0.1 per 100 in 2009. Our study reaffirms that computerized ordering systems can increase the quality and safety of neonatal PN orders. Calcium and AA intakes were optimized and ordering errors were minimized using the computer-based ordering program.

  19. The School Assessment for Environmental Typology (SAfETy): An Observational Measure of the School Environment.

    PubMed

    Bradshaw, Catherine P; Milam, Adam J; Furr-Holden, C Debra M; Johnson, Sarah Lindstrom

    2015-12-01

    School safety is of great concern for prevention researchers, school officials, parents, and students, yet there are a dearth of assessments that have operationalized school safety from an organizational framework using objective tools and measures. Such a tool would be important for deriving unbiased assessments of the school environment, which in turn could be used as an evaluative tool for school violence prevention efforts. The current paper presents a framework for conceptualizing school safety consistent with Crime Prevention through Environmental Design (CPTED) model and social disorganization theory, both of which highlight the importance of context as a driver for adolescents' risk for involvement in substance use and violence. This paper describes the development of a novel observational measure, called the School Assessment for Environmental Typology (SAfETy), which applies CPTED and social disorganizational frameworks to schools to measure eight indicators of school physical and social environment (i.e., disorder, trash, graffiti/vandalism, appearance, illumination, surveillance, ownership, and positive behavioral expectations). Drawing upon data from 58 high schools, we provide preliminary data regarding the validity and reliability of the SAfETy and describe patterns of the school safety indicators. Findings demonstrate the reliability and validity of the SAfETy and are discussed with regard to the prevention of violence in schools.

  20. Optical sensing technologies for rapid food safety and quality inspection

    USDA-ARS?s Scientific Manuscript database

    Public concerns for food safety and foodborne illness have risen in recent years. There is a need to expand efforts to prevent and mitigate any food contamination that can potentially be harmful to human health. Researchers at the Environmental Microbial and Food Safety Laboratory, ARS, USDA is one...

  1. Safety and Efficacy of Thoracostomy in the Air Medical Environment.

    PubMed

    High, Kevin; Brywczynski, Jeremy; Guillamondegui, Oscar

    2016-01-01

    The use of thoracostomy to treat tension pneumothorax is a core skill for prehospital providers. Tension pneumothoraces are potentially lethal and are often encountered in the prehospital environment. The authors reviewed the prehospital electronic medical records of patients who had undergone finger thoracostomy (FT) or tube thoracostomy (TT) while under the care of air medical crewmembers. Demographic data were obtained along with survival and complications. During the 90-month data period, 250 patients (18 years of age or older) underwent FT/TT, with a total of 421 procedures performed. The mean age of patients was 44.8 years, with 78.4% being male and 21.6% being female; 98.4% of patients had traumatic injuries. Cardiopulmonary resuscitation was required in 65.2% of patients undergoing FT/TT; 34.8% did not require cardiopulmonary resuscitation. Thirty percent of patients exhibited clinical improvement such as increasing systolic blood pressure, oxygen saturation, improved lung compliance, or a release of blood or air under tension. Patients who experienced complications such as tube dislodgement or empyema made up 3.4% of the cohort. The results of this study suggest that flight crews can use FT/TT in their practice on patients with actual or potential pneumothoraces with limited complications and generate clinical improvement in a subset of patients. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  2. Foodborne pathogens in milk and the dairy farm environment: food safety and public health implications.

    PubMed

    Oliver, S P; Jayarao, B M; Almeida, R A

    2005-01-01

    Milk and products derived from milk of dairy cows can harbor a variety of microorganisms and can be important sources of foodborne pathogens. The presence of foodborne pathogens in milk is due to direct contact with contaminated sources in the dairy farm environment and to excretion from the udder of an infected animal. Most milk is pasteurized, so why should the dairy industry be concerned about the microbial quality of bulk tank milk? There are several valid reasons, including (1) outbreaks of disease in humans have been traced to the consumption of unpasteurized milk and have also been traced back to pasteurized milk, (2) unpasteurized milk is consumed directly by dairy producers, farm employees, and their families, neighbors, and raw milk advocates, (3) unpasteurized milk is consumed directly by a large segment of the population via consumption of several types of cheeses manufactured from unpasteurized milk, (4) entry of foodborne pathogens via contaminated raw milk into dairy food processing plants can lead to persistence of these pathogens in biofilms, and subsequent contamination of processed milk products and exposure of consumers to pathogenic bacteria, (5) pasteurization may not destroy all foodborne pathogens in milk, and (6) inadequate or faulty pasteurization will not destroy all foodborne pathogens. Furthermore, pathogens such as Listeria monocytogenes can survive and thrive in post-pasteurization processing environments, thus leading to recontamination of dairy products. These pathways pose a risk to the consumer from direct exposure to foodborne pathogens present in unpasteurized dairy products as well as dairy products that become re-contaminated after pasteurization. The purpose of this communication is to review literature published on the prevalence of bacterial foodborne pathogens in milk and in the dairy environment, and to discuss public health and food safety issues associated with foodborne pathogens found in the dairy environment

  3. Analysis of Aviation Safety Reporting System Incident Data Associated with the Technical Challenges of the Atmospheric Environment Safety Technology Project

    NASA Technical Reports Server (NTRS)

    Withrow, Colleen A.; Reveley, Mary S.

    2014-01-01

    This study analyzed aircraft incidents in the NASA Aviation Safety Reporting System (ASRS) that apply to two of the three technical challenges (TCs) in NASA's Aviation Safety Program's Atmospheric Environment Safety Technology Project. The aircraft incidents are related to airframe icing and atmospheric hazards TCs. The study reviewed incidents that listed their primary problem as weather or environment-nonweather between 1994 and 2011 for aircraft defined by Federal Aviation Regulations (FAR) Parts 121, 135, and 91. The study investigated the phases of flight, a variety of anomalies, flight conditions, and incidents by FAR part, along with other categories. The first part of the analysis focused on airframe-icing-related incidents and found 275 incidents out of 3526 weather-related incidents over the 18-yr period. The second portion of the study focused on atmospheric hazards and found 4647 incidents over the same time period. Atmospheric hazards-related incidents included a range of conditions from clear air turbulence and wake vortex, to controlled flight toward terrain, ground encounters, and incursions.

  4. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Integration of environment... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  5. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Integration of environment... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  6. 30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., property, and the environment? 250.107 Section 250.107 Mineral Resources MINERALS MANAGEMENT SERVICE... Performance Standards § 250.107 What must I do to protect health, safety, property, and the environment? (a) You must protect health, safety, property, and the environment by: (1) Performing all operations in a...

  7. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Integration of environment... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  8. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Integration of environment... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  9. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Integration of environment... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  10. Implementing a patient safety and quality program across two merged pediatric institutions.

    PubMed

    Abramson, Erika; Hyman, Daniel; Osorio, S Nena; Kaushal, Rainu

    2009-01-01

    Academic centers are among the health care organizations that have used consolidation as a strategy to improve efficiency and reduce costs. In 1997, the New York Hospital and The Presbyterian Hospital underwent a full-asset merger to become New York City's largest medical center, known as the New York-Presbyterian Hospital (NYPH). In 2006, recognition of the challenges of the Children's Service Line at NYPH led to the formation of a Patient Safety and Quality Program to deliver consistently safe and effective health care. Each campus has a children's quality council, an interdisciplinary group that discusses and prioritizes safety and quality issues. The quality councils from each campus report directly to a bicampus children's quality steering committee formed to ensure that similar safety practices and standards are implemented across both children's hospitals. A safety subcommittee, which primarily coordinates and follows up on leadership safety walk rounds, and a significant-events subcommittee, which reviews morbidities and mortalities, report to each hospital's quality council. The bicampus pediatric quality and safety program is organized around five broad themes: improving the culture of safety, reducing the frequency of health care-acquired infections, reducing harm in the health care setting, using information technology to improve the quality and safety of care provided to patients and families, and measuring the effectiveness of care in key areas. Two sample initiatives--building family engagement and prevention of adverse medication events--illustrate the program's successes and challenges. Developing a pediatric safety and quality program across two campuses has been challenging but has led to important improvements at both organizations.

  11. Degraded visual environment image/video quality metrics

    NASA Astrophysics Data System (ADS)

    Baumgartner, Dustin D.; Brown, Jeremy B.; Jacobs, Eddie L.; Schachter, Bruce J.

    2014-06-01

    A number of image quality metrics (IQMs) and video quality metrics (VQMs) have been proposed in the literature for evaluating techniques and systems for mitigating degraded visual environments. Some require both pristine and corrupted imagery. Others require patterned target boards in the scene. None of these metrics relates well to the task of landing a helicopter in conditions such as a brownout dust cloud. We have developed and used a variety of IQMs and VQMs related to the pilot's ability to detect hazards in the scene and to maintain situational awareness. Some of these metrics can be made agnostic to sensor type. Not only are the metrics suitable for evaluating algorithm and sensor variation, they are also suitable for choosing the most cost effective solution to improve operating conditions in degraded visual environments.

  12. Building on a safety culture with transparency by participating in a mentored quality-improvement program for insulin pen safety.

    PubMed

    Botsford, Julie A

    2016-10-01

    The experience at a medium-sized regional medical center participating in the ASHP MENTORED QUALITY IMPROVEMENT IMPACT PROGRAM℠ (MQIIP) on Insulin Pen Safety in Hospitals is described. With the support of top hospital leaders, Munson Medical Center (MMC) applied in June 2014 to participate in the MQIIP to complement its ongoing risk assessment related to the use of pen devices for insulin administration. Nurse knowledge deficits, problems with insulin pen storage and labeling, and improper insulin injection practices identified in baseline assessments for the MQIIP were the basis for process improvements, including new policies and procedures, an electronic alert and education for nurses, and individualized communication with pharmacy and nursing personnel about insulin pen safety. The experiences of other hospitals helped us identify solutions to safety issues and formulate communication strategies for improving insulin pen safety in our hospital. Awareness of the importance of insulin pen safety increased in all staff. Implementing these process improvements during the five-month intervention period resulted in increases in nurse knowledge and improvements in insulin pen storage, labeling, and injection practices, although problems persisted. Additional plans have been made to further enhance the safety of insulin use at MMC. The ASHP MQIIP on Insulin Pen Safety in Hospitals provided a structured and supportive approach to identifying and addressing insulin pen safety issues at MMC. The insight gained through participation enabled us to devise strategies to communicate with staff about safety issues and improve the safety of insulin pen use in the institution. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. [Principles and applications of hyperspectral imaging technique in quality and safety inspection of fruits and vegetables].

    PubMed

    Zhang, Bao-Hua; Li, Jiang-Bo; Fan, Shu-Xiang; Huang, Wen-Qian; Zhang, Chi; Wang Qing-Yan; Xiao, Guang-Dong

    2014-10-01

    The quality and safety of fruits and vegetables are the most concerns of consumers. Chemical analytical methods are traditional inspection methods which are time-consuming and labor intensive destructive inspection techniques. With the rapid development of imaging technique and spectral technique, hyperspectral imaging technique has been widely used in the nondestructive inspection of quality and safety of fruits and vegetables. Hyperspectral imaging integrates the advantages of traditional imaging and spectroscopy. It can obtain both spatial and spectral information of inspected objects. Therefore, it can be used in either external quality inspection as traditional imaging system, or internal quality or safety inspection as spectroscopy. In recent years, many research papers about the nondestructive inspection of quality and safety of fruits and vegetables by using hyperspectral imaging have been published, and in order to introduce the principles of nondestructive inspection and track the latest research development of hyperspectral imaging in the nondestructive inspection of quality and safety of fruits and vegetables, this paper reviews the principles, developments and applications of hyperspectral imaging in the external quality, internal quality and safety inspection of fruits and vegetables. Additionally, the basic components, analytical methods, future trends and challenges are also reported or discussed in this paper.

  14. ABCs of Safety and Quality for the Pediatric Resident and Fellow.

    PubMed

    Mathias, Emily; Sethuraman, Usha

    2016-04-01

    The role of resident and fellow trainees in patient-centered improvement processes is critical to a health care system's success. There is a growing impetus to incorporate patient safety and quality improvement into the educational framework of physicians in training. As part of the Next Accreditation System, practice-based learning and improvement and systems-based practice domains mandate that residents and fellows be assessed on their ability to enhance the quality of care and advocate for patient safety. Best practices for incorporating quality improvement and patient safety into the curriculum of residents and fellows remains an area of interest for educators. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. [Demonstration of quality, safety and efficacy of biological products subject to changes in their manufacturing process].

    PubMed

    Vasil'ev, A N; Gavrishina, E V; Niiazov, R R; Snegireva, A A; Adonin, V K

    2013-01-01

    Ensuring quality, safety and efficacy of the medicinal products placed on the market of the Russian Federation constitutes the area that requires strict regulation. When changes are made to the manufacturing process, the manufacturer generally needs to evaluate the relevant quality attributes of the product to demonstrate that modifications did not occur that would adversely impact the safety and efficacy of the drug. Where there is the lack of a sound legal basis, there is a need in harmonization of current Russian legislation with international and European rules governing medicinal product for human use to ensure quality, safety and efficacy thereof.

  16. Patient safety and quality of care in mental health: a world of its own?

    PubMed

    D'Lima, Danielle; Crawford, Mike J; Darzi, Ara; Archer, Stephanie

    2017-10-01

    Quality and safety in healthcare, as an academic discipline, has made significant progress over recent decades, and there is now an active and established community of researchers and practitioners. However, work has predominantly focused on physical health, despite broader controversy regarding the attention paid to, and significance attributed to, mental health. Work from both communities is required in order to ensure that quality and safety is actively embedded within mental health research and practice and that the academic discipline of quality and safety accurately represents the scientific knowledge that has been accumulated within the mental health community.

  17. Proceedings from the 2008 Wisconsin Quality and Safety Forum, part II.

    PubMed

    2009-02-01

    In 2008, quality and safety improvement initiatives in Wisconsin focused on developing an organization-wide culture of quality, and implementing processes to improve patient care and satisfaction. Below are descriptions of improvement projects undertaken by hospitals and other health care organizations, and showcased at the 2008 Wisconsin Quality & Safety Forum. The projects are broken into 6 categories: clinical improvement, customer service, infection control, medications, performance improvement, and safety. The first 3 categories appeared in Issue 8 of Volume 107 of the Wisconsin Medical Journal. (WMJ. 2008;107[8]:382-388).

  18. Quality management and perceptions of teamwork and safety climate in European hospitals.

    PubMed

    Kristensen, Solvejg; Hammer, Antje; Bartels, Paul; Suñol, Rosa; Groene, Oliver; Thompson, Caroline A; Arah, Onyebuchi A; Kutaj-Wasikowska, Halina; Michel, Philippe; Wagner, Cordula

    2015-12-01

    This study aimed to investigate the associations of quality management systems with teamwork and safety climate, and to describe and compare differences in perceptions of teamwork climate and safety climate among clinical leaders and frontline clinicians. We used a multi-method, cross-sectional approach to collect survey data of quality management systems and perceived teamwork and safety climate. Our data analyses included descriptive and multilevel regression methods. Data on implementation of quality management system from seven European countries were evaluated including patient safety culture surveys from 3622 clinical leaders and 4903 frontline clinicians. Perceived teamwork and safety climate. Teamwork climate was reported as positive by 67% of clinical leaders and 43% of frontline clinicians. Safety climate was perceived as positive by 54% of clinical leaders and 32% of frontline clinicians. We found positive associations between implementation of quality management systems and teamwork and safety climate. Our findings, which should be placed in a broader clinical quality improvement context, point to the importance of quality management systems as a supportive structural feature for promoting teamwork and safety climate. To gain a deeper understanding of this association, further qualitative and quantitative studies using longitudinally collected data are recommended. The study also confirms that more clinical leaders than frontline clinicians have a positive perception of teamwork and safety climate. Such differences should be accounted for in daily clinical practice and when tailoring initiatives to improve teamwork and safety climate. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  19. Poor sleep quality affects spatial orientation in virtual environments.

    PubMed

    Valera, Silvana; Guadagni, Veronica; Slone, Edward; Burles, Ford; Ferrara, Michele; Campbell, Tavis; Iaria, Giuseppe

    2016-01-01

    Sleep is well known to have a significant impact on learning and memory. Specifically, studies adopting an experimentally induced sleep loss protocol in healthy individuals have provided evidence that the consolidation of spatial memories, as acquired through navigating and orienteering in spatial surroundings, is negatively affected by total sleep loss. Here, we used both objective and subjective measures to characterize individuals' quality of sleep, and grouped participants into either a poor (insomnia-like) or normal (control) sleep quality group. We asked participants to solve a wayfinding task in a virtual environment, and scored their performance by measuring the time spent to reach a target location and the number of wayfinding errors made while navigating. We found that participants with poor sleep quality were slower and more error-prone than controls in solving the task. These findings provide novel evidence that pre-existing sleep deficiencies in otherwise healthy individuals affects negatively the ability to learn novel routes, and suggest that sleep quality should be accounted for among healthy individuals performing experimental spatial orientation tasks in virtual environments.

  20. Energy systems programs funded by the Assistant Secretary for Environment, Safety and Health: FY 1993--FY 1994

    SciTech Connect

    Buttram, A.W.

    1994-12-31

    This document presents an overview of work at Martin Marietta Energy Systems, Inc., (Energy Systems) during FY 1993--FY 1994 that was funded by the Department of Energy`s (DOE`s) Assistant Secretary for Environment, Safety and Health (ASEH). To illustrate the programmatic breadth of Energy Systems and to establish the context within which this work was accomplished, this document also includes representative descriptions of ASEH-related work at Energy Systems done for other sponsors. Activities for ASEH cover a wide variety of subjects that are geared towards the environmental, safety, and health aspects of DOE operations. Subjects include the following: environmental compliance, environmental guidance, environmental audits, NEPA oversight, epidemiology and health surveillance, transportation and packaging safety, safety and quality assurance; technical standards, performance indicators, occurrence reporting, health physics instrumentation, risk management, security evaluations, and medical programs. The technical support section describes work in progress for ASEH, including specific program accomplishments. The work for others section describes work for non-ASEH sponsors that reinforces and supplements the ASEH work. Appendix A includes a list of FY 1993--FY 1994 publications related to the ASEH work.

  1. The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis.

    PubMed

    Salyers, Michelle P; Bonfils, Kelsey A; Luther, Lauren; Firmin, Ruth L; White, Dominique A; Adams, Erin L; Rollins, Angela L

    2017-04-01

    Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare. Publications were identified through targeted literature searches in Ovid MEDLINE, PsycINFO, Web of Science, CINAHL, and ProQuest Dissertations & Theses through March of 2015. Two coders extracted data to calculate effect sizes and potential moderators. We calculated Pearson's r for all independent relationships between burnout and quality measures, using a random effects model. Data were assessed for potential impact of study rigor, outliers, and publication bias. Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = -0.26, 95 % CI [-0.29, -0.23]) and safety (r = -0.23, 95 % CI [-0.28, -0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients. Moderators for the quality relationship included dimension of burnout, unit of analysis, and quality data source. Moderators for the relationship between burnout and safety were safety indicator type, population, and country. Rigor of the study was not a significant moderator. This is the first study to systematically, quantitatively analyze the links between healthcare provider burnout and healthcare quality and safety across disciplines. Provider burnout shows consistent negative relationships with perceived quality (including patient satisfaction), quality indicators, and perceptions of safety. Though the effects are small to medium, the findings highlight the importance of effective burnout interventions for

  2. Impact of Performance Obstacles on Intensive Care Nurses‘ Workload, Perceived Quality and Safety of Care, and Quality of Working Life

    PubMed Central

    Gurses, Ayse P; Carayon, Pascale; Wall, Melanie

    2009-01-01

    Objectives To study the impact of performance obstacles on intensive care nurses‘ workload, quality and safety of care, and quality of working life (QWL). Performance obstacles are factors that hinder nurses‘ capacity to perform their job and that are closely associated with their immediate work system. Data Sources/Study Setting Data were collected from 265 nurses in 17 intensive care units (ICUs) between February and August 2004 via a structured questionnaire, yielding a response rate of 80 percent. Study Design A cross-sectional study design was used. Data were analyzed by correlation analyses and structural equation modeling. Principal Findings Performance obstacles were found to affect perceived quality and safety of care and QWL of ICU nurses. Workload mediated the impact of performance obstacles with the exception of equipment-related issues on perceived quality and safety of care as well as QWL. Conclusions Performance obstacles in ICUs are a major determinant of nursing workload, perceived quality and safety of care, and QWL. In general, performance obstacles increase nursing workload, which in turn negatively affect perceived quality and safety of care and QWL. Redesigning the ICU work system to reduce performance obstacles may improve nurses‘ work. PMID:19207589

  3. Assessing Quality and Safety in Pediatric Supracondylar Humerus Fracture Care.

    PubMed

    Iobst, Christopher A; Stillwagon, Matthew; Ryan, Deidre; Shirley, Eric; Frick, Steven L

    Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons. An 88-question survey incorporating the ABOS PIQ was administered to 35 pediatric orthopaedic surgeons at 3 institutions. A retrospective chart review of patients who received operative management of a PSCHF during 2013 was performed. Each of the 17 eligible surgeons supplied 5 patients for a total of 85 patients. Medical records and radiographic imaging were reviewed using the ABOS PIQ data collection sheet. This data collection sheet encompasses the preoperative assessment, intraoperative treatment and assessment, and clinical and radiographic outcomes of patients with PSCHF. A total of 35 surgeons from 6 hospitals completed the online PSCHF survey. Uniform consensus among all 35 surgeons was identified in 21/79 of the questions (27%). Consensus among surgeons within a hospital group but not with surgeons from the other groups was identified in 39/79 (49%) of the questions. No consensus among the surveyed surgeons could be identified in 19/79 (24%) of the questions. For the 85 PSCHF patients the average age was 6 years, and 37% of fractures were type II, 57% of fractures were type III, and there was 1 flexion type. Ninety percent of the patients received a preoperative dose of antibiotics and the postoperative immobilization placed in the operating room was changed in the clinic before pin removal in 58% of the cases. Pins were removed at 3 weeks in 60%, 4 weeks in 30%, 5 weeks in 7%, and after 5 weeks in 3% of the patients and no malunions occurred. Pin tract infection

  4. Radiology Research in Quality and Safety: Current Trends and Future Needs.

    PubMed

    Zygmont, Matthew E; Itri, Jason N; Rosenkrantz, Andrew B; Duong, Phuong-Anh T; Mankowski Gettle, Lori; Mendiratta-Lala, Mishal; Scali, Elena P; Winokur, Ronald S; Probyn, Linda; Kung, Justin W; Bakow, Eric; Kadom, Nadja

    2017-03-01

    Promoting quality and safety research is now essential for radiology as reimbursement is increasingly tied to measures of quality, patient safety, efficiency, and appropriateness of imaging. This article provides an overview of key features necessary to promote successful quality improvement efforts in radiology. Emphasis is given to current trends and future opportunities for directing research. Establishing and maintaining a culture of safety is paramount to organizations wishing to improve patient care. The correct culture must be in place to support quality initiatives and create accountability for patient care. Focused educational curricula are necessary to teach quality and safety-related skills and behaviors to trainees, staff members, and physicians. The increasingly complex healthcare landscape requires that organizations build effective data infrastructures to support quality and safety research. Incident reporting systems designed specifically for medical imaging will benefit quality improvement initiatives by identifying and learning from system errors, enhancing knowledge about safety, and creating safer systems through the implementation of standardized practices and standards. Finally, validated performance measures must be developed to accurately reflect the value of the care we provide for our patients and referring providers. Common metrics used in radiology are reviewed with focus on current and future opportunities for investigation. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  5. Nurse qualifications and perceptions of patient safety and quality of care in South Africa.

    PubMed

    Blignaut, Alwiena J; Coetzee, Siedine K; Klopper, Hester C

    2014-06-01

    A plethora of research links professional nurses' qualifications to patient outcomes. Also, research has shown that reports by nurses on the quality of care correspond with process or outcome measures of quality in a hospital. New to the debate is whether professional nurses' qualifications impact on their perceptions of patient safety and quality of care. This research aims to investigate professional nurses' perceptions of patient safety and quality of care in South Africa, and the relationship between these perceptions and professional nurses' qualifications. A cross-sectional survey of 1117 professional nurses from medical and surgical units of 55 private and 7 public hospitals was conducted. Significant problems with regard to nurse-perceived patient safety and quality of care were identified, while adverse incidents in patients and professional nurses were underreported. Qualifications had no correlation with perceptions of patient safety and quality of care, although perceptions may serve as a valid indicator of patient outcomes. Creating an organizational culture that is committed to patient safety and encourages the sharing of adverse incidents will contribute to patient safety and quality of care in hospitals. © 2013 Wiley Publishing Asia Pty Ltd.

  6. A perinatal care quality and safety initiative: are there financial rewards for improved quality?

    PubMed

    Kozhimannil, Katy B; Sommerness, Samantha A; Rauk, Phillip; Gams, Rebecca; Hirt, Charles; Davis, Stanley; Miller, Kristi K; Landers, Daniel V

    2013-08-01

    Although costs of providing care may decrease with hospital initiatives to improve obstetric and neonatal outcomes, the accompanying reduced adverse outcomes may negatively affect hospital revenues. In 2008 a Minnesota-based hospital system (Fairview Health Services) launched the Zero Birth Injury (ZBI) initiative, which used evidence-based care bundles to guide management of obstetric services. A pre-post analysis of financial impacts of ZBI was conducted by using hospital administrative records to measure costs and revenues associated with changes in maternal and neonatal birth injuries before (2008) and after (2009-2011) the initiative. For the Fairview Health Services hospitals, after adjusting for relevant covariates, implementation of ZBI was associated with a mean 11% decrease in the rate of maternal and neonatal adverse outcomes between 2008 and 2011 (adjusted odds ratio [AOR] = 0.89, p = .076). As a result of the adverse events avoided, the hospital system saved $284,985 in costs but earned $324,333 less revenue, which produced a net financial decrease of $39,348 (or a $305 net financial loss per adverse event avoided) in 2011, compared with 2008. Adoption of a perinatal quality and safety initiative that reduced birth injuries had little net financial impact on the hospital. ZBI produced better clinical results at a lower cost, which represents potential savings for payers, but the hospital system offering improved quality reaped no clear financial rewards. These results highlight the important role for shared-savings collaborations (among patients, providers, government and third-party payers, and employers) to incentivize QI. Widespread adoption of perinatal safety initiatives combined with innovative payment models may contribute to better health at reduced cost.

  7. Perceptions of Psychological and Physical Safety Environments of Information Technology Employees: A Phenomenological Study

    ERIC Educational Resources Information Center

    Payne, Sheila C.

    2012-01-01

    A qualitative phenomenological study was conducted to gain a deeper understanding of psychological and safety environments of an oil and gas multinational enterprise. Twenty information technology professionals were interviewed to explore their feelings, perceptions, beliefs, and values of the phenomenon. The interviews elicited data about facets…

  8. Measuring School Climate in High Schools: A Focus on Safety, Engagement, and the Environment

    ERIC Educational Resources Information Center

    Bradshaw, Catherine P.; Waasdorp, Tracy E.; Debnam, Katrina J.; Johnson, Sarah Lindstrom

    2014-01-01

    Background: School climate has been linked to multiple student behavioral, academic, health, and social-emotional outcomes. The US Department of Education (USDOE) developed a 3-factor model of school climate comprised of safety, engagement, and environment. This article examines the factor structure and measurement invariance of the USDOE model.…

  9. Measuring School Climate in High Schools: A Focus on Safety, Engagement, and the Environment

    ERIC Educational Resources Information Center

    Bradshaw, Catherine P.; Waasdorp, Tracy E.; Debnam, Katrina J.; Johnson, Sarah Lindstrom

    2014-01-01

    Background: School climate has been linked to multiple student behavioral, academic, health, and social-emotional outcomes. The US Department of Education (USDOE) developed a 3-factor model of school climate comprised of safety, engagement, and environment. This article examines the factor structure and measurement invariance of the USDOE model.…

  10. The Joint Commission: an update on the environment of care and life safety challenges for 2011.

    PubMed

    Samet, Dean H

    2012-01-01

    In this article, the author, one of country's leading healthcare regulatory compliance services executives, describes the powers to withdraw Medicare reimbursement given to The Joint Commission and how they are exercised, especially in the areas of Environment of Care and Life Safety.

  11. Perceptions of Psychological and Physical Safety Environments of Information Technology Employees: A Phenomenological Study

    ERIC Educational Resources Information Center

    Payne, Sheila C.

    2012-01-01

    A qualitative phenomenological study was conducted to gain a deeper understanding of psychological and safety environments of an oil and gas multinational enterprise. Twenty information technology professionals were interviewed to explore their feelings, perceptions, beliefs, and values of the phenomenon. The interviews elicited data about facets…

  12. Role of a quality management system in improving patient safety - laboratory aspects.

    PubMed

    Allen, Lynn C

    2013-09-01

    The aim of this study is to describe how implementation of a quality management system (QMS) based on ISO 15189 enhances patient safety. A literature review showed that several European hospitals implemented a QMS based on ISO 9001 and assessed the impact on patient safety. An Internet search showed that problems affecting patient safety have occurred in a number of laboratories across Canada. The requirements of a QMS based on ISO 15189 are outlined, and the impact of the implementation of each requirement on patient safety is summarized. The Quality Management Program - Laboratory Services in Ontario is briefly described, and the experience of Ontario laboratories with Ontario Laboratory Accreditation, based on ISO 15189, is outlined. Several hospitals that implemented ISO 9001 reported either a positive impact or no impact on patient safety. Patient safety problems in Canadian laboratories are described. Implementation of each requirement of the QMS can be seen to have a positive effect on patient safety. Average laboratory conformance on Ontario Laboratory Accreditation is very high, and laboratories must address and resolve any nonconformities. Other standards, practices, and quality requirements may also contribute to patient safety. Implementation of a QMS based on ISO 15189 provides a solid foundation for quality in the laboratory and enhances patient safety. It helps to prevent patient safety issues; when such issues do occur, effective processes are in place for investigation and resolution. Patient safety problems in Canadian laboratories might have been prevented had effective QMSs been in place. Ontario Laboratory Accreditation has had a positive impact on quality in Ontario laboratories. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  13. High speed railway environment safety evaluation based on measurement attribute recognition model.

    PubMed

    Hu, Qizhou; Gao, Ningbo; Zhang, Bing

    2014-01-01

    In order to rationally evaluate the high speed railway operation safety level, the environmental safety evaluation index system of high speed railway should be well established by means of analyzing the impact mechanism of severe weather such as raining, thundering, lightning, earthquake, winding, and snowing. In addition to that, the attribute recognition will be identified to determine the similarity between samples and their corresponding attribute classes on the multidimensional space, which is on the basis of the Mahalanobis distance measurement function in terms of Mahalanobis distance with the characteristics of noncorrelation and nondimensionless influence. On top of the assumption, the high speed railway of China environment safety situation will be well elaborated by the suggested methods. The results from the detailed analysis show that the evaluation is basically matched up with the actual situation and could lay a scientific foundation for the high speed railway operation safety.

  14. High Speed Railway Environment Safety Evaluation Based on Measurement Attribute Recognition Model

    PubMed Central

    Hu, Qizhou; Zhang, Bing

    2014-01-01

    In order to rationally evaluate the high speed railway operation safety level, the environmental safety evaluation index system of high speed railway should be well established by means of analyzing the impact mechanism of severe weather such as raining, thundering, lightning, earthquake, winding, and snowing. In addition to that, the attribute recognition will be identified to determine the similarity between samples and their corresponding attribute classes on the multidimensional space, which is on the basis of the Mahalanobis distance measurement function in terms of Mahalanobis distance with the characteristics of noncorrelation and nondimensionless influence. On top of the assumption, the high speed railway of China environment safety situation will be well elaborated by the suggested methods. The results from the detailed analysis show that the evaluation is basically matched up with the actual situation and could lay a scientific foundation for the high speed railway operation safety. PMID:25435866

  15. Learning environment: the impact of clerkship location on instructional quality.

    PubMed

    Prunuske, Jacob P; Deci, David M

    2013-03-01

    Students provide variable feedback on instructional quality at ambulatory training sites. We hypothesized several strengths and weaknesses of placing students at resident and non-resident training sites, including differences in faculty behaviors, patient characteristics, work environment, learning opportunities, and levels of student engagement. We systematically assessed for differences in learning quality between clerkship sites with and without residents. Students completed the MedED IQ, a validated survey assessing four domains of instructional quality, after completing a required primary care rotation. We calculated descriptive and summary statistics and two sample tests of proportion analyzing student agreement with each MedEd IQ item with respect to the presence or absence of resident learners. Of 149 total, 113 (75.8%) students completed the MedEd IQ site survey. A greater percentage of students at resident training sites (25.8%) than at non-resident sites (7.3%) agreed with the statement "The opportunities were too diverse, preventing me from developing proficiency." A greater percentage of students at resident training sites (19.4%) than at non-resident sites (1.2%) agreed with the statement "The health care team was not supportive of my learning." There were no differences between sites with or without residents on 14 items measuring preceptor actions or seven items measuring student involvement. Ambulatory clerkship sites with and without residents provide comparable quality learning experiences and precepting. Students placed at resident training sites may be overwhelmed with diverse opportunities and have a less supportive learning environment than students placed at non-resident sites. Future research should evaluate the impact of health care team development programs designed to foster a more supportive training environment for medical students. Ways of aligning residency and medical student education goals within the training setting should be

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

    PubMed

    Waßmuth, Ralf

    2015-01-01

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

  17. Design of agricultural product quality safety retrospective supervision system of Jiangsu province

    NASA Astrophysics Data System (ADS)

    Wang, Kun

    2017-08-01

    In store and supermarkets to consumers can trace back agricultural products through the electronic province card to query their origin, planting, processing, packaging, testing and other important information and found that the problems. Quality and safety issues can identify the responsibility of the problem. This paper designs a retroactive supervision system for the quality and safety of agricultural products in Jiangsu Province. Based on the analysis of agricultural production and business process, the goal of Jiangsu agricultural product quality safety traceability system construction is established, and the specific functional requirements and non-functioning requirements of the retroactive system are analyzed, and the target is specified for the specific construction of the retroactive system. The design of the quality and safety traceability system in Jiangsu province contains the design of the overall design, the trace code design and the system function module.

  18. 30 CFR 250.806 - Safety and pollution prevention equipment quality assurance requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false Safety and pollution prevention equipment... pollution prevention equipment quality assurance requirements. (a) General requirements. (1) Except as provided in paragraph (b)(1) of this section, you may install only certified safety and pollution...

  19. Reducing Central Line-Associated Bloodstream Infection Rates in the Context of a Caring-Healing Environment: A Patient Safety Program Evaluation.

    PubMed

    Hanson, Daphne

    Central line-associated bloodstream infections (CLABSIs) prove to be detrimental to both the patient and the hospital. The present study was a quality improvement training project to affect CLABSI rates in the cardiac intensive care unit in the context of a caring-healing environment, and contributed to a culture of patient safety to empower staff to speak up if they see a breach in protocol at any time. A caring-healing environment encouraged staff to take the extra time and precautions to prevent infections for their patients and created a better quality of care for the patients.

  20. Safety net hospital performance on national quality of care process measures.

    PubMed

    Marshall, Lindsey; Harbin, Vanessa; Hooker, Jane; Oswald, John; Cummings, Linda

    2012-01-01

    Several studies have found poor or mixed performance by safety net hospitals on national measures of quality. The study's purposes were to determine whether safety net hospital performance is similar to the average U.S. hospital, both currently and during earlier reporting periods, and to summarize features commonly used to assess performance, including definition of safety net and patient characteristics. This study reviewed quality performance data for the Joint Commission's accountability measures for hospitals that are members of the National Association of Public Hospitals and Health Systems (NAPH)-safety net hospitals that serve a large proportion of Medicaid and uninsured patients. Analyses of quality performance on the earliest data show that on average there was no statistically significant difference in performance between NAPH members and other hospitals on 6 of 15 measures. According to the most recent data, NAPH hospitals on average had no statistically significant differences as other hospitals on 13 of 18 measures and had statistically significantly better scores on two measures. These results are an important addition to the literature regarding safety net hospitals that serve a high proportion of Medicaid, low income, and uninsured patients, and support the case that quality of care at safety net hospitals is equivalent to that of non-safety net hospitals. © 2011 National Association for Healthcare Quality.

  1. Documenting quality improvement and patient safety efforts: the quality portfolio. A statement from the academic hospitalist taskforce.

    PubMed

    Taylor, Benjamin B; Parekh, Vikas; Estrada, Carlos A; Schleyer, Anneliese; Sharpe, Bradley

    2014-01-01

    Physicians increasingly investigate, work, and teach to improve the quality of care and safety of care delivery. The Society of General Internal Medicine Academic Hospitalist Task Force sought to develop a practical tool, the quality portfolio, to systematically document quality and safety achievements. The quality portfolio was vetted with internal and external stakeholders including national leaders in academic medicine. The portfolio was refined for implementation to include an outlined framework, detailed instructions for use and an example to guide users. The portfolio has eight categories including: (1) a faculty narrative, (2) leadership and administrative activities, (3) project activities, (4) education and curricula, (5) research and scholarship, (6) honors, awards, and recognition, (7) training and certification, and (8) an appendix. The authors offer this comprehensive, yet practical tool as a method to document quality and safety activities. It is relevant for physicians across disciplines and institutions and may be useful as a standalone document or as an adjunct to traditional promotion documents. As the Next Accreditation System is implemented, academic medical centers will require faculty who can teach and implement the systems-based practice requirements. The quality portfolio is a method to document quality improvement and safety activities.

  2. 2017 National Quality and Safety Education for Nurses Faculty Survey Results.

    PubMed

    Altmiller, Gerry; Armstrong, Gail

    The Quality and Safety Education for Nurses (QSEN) national initiative, started in 2005, has supported the adoption and integration of updated quality and safety competencies in nursing education. However, faculty needs regarding QSEN competency integration, and the degree to which QSEN competencies are reflected in current nursing curricula, have not been assessed nationally. This study (N = 2037) reports the findings of the 2017 National QSEN Faculty Survey and discusses implications for nurse educators and programs of nursing education.

  3. Integration of Quality and Safety Education for Nurses Into Practice: Academic-Practice Partnership's Role.

    PubMed

    Koffel, Chris; Burke, Kathleen G; McGuinn, Kathy; Miltner, Rebecca S

    There is a trend to adopt the Quality and Safety Education for Nurses (QSEN) competencies into nursing practice's organizational activities. Incorporating the competencies has created unique challenges for the practice setting. The purpose of this article is to identify the different types of academic-practice partnerships that promote quality and safety, including a specific focus on how the QSEN competencies are being incorporated into practice settings.

  4. Patient safety and quality of care in developing countries in Southeast Asia: a systematic literature review.

    PubMed

    Harrison, Reema; Cohen, Adrienne Wai Seung; Walton, Merrilyn

    2015-08-01

    To establish current knowledge of patient safety and quality of care in developing countries in Southeast Asia, current interventions and the knowledge gaps. Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search seven electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1990 and 2014 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesized. Four inter-related safety and quality concerns were evident from 33 publications: (i) the risk of patient infection in healthcare delivery, (ii) medications errors/use, (iii) the quality and provision of maternal and perinatal care and (iv) the quality of healthcare provision overall. Large-scale prevalence studies are needed to identify the full range of safety and quality problems in developing countries in Southeast Asia. Sharing lessons learnt from extensive quality and safety work conducted in industrialized nations may contribute to significant improvements. Yet the applicability of interventions utilized in developed countries to the political and social context in this region must be considered. Strategies to facilitate the collection of robust safety and quality data in the context of limited resources and the local context in each country are needed. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  5. Safety, reliability, maintainability and quality provisions for the Space Shuttle program

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This publication establishes common safety, reliability, maintainability and quality provisions for the Space Shuttle Program. NASA Centers shall use this publication both as the basis for negotiating safety, reliability, maintainability and quality requirements with Shuttle Program contractors and as the guideline for conduct of program safety, reliability, maintainability and quality activities at the Centers. Centers shall assure that applicable provisions of the publication are imposed in lower tier contracts. Centers shall give due regard to other Space Shuttle Program planning in order to provide an integrated total Space Shuttle Program activity. In the implementation of safety, reliability, maintainability and quality activities, consideration shall be given to hardware complexity, supplier experience, state of hardware development, unit cost, and hardware use. The approach and methods for contractor implementation shall be described in the contractors safety, reliability, maintainability and quality plans. This publication incorporates provisions of NASA documents: NHB 1700.1 'NASA Safety Manual, Vol. 1'; NHB 5300.4(IA), 'Reliability Program Provisions for Aeronautical and Space System Contractors'; and NHB 5300.4(1B), 'Quality Program Provisions for Aeronautical and Space System Contractors'. It has been tailored from the above documents based on experience in other programs. It is intended that this publication be reviewed and revised, as appropriate, to reflect new experience and to assure continuing viability.

  6. Safety, reliability, maintainability and quality provisions for the Space Shuttle program

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This publication establishes common safety, reliability, maintainability and quality provisions for the Space Shuttle Program. NASA Centers shall use this publication both as the basis for negotiating safety, reliability, maintainability and quality requirements with Shuttle Program contractors and as the guideline for conduct of program safety, reliability, maintainability and quality activities at the Centers. Centers shall assure that applicable provisions of the publication are imposed in lower tier contracts. Centers shall give due regard to other Space Shuttle Program planning in order to provide an integrated total Space Shuttle Program activity. In the implementation of safety, reliability, maintainability and quality activities, consideration shall be given to hardware complexity, supplier experience, state of hardware development, unit cost, and hardware use. The approach and methods for contractor implementation shall be described in the contractors safety, reliability, maintainability and quality plans. This publication incorporates provisions of NASA documents: NHB 1700.1 'NASA Safety Manual, Vol. 1'; NHB 5300.4(IA), 'Reliability Program Provisions for Aeronautical and Space System Contractors'; and NHB 5300.4(1B), 'Quality Program Provisions for Aeronautical and Space System Contractors'. It has been tailored from the above documents based on experience in other programs. It is intended that this publication be reviewed and revised, as appropriate, to reflect new experience and to assure continuing viability.

  7. Quality and safety in medical care: what does the future hold?

    PubMed

    Liang, Bryan A; Mackey, Tim

    2011-11-01

    The rapid changes in health care policy, embracing quality and safety mandates, have culminated in programs and initiatives under the Patient Protection and Affordable Care Act. To review the context of, and anticipated quality and patient safety mandates for, delivery systems, incentives under health care reform, and models for future accountability for outcomes of care. Assessment of the provisions of Patient Protection and Affordable Care Act, other reform efforts, and reform initiatives focusing on future quality and safety provisions for health care providers. Health care reform and other efforts focus on consumerism in the context of price. Quality and safety efforts will be structured using financial incentives, best-practices research, and new delivery models that focus on reaching benchmarks while reducing costs. In addition, patient experience will be a key component of reimbursement, and a move toward "retail" approaches directed at the individual patient may supplant traditional "wholesale" efforts at attracting employers. Quality and safety have always been of prime importance in medicine. However, in the future, under health care reform and associated initiatives, a shift in the paradigm of medicine will integrate quality and safety measurement with financial incentives and a new emphasis on consumerism.

  8. Hazardous material/waste transportation safety -- its effect on the environment

    SciTech Connect

    Bonanti, C.J.

    1998-12-31

    The purpose of hazardous material/waste transportation accident investigations are to identify technical, operational, and human factor issues of safety that contributed to an accident. The National Transportation Safety Board (NTSB) is tasked with accident investigations in the following modes of transportation: aviation, highway, railroad, marine, and pipeline. Hazardous materials and wastes are transported in every mode within the US Transportation system, and account for more than 500,000 shipments per year. The NTSB selects specific accidents to investigate based on the release of hazardous material and its threat to public safety, if fatalities occurred, or if the accident caused a major disruption to the surrounding community. The NTSB also investigates accidents involving hazardous materials that could provide further evidence of a need for safety improvements. The NTSB makes safety recommendations for improving the safe transport of hazardous materials to several agencies of the US Department of Transportation, including the Research and Special Programs Administration, the Federal Aviation Administration, the Federal Railroad Administration, the Federal Highway Administration, and the US Coast Guard. In addition, the NTSB makes safety recommendations to industry and other private organizations. Safety recommendations are made as the result of accident investigations and are the most important product of the NTSB. Safety recommendations, when implemented, can reduce accidents and improve the US transportation system. The discussion of the investigations, research, container designs, and safety recommendations described in this paper, is to provide the reader with a basic understanding of issues related to the current transportation of hazardous materials in the United States, and what the possibilities will be in the future when dealing with issues that can have a detrimental effect on the environment.

  9. Safety and Environment aspects of Tokamak- type Fusion Power Reactor- An Overview

    NASA Astrophysics Data System (ADS)

    Doshi, Bharat; Reddy, D. Chenna

    2017-04-01

    Naturally occurring thermonuclear fusion reaction (of light atoms to form a heavier nucleus) in the sun and every star in the universe, releases incredible amounts of energy. Demonstrating the controlled and sustained reaction of deuterium-tritium plasma should enable the development of fusion as an energy source here on Earth. The promising fusion power reactors could be operated on the deuterium-tritium fuel cycle with fuel self-sufficiency. The potential impact of fusion power on the environment and the possible risks associated with operating large-scale fusion power plants is being studied by different countries. The results show that fusion can be a very safe and sustainable energy source. A fusion power plant possesses not only intrinsic advantages with respect to safety compared to other sources of energy, but also a negligible long term impact on the environment provided certain precautions are taken in its design. One of the important considerations is in the selection of low activation structural materials for reactor vessel. Selection of the materials for first wall and breeding blanket components is also important from safety issues. It is possible to fully benefit from the advantages of fusion energy if safety and environmental concerns are taken into account when considering the conceptual studies of a reactor design. The significant safety hazards are due to the tritium inventory and energetic neutron fluence induced activity in the reactor vessel, first wall components, blanket system etc. The potential of release of radioactivity under operational and accident conditions needs attention while designing the fusion reactor. Appropriate safety analysis for the quantification of the risk shall be done following different methods such as FFMEA (Functional Failure Modes and Effects Analysis) and HAZOP (Hazards and operability). Level of safety and safety classification such as nuclear safety and non-nuclear safety is very important for the FPR (Fusion

  10. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... safety and health standards applicable to the work conditions of contractor and subcontractor employees..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning...

  11. Patient safety culture in a district hospital in South Africa: An issue of quality.

    PubMed

    Mayeng, Lorraine M; Wolvaardt, Jacqueline E

    2015-11-05

    The Nursing Act 33 of 2005 holds nurse practitioners responsible for all acts and omissions in the delivery of quality patient care. But quality patient care is influenced by a number of factors beyond the control of nurse practitioners. Patient safety culture is one such factor and is seldom explored in hospitals in developing countries. This article describes the patient safety culture of a district hospital in South Africa. The study identified and analysed the factors that influence the patient safety culture by using the Manchester Patient Safety Framework at the National District Hospital, Bloemfontein, Free State Province. A descriptive cross-sectional study was conducted and included the total population of permanent staff; community service health professionals; temporarily employed health professionals and volunteers. The standard Manchester Patient Safety Framework questionnaire was distributed with a response rate of 61%. Less than half of the respondents (42.4%; n = 61) graded their units as acceptable. Several quality dimensions were statistically significant for the employment profile: overall commitment to quality (p = 0.001); investigating patient incidents (p = 0.031); organisational learning following incidents (p < 0.001); communication around safety issues (p = 0.001); and team working around safety issues (p = 0.005). These same quality dimensions were also statistically significant for the professional profiles. Medical doctors had negative perceptions of all the safety dimensions. The research measured and described patient safety culture (PSC) amongst the staff at the National District Hospital (NDH). This research has identified the perceived inadequacies with PSC and gives nurse managers a clear mandate to implement change to ensure a PSC that fosters quality patient care.

  12. The effect of safety hat on thermal responses and working efficiency under a high temperature environment.

    PubMed

    Kim, Hee-Eun; Park, So-Jin

    2004-09-01

    The purpose of this study is to examine the effect of a safety hat on thermal responses and work efficiency under a high temperature environment. Five healthy male subjects participated in the repeated 'Rest' and 'Exercise' periods in order to compare a safety hat without holes (annoted as 'without hole') and a safety hat with holes (annoted as 'with hole') in a climatic chamber of 30 degrees C, 50%RH. The main findings are as follows: (a) the core temperature (tympanic temperature) and heart rate showed significantly lower levels in the subjects who are under the 'with hole' condition than those who are under the 'without hole' condition; (b) the forehead skin temperature was significantly higher in the subjects who are under the 'without hole' condition than those who ar uder the 'with hole' condition; (c) blood pressure was significantly lower in the 'with hole' condition; and (d) sweat rate which was measured by weight loss before and after the experiment was higher in the 'without hole' condition; and (e) work ability which was measured by a grip strength dynamometer was higher in the 'with hole' condition. Making a hole in the safety hat, designed for proper ventilation and hygiene, is practical in letting out heat and decreasing the physiological burden under a hot working environment. The safety hat with holes is useful in maintaining the homeostasis of the body temperature by releasing body heat efficiently and it is meaningful to keep the working efficiency.

  13. Department of Energy Environment, Safety and Health Management Plan. Fiscal year 1996

    SciTech Connect

    1996-01-01

    This report describes efforts by the Department of Energy (DOE) to effectively plan for environment, safety and health activities that protect the environment, workers and the public from harm. This document, which covers fiscal year 1996, reflects planning by operating contractors and Program Offices in early 1994, updated to be consistent with the President`s FY 1996 budget submittal to Congress, and subsequent Department of Energy Program refinements. Prior to 1992, only a small number of facilities had a structured process for identifying environment, safety and health (ES and H) needs, reporting the costs (in both direct and indirect budgets) of ES and H requirements, prioritizing and allocating available resources, and efficiently communicating this information to DOE. Planned costs for ES and H activities were usually developed as an afterthought to program budgets. There was no visible, consistently applied mechanism for determining the appropriate amount of resources that should be allocated to ES and H, or for assuring that significant ES and H vulnerabilities were planned to be funded. To address this issue, the Secretary (in November 1991) directed DOE to develop a Safety and Health Five-Year Plan to serve as a line management tool to delineate DOE-wide programs to reduce and manage safety and health risks, and to establish a consistent framework for risk-based resource planning and allocation.

  14. Closing the Gap and Raising the Bar: Assessing Board Competency in Quality and Safety.

    PubMed

    McGaffigan, Patricia A; Ullem, Beth Daley; Gandhi, Tejal K

    2017-06-01

    Despite recognition of the important role that governance and executive leaders play in ensuring patient safety and quality, little research has examined leaders' involvement in these areas beyond surveys that assess higher-level knowledge and understanding of patient and workforce safety concepts. A survey was sent to a convenience sample of board members and CEOs, as well as unpaired safety and quality leaders (SQLs). The survey included approximately 36 questions asking board members and other non-CEO executives their knowledge, understanding, and board activities related to safety and quality, and SQLs their perceptions of their own boards' knowledge, understanding, and activities related to safety and quality. An analysis of the responses of each of the three groups was conducted to assess baseline ratings, as well as to examine similarities and differences. Overall, similar patterns of self-reported knowledge, understanding, and activities related to safety and quality were evident between the board and CEO groups across virtually all areas examined in this survey, although groups were unpaired. Differences of varying degree were found at the level of individual survey items between board members' and CEOs' responses. SQL ratings were generally lower than the ratings of both board members and CEOs. This survey reveals specific areas of focus for improving governance and leadership practices at board meetings, as well as several areas where knowledge and understanding of safety and quality were variable. Further research and consensus would be beneficial to identify best practices for board education and governance activities to drive quality and safety. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  15. The association between event learning and continuous quality improvement programs and culture of patient safety.

    PubMed

    Mazur, Lukasz; Chera, Bhishamjit; Mosaly, Prithima; Taylor, Kinley; Tracton, Gregg; Johnson, Kendra; Comitz, Elizabeth; Adams, Robert; Pooya, Pegah; Ivy, Julie; Rockwell, John; Marks, Lawrence B

    2015-01-01

    To present our approach and results from our quality and safety program and to report their possible impact on our culture of patient safety. We created an event learning system (termed a "good catch" program) and encouraged staff to report any quality or safety concerns in real time. Events were analyzed to assess the utility of safety barriers. A formal continuous quality improvement program was created to address these reported events and make improvements. Data on perceptions of the culture of patient safety were collected using the Agency for Health Care Research and Quality survey administered before, during, and after the initiatives. Of 560 good catches reported, 367 could be ascribed to a specific step on our process map. The calculated utility of safety barriers was highest for those embedded into the pretreatment quality assurance checks performed by physicists and dosimetrists (utility score 0.53; 93 of 174) and routine checks done by therapists on the initial day of therapy. Therapists and physicists reported the highest number of good catches (24% each). Sixty-four percent of events were caused by performance issues (eg, not following standardized processes, including suboptimal communications). Of 31 initiated formal improvement events, 26 were successfully implemented and sustained, 4 were discontinued, and 1 was not implemented. Most of the continuous quality improvement program was conducted by nurses (14) and therapists (7). Percentages of positive responses in the patient safety culture survey appear to have increased on all dimensions (p < .05). Results suggest that event learning and continuous quality improvement programs can be successfully implemented and that there are contemporaneous improvements in the culture of safety. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  16. Microbial safety and quality of Irradiated fresh produce

    USDA-ARS?s Scientific Manuscript database

    The lack of a broadly applicable bactericidal process (a “kill step”) is hampering the food safety efforts of the fresh produce industry. Irradiation in the form of electron beams, x-rays or gamma rays was recently approved by FDA for use on iceberg lettuce and spinach. This nonthermal process kills...

  17. An Innovative Approach Using Clinical Simulation to Teach Quality and Safety Principles to Undergraduate Nursing Students.

    PubMed

    Cantrell, Mary Ann; Mariani, Bette; Meakim, Colleen

    The aim of this learning experience was to enhance students' knowledge of safety practices. A threefold approach was used, which involved viewing a prerecorded scenario in which safety practices were violated and another scenario that consistently depicted safe practice behaviors. Students then performed an environmental safety check of the physical simulated scene and then participated in a debriefing session. The conceptual basis for this project was the teaching-learning strategy "What's Wrong With This Patient," which requires the learner to evaluate a simulated learning environment to identify safety practices that were not followed and suggest strategies to correct these errors.

  18. For all the right reasons. Approaching CPOE from a patient safety and care quality perspective is the first critical step toward success.

    PubMed

    Hagland, Mark

    2009-09-01

    True CPOE success is about facilitating improved patient safety, care quality, and efficiency in a multidisciplinar environment, and on an ongoing basis. CPOE implementation forces clinician leaders to examine and rework long-ingrained care delivery processes, especially as they build or adapt order sets. The likelihood that CPOE will be a requirement of meaningful use could compel a rapid acceleration in implementation.

  19. Technology Development, Evaluation, and Application (TDEA) FY 2001 Progress Report Environment, Safety, and Health (ESH) Division

    SciTech Connect

    L.G. Hoffman; K. Alvar; T. Buhl; E. Foltyn; W. Hansen; B. Erdal; P. Fresquez; D. Lee; B. Reinert

    2002-05-01

    This progress report presents the results of 11 projects funded ($500K) in FY01 by the Technology Development, Evaluation, and Application (TDEA) Committee of the Environment, Safety, and Health Division (ESH). Five projects fit into the Health Physics discipline, 5 projects are environmental science and one is industrial hygiene/safety. As a result of their TDEA-funded projects, investigators have published sixteen papers in professional journals, proceedings, or Los Alamos reports and presented their work at professional meetings. Supplement funds and in-kind contributions, such as staff time, instrument use, and workspace, were also provided to TDEA-funded projects by organizations external to ESH Divisions.

  20. Passenger ride quality within a noise and vibration environment

    NASA Technical Reports Server (NTRS)

    Dempsey, T. K.; Leatherwood, J. D.; Drezek, A. B.

    1976-01-01

    The subjective response to noise and vibration stimuli was studied in a ride quality simulator to determine their importance in the prediction of passenger ride quality. Subjects used category scales to rate noise discomfort, vibration discomfort, both noise and vibration discomfort, and overall discomfort in an effort to evaluate parametric arrangements of noise and vibration. The noise stimuli were composed of octave frequency bands centered at 125, 250, 2,000 and 4,000 Hz, each presented at 70, 75, 80, and 85 dB(A). The vertical vibration stimuli were 5 Hz bandwidth random vibrations centered at 3, 5, 7, and 9 Hz, each presented at 0.03, 0.06, 0.09, and 0.12 grms. Analyses were directed at (1) a determination of the subject's ability to separate noise and vibration as contributors to discomfort, (2) an assessment of the physical characteristics of noise and vibration that are needed for prediction of ride quality in this type of multifactor environment, and (3) an evaluation of the relative contribution of noise and vibration to passenger ride quality.

  1. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 1: Technical standard

    SciTech Connect

    1998-05-01

    This Department of Energy (DOE) technical standard (referred to as the Standard) provides guidance for integrating and enhancing worker, public, and environmental protection during facility disposition activities. It provides environment, safety, and health (ES and H) guidance to supplement the project management requirements and associated guidelines contained within DOE O 430.1A, Life-Cycle Asset Management (LCAM), and amplified within the corresponding implementation guides. In addition, the Standard is designed to support an Integrated Safety Management System (ISMS), consistent with the guiding principles and core functions contained in DOE P 450.4, Safety Management System Policy, and discussed in DOE G 450.4-1, Integrated Safety Management System Guide. The ISMS guiding principles represent the fundamental policies that guide the safe accomplishment of work and include: (1) line management responsibility for safety; (2) clear roles and responsibilities; (3) competence commensurate with responsibilities; (4) balanced priorities; (5) identification of safety standards and requirements; (6) hazard controls tailored to work being performed; and (7) operations authorization. This Standard specifically addresses the implementation of the above ISMS principles four through seven, as applied to facility disposition activities.

  2. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Integration of environment, safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and...

  3. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Integration of environment, safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and...

  4. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Integration of environment, safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and...

  5. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Integration of environment, safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and...

  6. Measuring hospital staff nurses perception on quality of the professional practice environment.

    PubMed

    De Brouwer, Brigitte Johanna Maria; Fingal, Cheryl; Schoonhoven, Lisette; Kaljouw, Marian J; Van Achterberg, Theo

    2017-10-01

    The purpose of this study was to determine construct validity of the Dutch Essentials of Magnetism II © instrument, designed to assess nursing practice environments, using hypotheses testing. Reduction in hospital length of stay and the number of inpatient beds increases care intensity. Educational levels and numbers of nursing staff in hospitals, however, do not match this increase, resulting in a strain on quality of care and patient safety. A possible answer to existing concerns about quality of care may be the creation of a productive and healthy practice environment, as this has an impact on the quality of care. Therefore, areas requiring improvement of the practice environment have to be defined. A cross-sectional, correlational study design. We determined construct validity with hypotheses testing by relating the Dutch Essentials of Magnetism II to the Dutch Practice Environment Scale of the Nursing Work Index. We formulated 15 hypotheses prior to data-analysis; 10 related to convergent validity and five related to discriminant validity. Data were collected from qualified nurses (N = 259) on nine randomly selected hospital wards from March to April 2012. Response rate was 47% (n = 121). Total scores of both instruments are strongly correlated (r = 0·88). In total, 12 of 15 hypotheses (80%) were confirmed and three were rejected. The D-EOMII has satisfactory construct validity for measuring the nursing practice environment in hospitals and can be used by nurses, managers, health policy makers, hospitals and governments to assess and identify processes and relationships that are in need of improvement. © 2017 John Wiley & Sons Ltd.

  7. Annotated Bibliography: Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement.

    PubMed

    Montano, Maria F; Mehdi, Harshal; Nash, David B

    2016-11-01

    The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care settings can be suggested. A better understanding of the myriad factors that influence delivery of patient care will catalyze future health care system development and implementation in the ambulatory setting.

  8. Improving the quality and safety of macadamia nuts

    USDA-ARS?s Scientific Manuscript database

    Macadamia nuts (M. integrifolia and M. tetraphylla) are grown in subtropical and tropical regions and are valued for their delicate flavor, crunchy texture, and healthful oil profile. The highest quality kernels are cream colored, with 72 to 78% oil and 1.5% moisture. Two major quality defects of ma...

  9. Current knowledge of water quality and safety for livestock.

    PubMed

    Carson, T L

    2000-11-01

    Basic laboratory evaluation of water quality for livestock should include measurement of TDS, sulfate, nitrate-nitrite, and coliform bacteria. Supplementary water tests may include pH, sodium, iron, magnesium, chloride, calcium, potassium, manganese, and contaminants specific to the situation. Using the best-quality drinking water available contributes to the optimal production of livestock. Restricted quantity of drinking water or drinking water containing excessive levels of nitrate, TDS, sulfate, and other constituents can affect growth and production of all classes of animals. Drinking-water quality and availability should be evaluated as a cause of poor performance or nonspecific disease conditions in livestock. It is important that attempts to evaluate water quality include obtaining a thorough history, making astute observations, and asking intelligent questions. A thorough laboratory examination of animal specimens and water samples should be evaluated in view of existing standards for livestock drinking-water quality.

  10. A broad and structured approach to improving patient safety and quality: lessons from Denver Health.

    PubMed

    Gabow, Patricia A; Mehler, Philip S

    2011-04-01

    America's health care systems have not achieved the desired level of quality and safety. This may be due, in part, to the lack of clear and robust approaches for institutions to follow. Denver Health, an integrated, public safety-net institution, developed a multifaceted, structured approach to quality and safety improvement that has produced positive outcomes. For example, in 2010 Denver Health ranked first of 112 US academic medical centers in terms of actual mortality observed relative to the national mortality rate. Given these results, we argue that regulatory bodies should refocus their oversight to consider an institution's overall structured approach to quality improvement and safety, instead of monitoring individual small outcomes, such as a patient's receipt of antibiotics for pneumonia within six hours of arriving in the emergency department.

  11. Soft qualities in healthcare. Method and tools for soft qualities design in hospitals' built environments.

    PubMed

    Capolongo, S; Bellini, E; Nachiero, D; Rebecchi, A; Buffoli, M

    2014-01-01

    The design of hospital environments is determined by functional requirements and technical regulations, as well as numerous protocols, which define the structure and system characteristics that such environments need to achieve. In order to improve people's well-being and the quality of their experience within public hospitals, design elements (soft qualities) are added to those 'necessary' features. The aim of this research has been to experiment a new design process and also to create health care spaces with high environmental quality and capable to meet users' emotional and perceptual needs. Such needs were investigated with the help of qualitative research tools and the design criteria for one of these soft qualities - colour - were subsequently defined on the basis of the findings. The colour scheme design for the new San Paolo Hospital Emergency Department in Milan was used as case study. Focus groups were fundamental in defining the project's goals and criteria. The issues raised have led to believe that the proper procedure is not the mere consultation of the users in order to define the goals: users should rather be involved in the whole design process and become co-agents of the choices that determine the environment characteristics, so as to meet the quality requirements identified by the users themselves. The case study has shown the possibility of developing a designing methodology made by three steps (or operational tools) in which users' groups are involved in the choices, loading to plan the environments where compliance with expectations is already implied and verified by means of the process itself. Thus, the method leads to the creation of soft qualities in Healthcare.

  12. Battery-free radio frequency identification (RFID) sensors for food quality and safety.

    PubMed

    Potyrailo, Radislav A; Nagraj, Nandini; Tang, Zhexiong; Mondello, Frank J; Surman, Cheryl; Morris, William

    2012-09-05

    Market demands for new sensors for food quality and safety stimulate the development of new sensing technologies that can provide an unobtrusive sensor form, battery-free operation, and minimal sensor cost. Intelligent labeling of food products to indicate and report their freshness and other conditions is one important possible application of such new sensors. This study applied passive (battery-free) radio frequency identification (RFID) sensors for the highly sensitive and selective detection of food freshness and bacterial growth. In these sensors, the electric field generated in the RFID sensor antenna extends from the plane of the RFID sensor and is affected by the ambient environment, providing the opportunity for sensing. This environment may be in the form of a food sample within the electric field of the sensing region or a sensing film deposited onto the sensor antenna. Examples of applications include monitoring of milk freshness, fish freshness, and bacterial growth in a solution. Unlike other food freshness monitoring approaches that require a thin film battery for operation of an RFID sensor and fabrication of custom-made sensors, the passive RFID sensing approach developed here combines the advantages of both battery-free and cost-effective sensor design and offers response selectivity that is impossible to achieve with other individual sensors.

  13. Battery-free radio frequency identification (RFID) sensors for food quality and safety

    PubMed Central

    Potyrailo, Radislav A.; Nagraj, Nandini; Tang, Zhexiong; Mondello, Frank J.; Surman, Cheryl; Morris, William

    2012-01-01

    The market demands for new sensors for food quality and safety stimulate the development of new sensing technologies that can provide an unobtrusive sensor form factor, battery-free operation, and minimal sensor cost. Intelligent labeling of food products to indicate and report their freshness and other conditions is one of important possible applications of such new sensors. We have applied passive (battery-free) radio frequency identification (RFID) sensors for highly sensitive and selective detection of food freshness and bacterial growth. In these sensors, the electric field generated in the RFID sensor antenna extends out from the plane of the RFID sensor and is affected by the ambient environment providing the opportunity for sensing. This environment may be in the form of a food sample within the electric field of the sensing region or a sensing film deposited onto the sensor antenna. Examples of applications include monitoring of freshness of milk, freshness of fish, and bacterial growth in a solution. Unlike other food freshness monitoring approaches that require a thin film battery for operation of an RFID sensor and fabrication of custom-made sensors, our developed passive RFID sensing approach combines advantages of both battery-free and cost-effective sensor design and offers response selectivity that is impossible to achieve with other individual sensors. PMID:22881825

  14. Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts.

    PubMed

    Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

    2016-08-05

    The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions

  15. Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

    PubMed Central

    Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

    2016-01-01

    Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The

  16. [Discussion on agricultural product quality and safety problem from ecological view].

    PubMed

    Xiao, Ming; Dong, Nan; Lyu, Xin

    2015-08-01

    There are many different perspectives about the sustainable agriculture, which had been proposed since the last three decades in the world. While China's ecologists and agronomists proposed a similar concept named 'ecological agriculture'. Although ecological agriculture in China has achieved substantial progress, including theory, models and supporting technologies nearly several decades of practice and development, its application guidance still is not yet clear. The organic agriculture model proposed by European Union is popular, but it is limited in the beneficiary groups and the social and ecological responsibility. In this context, the article based on an ecological point of view, analyzed the shortcomings of ecological imbalance caused by a single mode of agricultural production and the negative impact on the quality of agricultural products, and discussed the core values of ecological agriculture. On this basis, we put forward the concept of sustainable security of agricultural products. Based on this concept, an agricultural platform was established under the healthy ecosysphere environment, and from this agricultural platform, agricultural products could be safely and sustainably obtained. Around the central value of the concept, we designed the agricultural sustainable and security production model. Finally, we compared the responsibility, benefiting groups, agronomic practices selection and other aspects of sustainable agriculture with organic agriculture, and proved the advancement of sustainable agricultural model in agricultural production quality and safety.

  17. Quality and Safety of Minimally Invasive Surgery: Past, Present, and Future

    PubMed Central

    McCrory, Bernadette; LaGrange, Chad A; Hallbeck, MS

    2014-01-01

    Adverse events because of medical errors are a leading cause of death in the United States (US) exceeding the mortality rates of motor vehicle accidents, breast cancer, and AIDS. Improvements can and should be made to reduce the rates of preventable surgical errors because they account for nearly half of all adverse events within hospitals. Although minimally invasive surgery (MIS) has proven patient benefits such as reduced postoperative pain and hospital stay, its operative environment imposes substantial physical and cognitive strain on the surgeon increasing the risk of error. To mitigate errors and protect patients, a multidisciplinary approach is needed to improve MIS. Clinical human factors, and biomedical engineering principles and methodologies can be used to develop and assess laparoscopic surgery instrumentation, practices, and procedures. First, the foundational understanding and the imperative to transform health care into a high-quality and safe system is discussed. Next, a generalized perspective is presented on the impact of the design and redesign of surgical technologies and processes on human performance. Finally, the future of this field and the research needed to further improve the quality and safety of MIS is discussed. PMID:25288906

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

    ERIC Educational Resources Information Center

    Gardner, John Wallace

    2012-01-01

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

  19. Hospital quality and patient safety competencies: development, description, and recommendations for use.

    PubMed

    O'Leary, Kevin J; Afsar-Manesh, Nasim; Budnitz, Tina; Dunn, Andrew S; Myers, Jennifer S

    2011-11-01

    Hospitalists are poised to have a tremendous impact on improving the quality of care for hospitalized patients. However, many hospitalists are inadequately prepared to engage in efforts to improve quality, because medical schools and residency programs have not traditionally emphasized healthcare quality and patient safety in their curricula. Through a multistep process, the Society of Hospital Medicine (SHM) Quality Improvement Education (QIE) subcommittee developed the Hospital Quality and Patient Safety (HQPS) Competencies to provide a framework for developing and assessing curricula and other professional development experiences. This article describes the development, provides definitions, and makes recommendations on the use of the HQPS Competencies. The 8 areas of competence include: Quality Measurement and Stakeholder Interests, Data Acquisition and Interpretation, Organizational Knowledge and Leadership Skills, Patient Safety Principles, Teamwork and Communication, Quality and Safety Improvement Methods, Health Information Systems, and Patient Centeredness. Reflecting differing levels of hospitalist involvement in healthcare quality, 3 levels of expertise within each area of competence have been established: basic, intermediate, and advanced. Standards for each competency area use carefully selected action verbs to reflect educational goals for hospitalists at each level. Formal incorporation of the HQPS Competencies into professional development programs, and innovative educational initiatives and curricula, will help provide current hospitalists and the next generations of hospitalists with the needed skills to be successful. Copyright © 2011 Society of Hospital Medicine.

  20. POSNA Quality, Safety, Value Initiative 3 Years Old and Growing Strong. POSNA Precourse 2014.

    PubMed

    McCarthy, James J; Alessandrini, Evaline A; Schoettker, Pamela J

    2015-01-01

    The purpose of this paper is to summarize the Pediatric Orthopaedic Society of North America (POSNA) quality, safety, and value initiative (QSVI). Specifically, it will outline the history of the program, describe typical quality improvement techniques, and how they differ from traditional research techniques, and, finally, describe some of the many projects completed, currently underway, or in planning for POSNA QSVI.

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

    ERIC Educational Resources Information Center

    Gardner, John Wallace

    2012-01-01

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

  2. Role of Informatics in Patient Safety and Quality Assurance.

    PubMed

    Nakhleh, Raouf E

    2015-06-01

    Quality assurance encompasses monitoring daily processes for accurate, timely, and complete reports in surgical pathology. Quality assurance also includes implementation of policies and procedures that prevent or detect errors in a timely manner. This article presents uses of informatics in quality assurance. Three main foci are critical to the general improvement of diagnostic surgical pathology. First is the application of informatics to specimen identification with lean methods for real-time statistical control of specimen receipt and processing. Second is the development of case reviews before sign-out. Third is the development of information technology in communication of results to assure treatment in a timely manner.

  3. Pacific Northwest Laboratory annual report for 1990 to the Assistant Secretary for Environment, Safety, and Health

    SciTech Connect

    Faust, L.G.; Moraski, R.V.; Selby, J.M.

    1991-05-01

    Part 5 of the 1990 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Environmental Guidance, the Office of Environmental Compliance, the Office of Environmental Audit, the Office of National Environmental Policy Act Project Assistance, the Office of Nuclear Safety, the Office of Safety Compliance, and the Office of Policy and Standards. For each project, as identified by the Field Work Proposal, there is an article describing progress made during fiscal year 1990. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work.

  4. Educational background of nurses and their perceptions of the quality and safety of patient care.

    PubMed

    Swart, Reece P; Pretorius, Ronel; Klopper, Hester

    2015-04-30

    International health systems research confirms the critical role that nurses play in ensuring the delivery of high quality patient care and subsequent patient safety. It is therefore important that the education of nurses should prepare them for the provision of safe care of a high quality. The South African healthcare system is made up of public and private hospitals that employ various categories of nurses. The perceptions of the various categories of nurses with reference to quality of care and patient safety are unknown in South Africa (SA). To determine the relationship between the educational background of nurses and their perceptions of quality of care and patient safety in private surgical units in SA. A descriptive correlational design was used. A questionnaire was used for data collection, after which hierarchical linear modelling was utilised to determine the relationships amongst the variables. Both the registered- and enrolled nurses seemed satisfied with the quality of care and patient safety in the units were they work. Enrolled nurses (ENs) indicated that current efforts to prevent errors are adequate, whilst the registered nurses (RNs) obtained high scores in reporting incidents in surgical wards. From the results it was evident that perceptions of RNs and ENs related to the quality of care and patient safety differed. There seemed to be a statistically-significant difference between RNs and ENs perceptions of the prevention of errors in the unit, losing patient information between shifts and patient incidents related to medication errors, pressure ulcers and falls with injury.

  5. Safe RESIDential Environments? A longitudinal analysis of the influence of crime-related safety on walking.

    PubMed

    Foster, Sarah; Hooper, Paula; Knuiman, Matthew; Christian, Hayley; Bull, Fiona; Giles-Corti, Billie

    2016-02-16

    Numerous cross-sectional studies have investigated the premise that the perception of crime will cause residents to constrain their walking; however the findings to date are inconclusive. In contrast, few longitudinal or prospective studies have examined the impact of crime-related safety on residents walking behaviours. This study used longitudinal data to test whether there is a causal relationship between crime-related safety and walking in the local neighbourhood. Participants in the RESIDential Environments Project (RESIDE) in Perth, Australia, completed a questionnaire before moving to their new neighbourhood (n = 1813) and again approximately one (n = 1467), three (n = 1230) and seven years (n = 531) after relocating. Self-report measures included neighbourhood perceptions (modified NEWS items) and walking inside the neighbourhood (min/week). Objective built environmental measures were generated for each participant's 1600 m neighbourhood at each time-point, and the count of crimes reported to police were generated at the suburb-level for the first three time-points only. The impact of crime-related safety on walking was examined in SAS using the Proc Mixed procedure (marginal repeated measures model with unrestricted variance pattern). Initial models controlled for demographics, time and self-selection, and subsequent models progressively adjusted for other built and social environment factors based on a social ecological model. For every increase of one level on a five-point Likert scale in perceived safety from crime, total walking within the local neighbourhood increased by 18.0 min/week (p = 0.000). This relationship attenuated to an increase of 10.5 min/week after accounting for other built and social environment factors, but remained significant (p = 0.008). Further analyses examined transport and recreational walking separately. In the fully adjusted models, each increase in safety from crime was associated with a 7.0

  6. Design and Implementation of the Harvard Fellowship in Patient Safety and Quality.

    PubMed

    Gandhi, Tejal K; Abookire, Susan A; Kachalia, Allen; Sands, Kenneth; Mort, Elizabeth; Bommarito, Grace; Gagne, Jane; Sato, Luke; Weingart, Saul N

    2016-01-01

    The Harvard Fellowship in Patient Safety and Quality is a 2-year physician-oriented training program with a strong operational orientation, embedding trainees in the quality departments of participating hospitals. It also integrates didactic and experiential learning and offers the option of obtaining a master's degree in public health. The program focuses on methodologically rigorous improvement and measurement, with an emphasis on the development and implementation of innovative practice. The operational orientation is intended to foster the professional development of future quality and safety leaders. The purpose of this article is to describe the design and development of the fellowship. © The Author(s) 2014.

  7. Consumer Choice between Food Safety and Food Quality: The Case of Farm-Raised Atlantic Salmon

    PubMed Central

    Haghiri, Morteza

    2016-01-01

    Since the food incidence of polychlorinated biphenyls in farm-raised Atlantic salmon, its market demand has drastically changed as a result of consumers mistrust in both the quality and safety of the product. Policymakers have been trying to find ways to ensure consumers that farm-raised Atlantic salmon is safe. One of the suggested policies is the implementation of integrated traceability methods and quality control systems. This article examines consumer choice between food safety and food quality to purchase certified farm-raised Atlantic salmon, defined as a product that has passed through various stages of traceability systems in the province of Newfoundland and Labrador, Canada. PMID:28231118

  8. Effective governance: helping boards acquire, adapt and apply evidence to improve quality and patient safety.

    PubMed

    Barclay, Kevin

    2010-01-01

    They don't spend a lot of time treating patients. And they're seldom included on grand rounds. But health services boards of directors still have a significant role to play in quality and patient safety. Their responsibilities for quality go beyond those of boards in many other settings and so, therefore, does their need for specialized education and training. As Maura Davies, chief executive officer (CEO) of Saskatoon Health Region, has pointed out, "There is increasing awareness that health services boards cannot abdicate their responsibilities for ensuring quality and safety and need to take specific actions to address these duties" (Davies 2010: 37).

  9. The quest for quality: perspectives from the safety net.

    PubMed

    Anderson, Ron J; Amarasingham, Ruben; Pickens, S Sue

    2007-01-01

    The American healthcare system is in need of fundamental change. With more than a decade of annual forums on quality improvement in healthcare and alarming statistics ranking medical errors among the top 10 causes of death in the United States, hospitals and health systems across the country are responding with a coordinated approach to quality improvement. Parkland Health & Hospital System believes the ideal public hospital system requires three critical components to achieve the Institute of Medicine's quality aims: (I) an emphasis on quality that is embraced by senior leadership, (2) careful measurement selection, and (3) the development of a robust infrastructure for outcomes research. This article describes Parkland's approach to each component and takes a look at selected processes and outcomes.

  10. An assessment of galactic cosmic radiation quality considering heavy ion track structures within the cellular environment

    NASA Astrophysics Data System (ADS)

    Craven, P. A.; Rycroft, M. J.

    Beyond the magnetic influence of the Earth, the flux of galactic cosmic radiation (GCR) represents a radiological concern for long-term manned space missions. Current concepts of radiation quality and equivalent dose are inadequate for accurately specifying the relative biological ``efficiency'' of low doses of such heavily ionising radiations, based as they are on the single parameter of Linear Energy Transfer (LET). Such methods take no account of the mechanisms, nor of the highly inhomogeneous spatial structure, of energy deposition in radiation tracks. DNA damage in the cell nucleus, which ultimately leads to the death or transformation of the cell, is usually initiated by electrons liberated from surrounding molecules by the incident projectile ion. The characteristics of these emitted ``delta-rays'', dependent primarily upon the charge and velocity of the ion, are considered in relation to an idealised representation of the cellular environment. Theoretically calculated delta-ray energy spectra are multiplied by a series of weighting algorithms designed to represent the potential for DNA insult in this environment, both in terms of the quantity and quality of damage. By evaluating the resulting curves, and taking into account the energy spectra of heavy ions in space, a relative measure of the biological relevance of the most abundant GCR species is obtained, behind several shielding configurations. It is hoped that this method of assessing the radiation quality of galactic cosmic rays will be of value when considering the safety of long-term manned space missions.

  11. Improving quality and safety in graduate education using an electronic student tracking system.

    PubMed

    McNelis, Angela M; Horton-Deutsch, Sara; Friesth, Barbara M

    2012-10-01

    The Institute of Medicine report on the future of nursing, the Quality and Safety Education for Nurses initiative, and the Technology Informatics Guiding Education Reform movement are among the most prominent forces guiding change related to information technology and informatics in nursing to improve quality and safety in practice. Informatics competencies are essential for psychiatric nurses to leverage and integrate information technology into education, practice, and research. This article examines informatics and information technology from the perspective of educational preparation of the psychiatric mental health nurse practitioner. Literature related to informatics, information technology, and quality and safety in advanced practice psychiatric nursing. Strategies for integration of information technology in educating psychiatric mental health nurse practitioner students are described. Informatics competency will result in safer and higher quality care. Published by Elsevier Inc.

  12. Improving the quality and safety of care on the medical ward: A review and synthesis of the evidence base.

    PubMed

    Pannick, Samuel; Beveridge, Iain; Wachter, Robert M; Sevdalis, Nick

    2014-12-01

    Despite its place at the heart of inpatient medicine, the evidence base underpinning the effective delivery of medical ward care is highly fragmented. Clinicians familiar with the selection of evidence-supported treatments for specific diseases may be less aware of the evolving literature surrounding the organisation of care on the medical ward. This review is the first synthesis of that disparate literature. An iterative search identified relevant publications, using terms pertaining to medical ward environments, and objective and subjective patient outcomes. Articles (including reviews) were selected on the basis of their focus on medical wards, and their relevance to the quality and safety of ward-based care. Responses to medical ward failings are grouped into five common themes: staffing levels and team composition; interdisciplinary communication and collaboration; standardisation of care; early recognition and treatment of the deteriorating patient; and local safety climate. Interventions in these categories are likely to improve the quality and safety of care in medical wards, although the evidence supporting them is constrained by methodological limitations and inadequate investment in multicentre trials. Nonetheless, with infrequent opportunities to redefine their services, institutions are increasingly adopting multifaceted strategies that encompass groups of these themes. As the literature on the quality of inpatient care moves beyond its initial focus on the intensive care unit and operating theatre, physicians should be mindful of opportunities to incorporate evidence-based practice at a ward level. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  13. US Department of Energy Environment, Safety and Health Progress Assessment of the Nevada Test Site

    SciTech Connect

    Not Available

    1992-08-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety, and Health (ES&H) Progress Assessment of the Nevada Test Site (NTS), Nye County, Nevada. The assessment, which was conducted from July 20 through August 4, 1992, included a selective review of the ES&H management systems and progress of the responsible DOE Headquarters Program Offices; the DOE Nevada Field Office (NV); and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. This report presents a summary of issues and progress in the areas of environment, safety and health, and management.

  14. Air quality inside subway metro indoor environment worldwide: A review.

    PubMed

    Xu, Bin; Hao, Jinliang

    2017-10-01

    The air quality in the subway metro indoor microenvironment has been of particular public concern. With specific reference to the growing demand of green transportation and sustainable development, subway metro systems have been rapidly developed worldwide in last decades. The number of metro commuters has continuously increased over recent years in metropolitan cities. In some cities, metro system has become the primary public transportation mode. Although commuters typically spend only 30-40min in metros, the air pollutants emitted from various interior components of metro system as well as air pollutants carried by ventilation supply air are significant sources of harmful air pollutants that could lead to unhealthy human exposure. Commuters' exposure to various air pollutants in metro carriages may cause perceivable health risk as reported by many environmental health studies. This review summarizes significant findings in the literature on air quality inside metro indoor environment, including pollutant concentration levels, chemical species, related sources and health risk assessment. More than 160 relevant studies performed across over 20 countries were carefully reviewed. These comprised more than 2000 individual measurement trips. Particulate matters, aromatic hydrocarbons, carbonyls and airborne bacteria have been identified as the primary air pollutants inside metro system. On this basis, future work could focus on investigating the chronic health risks of exposure to various air pollutants other than PM, and/or further developing advanced air purification unit to improve metro in-station air quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Fostering a Commitment to Quality: Best Practices in Safety-net Hospitals.

    PubMed

    Hochman, Michael; Briggs-Malonson, Medell; Wilkes, Erin; Bergman, Jonathan; Daskivich, Lauren Patty; Moin, Tannaz; Brook, Ilanit; Ryan, Gery W; Brook, Robert H; Mangione, Carol M

    2016-01-01

    In 2007, the Martin Luther King, Jr.-Harbor Hospital (MLK-Harbor), which served a large safety-net population in South Los Angeles, closed due to quality challenges. Shortly thereafter, an agreement was made to establish a new hospital, Martin Luther King, Jr. Community Hospital (MLKCH), to serve the unmet needs of the community. To assist the newly appointed MLKCH Board of Directors in building a culture of quality, we conducted a series of interviews with five high-performing hospital systems. In this report, we describe our findings. The hospitals we interviewed achieved a culture of quality by: 1) developing guiding principles that foster quality; 2) hiring and retaining personnel who are stewards of quality; 3) promoting efficient resource utilization; 4) developing a well-organized quality improvement infrastructure; and 5) cultivating integrated, patient-centric care. The institutions highlighted in this report provide important lessons for MLKCH and other safety-net institutions.

  16. The moral imperative of designating patient safety and quality care as a national nursing research priority.

    PubMed

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2006-01-01

    Since the early 1990s, research studies conducted respectively in the USA, UK and Australia have found that between 4 and 16.6 per cent of patients suffer from some kind of harm (including permanent disability and death) as a result of human errors and adverse events while in hospital. It has been further estimated that approximately 50 per cent of these human errors/adverse events resulting in harm could have been prevented. In response to the significant financial, social, and political implications of these figures, a range of processes have been put in place in an attempt to improve patient safety and quality care in Australia. Nonetheless, it is evident that more can be done to improve the status quo. One process that warrants consideration is that of peak health professional groups and organisations providing active leadership in the promotion of patient safety, such as by making a visible and recognisable commitment to patient safety as a strategic research priority area. In this paper it is contended that, given the moral importance of patient safety and quality care in nursing and related health care domains, the inseparable link between nursing practice and patient safety, and the central role that research has to play in driving safety improvements in these domains, it is morally imperative that the nursing profession gives sustained and focussed public attention to patient safety and quality care as a national research priority.

  17. Aviation Trends Related to Atmospheric Environment Safety Technologies Project Technical Challenges

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.; Withrow, Colleen A.; Barr, Lawrence C.; Evans, Joni K.; Leone, Karen M.; Jones, Sharon M.

    2014-01-01

    Current and future aviation safety trends related to the National Aeronautics and Space Administration's Atmospheric Environment Safety Technologies Project's three technical challenges (engine icing characterization and simulation capability; airframe icing simulation and engineering tool capability; and atmospheric hazard sensing and mitigation technology capability) were assessed by examining the National Transportation Safety Board (NTSB) accident database (1989 to 2008), incidents from the Federal Aviation Administration (FAA) accident/incident database (1989 to 2006), and literature from various industry and government sources. The accident and incident data were examined for events involving fixed-wing airplanes operating under Federal Aviation Regulation (FAR) Parts 121, 135, and 91 for atmospheric conditions related to airframe icing, ice-crystal engine icing, turbulence, clear air turbulence, wake vortex, lightning, and low visibility (fog, low ceiling, clouds, precipitation, and low lighting). Five future aviation safety risk areas associated with the three AEST technical challenges were identified after an exhaustive survey of a variety of sources and include: approach and landing accident reduction, icing/ice detection, loss of control in flight, super density operations, and runway safety.

  18. BC Patient Safety & Quality Council: using network and social movement theory to improve healthcare.

    PubMed

    Krause, Christina; Cochrane, Doug

    2012-01-01

    The BC Patient Safety & Quality Council has a mandate to bring health system stakeholders together in a collaborative partnership to improve quality of care. Our experience has demonstrated the value of networks to provide a forum for individuals to "think like a system," considering the perspectives of others in addressing system issues. This transition from silo-based thinking is important as we move to improve the quality of care at the pace that is required.

  19. Transportation of Organs by Air: Safety, Quality, and Sustainability Criteria.

    PubMed

    Mantecchini, L; Paganelli, F; Morabito, V; Ricci, A; Peritore, D; Trapani, S; Montemurro, A; Rizzo, A; Del Sordo, E; Gaeta, A; Rizzato, L; Nanni Costa, A

    2016-03-01

    The outcomes of organ transplantation activities are greatly affected by the ability to haul organs and medical teams quickly and safely. Organ allocation and usage criteria have greatly improved over time, whereas the same result has not been achieved so far from the transport point of view. Safety and the highest level of service and efficiency must be reached to grant transplant recipients the healthiest outcome. The Italian National Transplant Centre (CNT), in partnership with the regions and the University of Bologna, has promoted a thorough analysis of all stages of organ transportation logistics chains to produce homogeneous and shared guidelines throughout the national territory, capable of ensuring safety, reliability, and sustainability at the highest levels. The mapping of all 44 transplant centers and the pertaining airport network has been implemented. An analysis of technical requirements among organ shipping agents at both national and international level has been promoted. A national campaign of real-time monitoring of organ transport activities at all stages of the supply chain has been implemented. Parameters investigated have been hospital and region of both origin and destination, number and type of organs involved, transport type (with or without medical team), stations of arrival and departure, and shipping agents, as well as actual times of activities involved. National guidelines have been issued to select organ storage units and shipping agents on the basis of evaluation of efficiency, reliability, and equipment with reference to organ type and ischemia time. Guidelines provide EU-level standards on technical equipment of aircrafts, professional requirements of shipping agencies and cabin crew, and requirements on service provision, including pricing criteria. The introduction in the Italian legislation of guidelines issuing minimum requirements on topics such as the medical team, packaging, labeling, safety and integrity, identification

  20. Establishing an Ambulatory Medicine Quality and Safety Oversight Structure: Leveraging the Fractal Model.

    PubMed

    Kravet, Steven J; Bailey, Jennifer; Demski, Renee; Pronovost, Peter

    2016-07-01

    Academic health systems face challenges in the governance and oversight of quality and safety efforts across their organizations. Ambulatory practices, which are growing in number, size, and complexity, face particular challenges in these areas. In February 2014, leaders at Johns Hopkins Medicine (JHM) implemented a governance, oversight, and accountability structure for quality and safety efforts across JHM ambulatory practices. This model was based on the fractal approach, which balances independence and interdependence and provides horizontal and vertical support. It set expectations of accountability at all levels from the Board of Trustees to frontline staff and featured a cascading structure that reached all units and ambulatory practices. This model leveraged an Ambulatory Quality Council led by a physician and nurse dyad to provide the infrastructure to share best practices, continuously improve, and define accountable local leaders. This model was incorporated into the quality and safety infrastructure across JHM. Improved outcomes in the domains of patient safety/risk reduction, externally reported quality measures, patient care/experience, and value have been demonstrated. An additional benefit was an improvement in Medicaid value-based purchasing metrics, which are linked to several million dollars of revenue. As this model matures, it will serve as a mechanism to align quality standards and programs across regional, national, and international partners and to provide a clear quality structure as new practices join the health system. Future efforts will link this model to JHM's academic mission, enhancing education to address Accreditation Council for Graduate Medical Education core competencies.

  1. Quality improvement and patient safety in the pediatric ambulatory setting: current knowledge and implications for residency training.

    PubMed

    Neuspiel, Daniel R; Hyman, Daniel; Lane, Mariellen

    2009-08-01

    The outpatient environment has been the leading edge of improvement work in pediatrics and it has similarly served as an effective locale for the training of pediatric residents in the science of improvement. This review summarizes what is known about the measurement of quality and patient safety in pediatric ambulatory settings. The current Accreditation Council for Graduate Medical Education (ACGME) requirements for resident training in improvement and their application in these settings are discussed. Some approaches and challenges to meeting these requirements are reviewed. Finally, some future directions that this work may follow are presented; the goal is to strengthen the effectiveness of improvement methods and their linkage to professional education.

  2. Nurse practitioner perceptions of the impact of physician oversight on quality and safety of nurse practitioner practice.

    PubMed

    Lowery, Bobby; Scott, Elaine; Swanson, Mel

    2016-08-01

    Nurse practitioner (NP) regulation and physician oversight (PO) of NP practice are inextricably intertwined. A flexible, well-prepared workforce is needed to meet consumer healthcare needs. All outcome studies have revealed that NPs provide safe, effective, quality care with outcomes equal to or better than that of physicians or physician assistants. Variability in state regulation of NP practice limits the full deployment of these proven healthcare providers, threatens the quality and safety of NP-delivered care, and limits consumer choice in healthcare access. The purpose of this study was to document NP perceptions of the impact of PO on the safety and quality of NP practice. A total of 1139 NP respondents completed an exploratory survey, Impact of Regulatory Requirements for Physician Oversight on Nurse Practitioner Practice. Participants were asked their perceptions of the impact of PO on patient care and NP practice. Descriptive statistics on the state of residence regulatory requirements and personal demographics were also collected. NP perceptions of the impact of PO on the safety and quality of NP practice were predicted by NP experience and state regulatory environment ranking. The results of this study have implications for educators, policy makers, and nursing advocacy groups seeking to increase access to care in U.S. Study participants perceived that requirements for PO impacted their practice and may jeopardize patient safety. An understanding of the impact of influences on regulatory processes is critical to ensuring full deployment of NPs as interprofessional leaders to meet current and future healthcare access. ©2015 American Association of Nurse Practitioners.

  3. Exploring health, safety and environment in central and Eastern Europe: an introduction to the European Centre for Occupational Health, Safety and the Environment (ECOHSE).

    PubMed

    Beck, M; Robson, M; Watterson, A; Woolfson, C

    2001-01-01

    This article traces the development of the European Centre for Occupational Health, Safety and the Environment (ECOHSE) at the University of Glasgow. ECOHSE recently has been designated a Thematic Network by the European Union which is providing administrative support through 2004. The de facto de-regulation that accompanied emergent capitalism in Eastern Europe created opportunities for exploitation of the work force. Voluntary efforts of a loose network of occupational and environmental health academics led to a series of yearly conferences to discuss these problems and the lack of research about them. Then, in 1999, a more formal organization was established at Glasgow to pursue continuity and funding. The first occupational and environmental health conference under ECOHSE was held last year in Lithuania, and selected presentations of that meeting are offered in this journal. A second ECOHSE conference will be held this fall in Romania.

  4. Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking.

    PubMed

    Dolansky, Mary A; Moore, Shirley M

    2013-09-30

    Over a decade has passed since the Institute of Medicine's reports on the need to improve the American healthcare system, and yet only slight improvement in quality and safety has been reported. The Quality and Safety Education for Nurses (QSEN) initiative was developed to integrate quality and safety competencies into nursing education. The current challenge is for nurses to move beyond the application of QSEN competencies to individual patients and families and incorporate systems thinking in quality and safety education and healthcare delivery. This article provides a history of QSEN and proposes a framework in which systems thinking is a critical aspect in the application of the QSEN competencies. We provide examples of how using this framework expands nursing focus from individual care to care of the system and propose ways to teach and measure systems thinking. The conclusion calls for movement from personal effort and individual care to a focus on care of the system that will accelerate improvement of healthcare quality and safety.

  5. [Application of Raman Spectroscopy Technique to Agricultural Products Quality and Safety Determination].

    PubMed

    Liu, Yan-de; Jin, Tan-tan

    2015-09-01

    The quality and safety of agricultural products and people health are inseparable. Using the conventional chemical methods which have so many defects, such as sample pretreatment, complicated operation process and destroying the samples. Raman spectroscopy as a powerful tool of analysing and testing molecular structure, can implement samples quickly without damage, qualitative and quantitative detection analysis. With the continuous improvement and the scope of the application of Raman spectroscopy technology gradually widen, Raman spectroscopy technique plays an important role in agricultural products quality and safety determination, and has wide application prospects. There have been a lot of related research reports based on Raman spectroscopy detection on agricultural product quality safety at present. For the understanding of the principle of detection and the current development situation of Raman spectroscopy, as well as tracking the latest research progress both at home and abroad, the basic principles and the development of Raman spectroscopy as well as the detection device were introduced briefly. The latest research progress of quality and safety determination in fruits and vegetables, livestock and grain by Raman spectroscopy technique were reviewed deeply. Its technical problems for agricultural products quality and safety determination were pointed out. In addition, the text also briefly introduces some information of Raman spectrometer and the application for patent of the portable Raman spectrometer, prospects the future research and application.

  6. Temporal Patterns in Seawater Quality from Dredging in Tropical Environments

    PubMed Central

    Jones, Ross; Fisher, Rebecca; Stark, Clair; Ridd, Peter

    2015-01-01

    Maintenance and capital dredging represents a potential risk to tropical environments, especially in turbidity-sensitive environments such as coral reefs. There is little detailed, published observational time-series data that quantifies how dredging affects seawater quality conditions temporally and spatially. This information is needed to test realistic exposure scenarios to better understand the seawater-quality implications of dredging and ultimately to better predict and manage impacts of future projects. Using data from three recent major capital dredging programs in North Western Australia, the extent and duration of natural (baseline) and dredging-related turbidity events are described over periods ranging from hours to weeks. Very close to dredging i.e. <500 m distance, a characteristic features of these particular case studies was high temporal variability. Over several hours suspended sediment concentrations (SSCs) can range from 100–500 mg L-1. Less turbid conditions (10–80 mg L-1) can persist over several days but over longer periods (weeks to months) averages were <10 mg L-1. During turbidity events all benthic light was sometimes extinguished, even in the shallow reefal environment, however a much more common feature was very low light ‘caliginous’ or daytime twilight periods. Compared to pre-dredging conditions, dredging increased the intensity, duration and frequency of the turbidity events by 10-, 5- and 3-fold respectively (at sites <500 m from dredging). However, when averaged across the entire dredging period of 80–180 weeks, turbidity values only increased by 2–3 fold above pre-dredging levels. Similarly, the upper percentile values (e.g., P99, P95) of seawater quality parameters can be highly elevated over short periods, but converge to values only marginally above baseline states over longer periods. Dredging in these studies altered the overall probability density distribution, increasing the frequency of extreme values. As such

  7. Quality and safety of human hepatitis B vaccine.

    PubMed

    Hilleman, M R; McAleer, W J; Buynak, E B; McLean, A A

    1983-01-01

    Preparation of hepatitis B vaccine in our laboratories consists of a series of steps that include initial concentration of surface antigen by ammonium sulfate precipitation, followed by isopycnic banding and rate zonal centrifugation in a K-II centrifuge. The partially purified antigen concentrate is digested with pepsin at pH2 and the antigen is unfolded in 8M urea solution followed by renaturation. After gel filtration, the antigen is treated with formalin in 1:4000 dilution, adsorbed onto alum, and preserved with thimerosal. The final product contains essentially pure hepatitis B surface antigen. The process relies both on physical elimination of infectious virus particles and treatment with highly viral-destructive reagents in the pepsin, urea and formalin steps. The process is known to be highly destructive of all known viruses tested and to include procedures that are known to be highly destructive of representatives of all known groups of animal viral agents. The three-step process in inactivation provides a fail-safe system for establishing safety of the product. Tests in more than 20'000 persons, who are under surveillance, have shown no untoward effect and have confirmed the safety of the product.

  8. Quality and safety in adult epilepsy monitoring units: A systematic review and meta-analysis.

    PubMed

    Sauro, Khara M; Wiebe, Natalie; Macrodimitris, Sophie; Wiebe, Samuel; Lukmanji, Sara; Jetté, Nathalie

    2016-11-01

    The epilepsy monitoring unit (EMU) is a valuable resource for optimizing management of persons with epilepsy, but may place patients at risk for adverse events due to withdrawal of treatment and induction of symptoms. The purpose of this study was to synthesize data on the safety and quality of care in EMUs to inform the development of quality indicators for EMUs. A systematic review was conducted according to the Preferred Reporting and Items for Systematic Review and Meta-Analysis (PRISMA) statement. The search strategy, which included broad search terms and synonyms pertaining to the EMU, was run in six medical databases and included conference proceedings. Data abstracted included patient and EMU demographics and quality and safety variables. Study quality was evaluated using a modified 15-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Descriptive statistics and meta-analyses were used to describe and synthesize the evidence. The search yielded 7,601 references, of which 604 were reviewed in full text. One-hundred thirty-five studies were included. The quality and safety data came from 181,823 patients and reported on 34 different quality and safety variables. Included studies commonly reported the number of patients (108 studies; median number patients, 171.5), age (49 studies; mean age 35.7 years old), and the reason for admission (34 studies). The most common quality and safety data reported were the utility of the EMU admission (38 studies). Thirty-three studies (24.4%) reported on adverse events, and yielded a pooled proportion of adverse events of 7% (95% confidence interval [CI] 5-9%). The mean quality score was 73.3% (standard deviation [SD] 17.2). This study demonstrates that there is a great deal of variation in the reporting of quality and safety measures and in the quality and safety in EMUs. Study quality also varied considerably from one study to the next. These findings highlight the need to develop

  9. Integrating quality and patient safety concepts in medical curricula. Baseline assessment in Lebanon.

    PubMed

    Natafgi, Nabil; Saliba, Miriam; Daya, Rami; El-Jardali, Fadi

    2012-01-01

    Hospital accreditation places emphasis on the role of health professionals in quality of patient care. Training physicians in quality and patient safety influences quality improvement efforts in healthcare. Little is known about the attitudes and knowledge of medical students towards the concepts of quality of care, patient safety and accreditation. The objective of this study was to determine the extent to which Lebanese medical students are aware of and familiar with these aforementioned concepts. The study adopted a cross-sectional research design on a sample of (148 participants) graduating medical students from four major universities in Lebanon. A semi-structured self-completion questionnaire was developed to assess students' knowledge towards: (A) quality concepts; (B) quality tools ; (C) patient safety & risk management; (D) accreditation ; and (E) policies & procedures/guidelines. Two statistical tests, MANOVA (parametric) and Kruskal-Wallis (nonparametric) were used to analyze the data. Study results showed that 85% of medical students did not receive any course about quality and patient safety, although 93% considered them to be important and called for their integration into curricula. Lowest mean scores were recorded for the theme on quality concepts and tools (1.60 +/- 0.81 and 1A.49 +/- 0.71 respectively). Respondents from sampled universities showed a general lack of knowledge of the themes studied. Quality, patient safety and accreditation are important disciplines that need to be incorporated into medical curricula. This would be a positive step towards enabling future physicians to meet the changing needs of the constantly evolving healthcare system.

  10. Astronauts Thornton and Parazynski during quality safety inspection at WETF

    NASA Image and Video Library

    1995-04-19

    S95-08375 (August 1995) --- Astronaut Kathryn C. Thornton, payload commander for the U.S. Microgravity Laboratory (USML-2) mission, prepares to go underwater in the Johnson Space Center?s (JSC) Weightless Environment Training Facility (WET-F) pool. Thornton was about to rehearse contingency space walk tasks; there is no Extravehicular Activity (EVA) planned for the STS-73 mission.

  11. Radiation Safety and Quality Assurance in North American Dental Schools.

    ERIC Educational Resources Information Center

    Farman, Allan G.; Hines, Vickie G.

    1986-01-01

    A survey of dental schools that revealed processing quality control and routine maintenance checks on x-ray generators are being carried out in a timely manner is discussed. However, methods for reducing patient exposure to radiation are not being fully implemented, and some dental students are being exposed to x-rays. (Author/MLW)

  12. Radiation Safety and Quality Assurance in North American Dental Schools.

    ERIC Educational Resources Information Center

    Farman, Allan G.; Hines, Vickie G.

    1986-01-01

    A survey of dental schools that revealed processing quality control and routine maintenance checks on x-ray generators are being carried out in a timely manner is discussed. However, methods for reducing patient exposure to radiation are not being fully implemented, and some dental students are being exposed to x-rays. (Author/MLW)

  13. Overarching goals: a strategy for improving healthcare quality and safety?

    PubMed

    Nanji, Karen C; Ferris, Timothy G; Torchiana, David F; Meyer, Gregg S

    2013-03-01

    The management literature reveals that many successful organisations have strategic plans that include a bold 'stretch-goal' to stimulate progress over a ten-to-thirty-year period. A stretch goal is clear, compelling and easily understood. It serves as a unifying focal point for organisational efforts. The ambitiousness of such goals has been emphasised with the phrase Big Hairy Audacious Goal ('BHAG'). President Kennedy's proclamation in 1961 that 'this Nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to earth' provides a famous example. This goal energised the US National Aeronautics and Space Administration, and it captured the attention of the American public and resulted in one of the largest accomplishments of any organisation. The goal set by Sony, a small, cash-strapped electronics company in the 1950s, to change the poor image of Japanese products around the world represents a classic BHAG. Few examples of quality goals that conform to the BHAG definition exist in the healthcare literature. However, the concept may provide a useful framework for organisations seeking to transform the quality of care they deliver. This review examines the merits and cautions of setting overarching quality goals to catalyse quality improvement efforts, and assists healthcare organisations with determining whether to adopt these goals.

  14. Quality of Care is Similar for Safety-Net and Non-Safety-Net Hospitals

    MedlinePlus

    ... on your PDA or mobile device Health Care Innovations Exchange Innovations and Tools to Improve Quality and Reduce Disparities ... funding sources affects physician evaluation of research studies Trends in diabetes treatment suggest more multidrug regimens, resulting ...

  15. Effects of characteristics of image quality in an immersive environment

    NASA Technical Reports Server (NTRS)

    Duh, Henry Been-Lirn; Lin, James J W.; Kenyon, Robert V.; Parker, Donald E.; Furness, Thomas A.

    2002-01-01

    Image quality issues such as field of view (FOV) and resolution are important for evaluating "presence" and simulator sickness (SS) in virtual environments (VEs). This research examined effects on postural stability of varying FOV, image resolution, and scene content in an immersive visual display. Two different scenes (a photograph of a fountain and a simple radial pattern) at two different resolutions were tested using six FOVs (30, 60, 90, 120, 150, and 180 deg.). Both postural stability, recorded by force plates, and subjective difficulty ratings varied as a function of FOV, scene content, and image resolution. Subjects exhibited more balance disturbance and reported more difficulty in maintaining posture in the wide-FOV, high-resolution, and natural scene conditions.

  16. [Organize quality assurance as in aviation; improve patient safety in Dutch hospitals].

    PubMed

    Haerkens, Marck H T M; Beekmann, Roland T A; van den Elzen, Guus J P; Lansbergen, Michael D I; Berlijn, Dick L

    2009-01-01

    Failing teamwork is a major cause of adverse events in hospitals in the Netherlands. Training team-skills can improve the safety standards in clinical heath care. An adapted version of Crew Resource Management (CRM) training is proving to be a usable format in the hospital environment. We emphasize that paying attention to the subject of safety has to start early in medical education in order to incorporate non-technical skills into the hospital culture.

  17. Bridging the Gap: A Framework and Strategies for Integrating the Quality and Safety Mission of Teaching Hospitals and Graduate Medical Education.

    PubMed

    Tess, Anjala; Vidyarthi, Arpana; Yang, Julius; Myers, Jennifer S

    2015-09-01

    Integrating the quality and safety mission of teaching hospitals and graduate medical education (GME) is a necessary step to provide the next generation of physicians with the knowledge, skills, and attitudes they need to participate in health system improvement. Although many teaching hospital and health system leaders have made substantial efforts to improve the quality of patient care, few have fully included residents and fellows, who deliver a large portion of that care, in their efforts. Despite expectations related to the engagement of these trainees in health care quality improvement and patient safety outlined by the Accreditation Council for Graduate Medical Education in the Clinical Learning Environment Review program, a structure for approaching this integration has not been described.In this article, the authors present a framework that they hope will assist teaching hospitals in integrating residents and fellows into their quality and safety efforts and in fostering a positive clinical learning environment for education and patient care. The authors define the six essential elements of this framework-organizational culture, teaching hospital-GME alignment, infrastructure, curricular resources, faculty development, and interprofessional collaboration. They then describe the organizational characteristics required for each element and offer concrete strategies to achieve integration. This framework is meant to be a starting point for the development of robust national models of infrastructure, alignment, and collaboration between GME and health care quality and safety leaders at teaching hospitals.

  18. Food Safety and Quality: Who does What in the Federal Government, Volume 2

    DTIC Science & Technology

    1990-12-21

    food safety will increase. Also, i’is senses a growing concern for better quality of grains and oil seeds by importers and domestic buyers. FGIS...microbes; * studying the ecological, biological, and physical interactions, accumula- tion, stability , and chemical structure of marine toxins and evaluating...contain one or more inert ingredients-those that propel, dilute, or stabilize the active ingredi- ents-which may also be toxic and pose a food safety risk

  19. Unlocking Potentials of Microwaves for Food Safety and Quality

    PubMed Central

    Tang, Juming

    2015-01-01

    Microwave is an effective means to deliver energy to food through polymeric package materials, offering potential for developing short-time in-package sterilization and pasteurization processes. The complex physics related to microwave propagation and microwave heating require special attention to the design of process systems and development of thermal processes in compliance with regulatory requirements for food safety. This article describes the basic microwave properties relevant to heating uniformity and system design, and provides a historical overview on the development of microwave-assisted thermal sterilization (MATS) and pasteurization systems in research laboratories and used in food plants. It presents recent activities on the development of 915 MHz single-mode MATS technology, the procedures leading to regulatory acceptance, and sensory results of the processed products. The article discusses needs for further efforts to bridge remaining knowledge gaps and facilitate transfer of academic research to industrial implementation. PMID:26242920

  20. The Gluten-Free Diet: Safety and Nutritional Quality

    PubMed Central

    Saturni, Letizia; Ferretti, Gianna; Bacchetti, Tiziana

    2010-01-01

    The prevalence of Celiac Disease (CD), an autoimmune enteropathy, characterized by chronic inflammation of the intestinal mucosa, atrophy of intestinal villi and several clinical manifestations has increased in recent years. Subjects affected by CD cannot tolerate gluten protein, a mixture of storage proteins contained in several cereals (wheat, rye, barley and derivatives). Gluten free-diet remains the cornerstone treatment for celiac patients. Therefore the absence of gluten in natural and processed foods represents a key aspect of food safety of the gluten-free diet. A promising area is the use of minor or pseudo-cereals such as amaranth, buckwheat, quinoa, sorghum and teff. The paper is focused on the new definition of gluten-free products in food label, the nutritional properties of the gluten-free cereals and their use to prevent nutritional deficiencies of celiac subjects. PMID:22253989

  1. Unlocking Potentials of Microwaves for Food Safety and Quality.

    PubMed

    Tang, Juming

    2015-08-01

    Microwave is an effective means to deliver energy to food through polymeric package materials, offering potential for developing short-time in-package sterilization and pasteurization processes. The complex physics related to microwave propagation and microwave heating require special attention to the design of process systems and development of thermal processes in compliance with regulatory requirements for food safety. This article describes the basic microwave properties relevant to heating uniformity and system design, and provides a historical overview on the development of microwave-assisted thermal sterilization (MATS) and pasteurization systems in research laboratories and used in food plants. It presents recent activities on the development of 915 MHz single-mode MATS technology, the procedures leading to regulatory acceptance, and sensory results of the processed products. The article discusses needs for further efforts to bridge remaining knowledge gaps and facilitate transfer of academic research to industrial implementation.

  2. Microbial interactions in cheese: implications for cheese quality and safety.

    PubMed

    Irlinger, Françoise; Mounier, Jérôme

    2009-04-01

    The cheese microbiota, whose community structure evolves through a succession of different microbial groups, plays a central role in cheese-making. The subtleties of cheese character, as well as cheese shelf-life and safety, are largely determined by the composition and evolution of this microbiota. Adjunct and surface-ripening cultures marketed today for smear cheeses are inadequate for adequately mimicking the real diversity encountered in cheese microbiota. The interactions between bacteria and fungi within these communities determine their structure and function. Yeasts play a key role in the establishment of ripening bacteria. The understanding of these interactions offers to enhance cheese flavour formation and to control and/or prevent the growth of pathogens and spoilage microorganisms in cheese.

  3. ICT for quality and safety of care: beyond interoperability.

    PubMed

    Kolitsi, Zoi

    2011-01-01

    Risk Management in healthcare is a particularly challenging task. From a health system perspective a systemic and person centered approach is needed. From an ICT perspective, continuity of care and sharing information for clinical purposes, research and care improvement can be supported though interoperable systems and services and concurrent ability of proper interpretation of this knowledge by different users. Research provides solutions to specific patient safety challenges. Supporting the dynamics of change will furthermore necessitate strategies to shorten the innovation cycle from research to implementation, deployment, adoption and routine use. Transferring research results to deployable solutions requires in addition a high degree of co-ordination at EU level, with strong links to the national competent organisations and stakeholder communities. The breadth and complexity of the issues that need to be addressed require that an appropriate, EU Collaborative Governance is set up.

  4. Understanding the role of sleep quality and sleep duration in commercial driving safety.

    PubMed

    Lemke, Michael K; Apostolopoulos, Yorghos; Hege, Adam; Sönmez, Sevil; Wideman, Laurie

    2016-12-01

    Long-haul truck drivers in the United States suffer disproportionately high injury rates. Sleep is a critical factor in these outcomes, contributing to fatigue and degrading multiple aspects of safety-relevant performance. Both sleep duration and sleep quality are often compromised among truck drivers; however, much of the efforts to combat fatigue focus on sleep duration rather than sleep quality. Thus, the current study has two objectives: (1) to determine the degree to which sleep impacts safety-relevant performance among long-haul truck drivers; and (2) to evaluate workday and non-workday sleep quality and duration as predictors of drivers' safety-relevant performance. A non-experimental, descriptive, cross-sectional design was employed to collect survey and biometric data from 260 long-haul truck drivers. The Trucker Sleep Disorders Survey was developed to assess sleep duration and quality, the impact of sleep on job performance and accident risk, and other relevant work organization characteristics. Descriptive statistics assessed work organization variables, sleep duration and quality, and frequency of engaging in safety-relevant performance while sleepy. Linear regression analyses were conducted to evaluate relationships between sleep duration, sleep quality, and work organization variables with safety composite variables. Drivers reported long work hours, with over 70% of drivers working more than 11h daily. Drivers also reported a large number of miles driven per week, with an average of 2,812.61 miles per week, and frequent violations of hours-of-service rules, with 43.8% of drivers "sometimes to always" violating the "14-h rule." Sleep duration was longer, and sleep quality was better, on non-workdays compared on workdays. Drivers frequently operated motor vehicles while sleepy, and sleepiness impacted several aspects of safety-relevant performance. Sleep quality was better associated with driving while sleepy and with job performance and concentration

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

    PubMed Central

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

    2009-01-01

    Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe. PMID:19188462

  6. [Toxicity tests and their application in safety assessment of water quality].

    PubMed

    Xu, Jian-Ying; Zhao, Chun-Tao; Wei, Dong-Bin

    2014-10-01

    The safety of water quality has important impacts not only on the health of ecological system, but also on the survival and development of human beings. The conventional assessment methods for water quality based on the concentration limits are not reliable. The toxicity tests can vividly reflect the whole adverse biological effects of multiple chemicals in water body, which has been regarded as a necessary supplement for conventional water quality assessment methods based on physicochemical parameters. Considering the chemical pollutants usually have various adverse biological effects, the ecotoxicity testing methods, including lethality, genotoxicity, endocrine disrupting effects, were classified according to the different toxicity types. Then, the potential applications of toxicity testing methods and corresponding evaluation indices in evaluating the toxicity characteristics of ambient water samples were discussed. Particularly, the safety assessment methods for water quality based on the toxicity tests, including potential toxicology, toxicity unit classification system, potential ecotoxic effect probe, and safety assessment of water quality based on toxicity test battery, were summarized. This paper not only systematically reviewed the progress of toxicity tests and their application in safety assessment of water quality, but also provided the scientific basis for the further development in the future.

  7. The role of hospital managers in quality and patient safety: a systematic review

    PubMed Central

    Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles

    2014-01-01

    Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance. PMID:25192876

  8. What is the value and impact of quality and safety teams? A scoping review

    PubMed Central

    2011-01-01

    Background The purpose of this study was to conduct a scoping review of the literature about the establishment and impact of quality and safety team initiatives in acute care. Methods Studies were identified through electronic searches of Medline, Embase, CINAHL, PsycINFO, ABI Inform, Cochrane databases. Grey literature and bibliographies were also searched. Qualitative or quantitative studies that occurred in acute care, describing how quality and safety teams were established or implemented, the impact of teams, or the barriers and/or facilitators of teams were included. Two reviewers independently extracted data on study design, sample, interventions, and outcomes. Quality assessment of full text articles was done independently by two reviewers. Studies were categorized according to dimensions of quality. Results Of 6,674 articles identified, 99 were included in the study. The heterogeneity of studies and results reported precluded quantitative data analyses. Findings revealed limited information about attributes of successful and unsuccessful team initiatives, barriers and facilitators to team initiatives, unique or combined contribution of selected interventions, or how to effectively establish these teams. Conclusions Not unlike systematic reviews of quality improvement collaboratives, this broad review revealed that while teams reported a number of positive results, there are many methodological issues. This study is unique in utilizing traditional quality assessment and more novel methods of quality assessment and reporting of results (SQUIRE) to appraise studies. Rigorous design, evaluation, and reporting of quality and safety team initiatives are required. PMID:21861911

  9. What is the value and impact of quality and safety teams? A scoping review.

    PubMed

    White, Deborah E; Straus, Sharon E; Stelfox, H Tom; Holroyd-Leduc, Jayna M; Bell, Chaim M; Jackson, Karen; Norris, Jill M; Flemons, W Ward; Moffatt, Michael E; Forster, Alan J

    2011-08-23

    The purpose of this study was to conduct a scoping review of the literature about the establishment and impact of quality and safety team initiatives in acute care. Studies were identified through electronic searches of Medline, Embase, CINAHL, PsycINFO, ABI Inform, Cochrane databases. Grey literature and bibliographies were also searched. Qualitative or quantitative studies that occurred in acute care, describing how quality and safety teams were established or implemented, the impact of teams, or the barriers and/or facilitators of teams were included. Two reviewers independently extracted data on study design, sample, interventions, and outcomes. Quality assessment of full text articles was done independently by two reviewers. Studies were categorized according to dimensions of quality. Of 6,674 articles identified, 99 were included in the study. The heterogeneity of studies and results reported precluded quantitative data analyses. Findings revealed limited information about attributes of successful and unsuccessful team initiatives, barriers and facilitators to team initiatives, unique or combined contribution of selected interventions, or how to effectively establish these teams. Not unlike systematic reviews of quality improvement collaboratives, this broad review revealed that while teams reported a number of positive results, there are many methodological issues. This study is unique in utilizing traditional quality assessment and more novel methods of quality assessment and reporting of results (SQUIRE) to appraise studies. Rigorous design, evaluation, and reporting of quality and safety team initiatives are required.

  10. Long-term care: nursing home quality and safety--2005. End of Year Issue Brief.

    PubMed

    Tanner, Rachel; Bercaw, Lawren

    2005-12-31

    In 2002, the Government Accountability Office reported that more than 1.7 million senior citizens resided in over 17,000 nursing homes across the United States. A 2003 Administration on Aging report predicted that number would increase dramatically as the "baby-boom" generation ages. Accordingly, legislators and nursing home administrators have striven to develop facilities that provide safe, high-quality eldercare to the nations' growing senior population. The Health Policy Tracking Service (HPTS) published a study in January--2005 Health Care Priorities Report--that depicts state lawmakers' concern for nursing home quality and safety. To policymakers, nursing home quality and safety is a very high priority, second only to Medicaid. The HPTS survey also indicated that 38 states planned to address senior facility safety in 2005 by adopting more stringent employee background checks, higher staffing standards and strict licensure requirements

  11. Integration of occupational health and safety, environmental and quality management system standards.

    PubMed

    Stromsvag, A; Winder, C

    1997-01-01

    Occupational health and safety, environmental, and quality (SEQ) issues are commonly managed by three separate departments within organizations. Because of a number of commonalities in the three management systems, there could be a degree of overlap that might lead to inefficiencies. By integrating these three management systems into one SEQ system, the duplication of effort could be minimized and the health and safety, environmental, and quality issues could be managed by one common proactive approach. The draft Australian standard for an occupational health and safety (OHS) management system and the internationally accepted standards for environmental (ISO 14001) and quality (ISO 9001) management systems were analyzed to identify all requirements of the three management systems and integrate this into one SEQ management system standard.

  12. The new fundamentals in nursing: introducing beginning quality and safety education for nurses' competencies.

    PubMed

    Preheim, Gayle J; Armstrong, Gail E; Barton, Amy J

    2009-12-01

    This article describes the redesign of the fundamentals of nursing course using an organizing framework and teaching strategies identified in the Quality and Safety Education for Nurses (QSEN) initiative. Six QSEN competencies (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) are essential for nursing practice. Beginning knowledge, skills, and attitudes (KSAs) associated with each competency were identified in a preliminary Delphi survey as important to incorporate early in prelicensure nursing curricula. Redesign requires a shift in focus from task-training and psychomotor skills development to incorporation of a systems context, reflecting redefined values and interventions associated with safety, quality, and professional nursing roles. A course revision, based on the QSEN competencies definitions, selected beginning KSAs, exemplar resources, and teaching strategies, is described. The reframing of fundamentals of nursing is essential to prepare new graduates for contemporary practice.

  13. Research priorities for coordinating management of food safety and water quality.

    PubMed

    Crohn, David M; Bianchi, Mary L

    2008-01-01

    Efforts to exclude disease organisms from farms growing irrigated lettuce and leafy vegetables on California's central coast are conflicting with traditionally accepted strategies to protect surface water quality. To begin resolving this dilemma, over 100 officials, researchers, and industry representatives gathered in April 2007 to set research priorities that could lead to effective co-management of both food safety and water quality. Following the meeting, research priorities were refined and ordered by way of a Delphi process completed by 35 meeting participants. Although water quality and food safety experts conceptualized the issues differently, there were no deep disagreements with respect to research needs. Top priority was given to investigating the fate of pathogens potentially present on farms. Intermediate priorities included characterizing the influence of specific farm management practices on food safety and improving our understanding of vector processes. A scientific subdiscipline focusing on competing risks is needed to characterize and resolve conflicts between human and environmental health.

  14. A task force model for statewide change in nursing education: building quality and safety.

    PubMed

    Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

    2013-01-01

    The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety.

  15. Patient safety is not enough: targeting quality improvements to optimize the health of the population.

    PubMed

    Woolf, Steven H

    2004-01-06

    Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

  16. Implementing quality/productivity improvement initiatives in an engineering environment

    NASA Technical Reports Server (NTRS)

    Ruda, R. R.

    1985-01-01

    Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

  17. Implementing quality/productivity improvement initiatives in an engineering environment

    NASA Technical Reports Server (NTRS)

    Ruda, R. R.

    1985-01-01

    Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

  18. [Quality & Safety in radiotherapy: advocacy for a professional strategy].

    PubMed

    Parmentier, G

    2008-11-01

    In medicine, as in oncological radiotherapy, as elsewhere, the precept of quality has no meaning if it is not defined. In France as everywhere radiotherapy has its forces and its weaknesses. As in every country, its future seems assured by its character cost effective as by its capacity to make progress in the triple point of view of its equipment, its professions and its organization. However, the French radiotherapy is in crisis. The professionals saw clearly. For more than 10 years they had recalled the medical authorities to their responsibilities concerning the demographic trends for the radiotherapists and the physicists, the renovation of the equipment, the modernization of the organizations, the promotion of the evaluation of procedures and outcomes and the development of a greater fairness in the financings. But the delay taken, the setting under pressure of the professionals by the State, its services, its agencies and the media following the recent accidents cause numerous perverse effects and worried the staff. The accident of Epinal was the starting fact of an effort of professionalisation of the risk management, but also of a disturbed period favourable with a certain confusion of minds, discouragement and protective behaviors. The risks felt by the professionals then seem especially to come from the authorities and the media. It appears that the topic of quality is at the center of all these speeches. Under this vocable, it is in fact the respect of the procedures related to the requirement of security which is privileged by the State and its representatives. The apparent security seems to override the real quality of the practices. Thus, time came for a clarification of the quality and security concepts, of organizations which contribute to it and for the development of a clear strategy bringing together the interprofessionnal actors. In this context, the implication of the College and especially of the Société française de radioth

  19. Radiation safety and quality assurance in North American dental schools

    SciTech Connect

    Farman, A.G.; Hines, V.G.

    1986-06-01

    A survey of North American dental schools revealed that processing quality control and routine maintenance checks on x-ray generators are, in most instances, being carried out in a timely manner. Available methods for reducing patient exposure to ionizing radiation are, however, not being fully implemented. Furthermore, in some instances, dental students are still being exposed to x-rays primarily for teaching purposes.

  20. Teach-Back for quality education and patient safety.

    PubMed

    Tamura-Lis, Winifred

    2013-01-01

    Effective clinician-patient communication, a clear understanding of patient literacy, and use of the Teach-Back Method are useful tools in helping patients to better understand their own medical conditions. Educated patients are able to manage their medications, fully participate in their treatments, and follow protocols to achieve the goal of safe quality care. The end result is win-win: positive patient outcomes and increased patient satisfaction.

  1. The Patient Safety and Quality Improvement Act of 2005--The federal law and its implications for Mssouri.

    PubMed

    Miller, Rebecca G; Druckman, Jennifer L

    2007-01-01

    The Patient Safety and Quality Improvement Act of 2005 establishes a network of federally certified Patient Safety Organizations (PSO). PSOs will establish voluntary, confidential data systems and forums for providers to learn and improve patient safety. The Act provides protections, not available in Missouri, from discovery of data reported to a PSO. Providers should begin assessing patient safety activities and benefits of PSO participation. The Missouri Center for Patient Safety plans to become a statewide PSO.

  2. Environment, Safety, and Health Self-Assessment Report, Fiscal Year 2008

    SciTech Connect

    Chernowski, John

    2009-02-27

    Lawrence Berkeley National Laboratory's Environment, Safety, and Health (ES&H) Self-Assessment Program ensures that Integrated Safety Management (ISM) is implemented institutionally and by all divisions. The Self-Assessment Program, managed by the Office of Contract Assurance (OCA), provides for an internal evaluation of all ES&H programs and systems at LBNL. The functions of the program are to ensure that work is conducted safely, and with minimal negative impact to workers, the public, and the environment. The Self-Assessment Program is also the mechanism used to institute continuous improvements to the Laboratory's ES&H programs. The program is described in LBNL/PUB 5344, Environment, Safety, and Health Self-Assessment Program and is composed of four distinct assessments: the Division Self-Assessment, the Management of Environment, Safety, and Health (MESH) review, ES&H Technical Assurance, and the Appendix B Self-Assessment. The Division Self-Assessment uses the five core functions and seven guiding principles of ISM as the basis of evaluation. Metrics are created to measure performance in fulfilling ISM core functions and guiding principles, as well as promoting compliance with applicable regulations. The five core functions of ISM are as follows: (1) Define the Scope of Work; (2) Identify and Analyze Hazards; (3) Control the Hazards; (4) Perform the Work; and (5) Feedback and Improvement. The seven guiding principles of ISM are as follows: (1) Line Management Responsibility for ES&H; (2) Clear Roles and Responsibilities; (3) Competence Commensurate with Responsibilities; (4) Balanced Priorities; (5) Identification of ES&H Standards and Requirements; (6) Hazard Controls Tailored to the Work Performed; and (7) Operations Authorization. Performance indicators are developed by consensus with OCA, representatives from each division, and Environment, Health, and Safety (EH&S) Division program managers. Line management of each division performs the Division Self

  3. Introduction to the STS National Database Series: Outcomes Analysis, Quality Improvement, and Patient Safety.

    PubMed

    Jacobs, Jeffrey P; Shahian, David M; Prager, Richard L; Edwards, Fred H; McDonald, Donna; Han, Jane M; D'Agostino, Richard S; Jacobs, Marshall L; Kozower, Benjamin D; Badhwar, Vinay; Thourani, Vinod H; Gaissert, Henning A; Fernandez, Felix G; Wright, Cam; Fann, James I; Paone, Gaetano; Sanchez, Juan A; Cleveland, Joseph C; Brennan, J Matthew; Dokholyan, Rachel S; O'Brien, Sean M; Peterson, Eric D; Grover, Frederick L; Patterson, G Alexander

    2015-12-01

    The Society of Thoracic Surgeons (STS) National Database is the foundation for most of the Society's quality, research, and patient safety activities. Beginning in January 2016 and repeating each year, The Annals of Thoracic Surgery will publish a monthly Database series of scholarly articles on outcomes analysis, quality improvement, and patient safety. Six articles will be directly derived from the STS National Database and will be published every other month: three articles on outcomes and quality (one each from the STS Adult Cardiac Surgery Database, the STS Congenital Heart Surgery Database, and the STS General Thoracic Surgery Database), and three articles on research (one from each of these three specialty databases). These six articles will alternate with five additional articles on topics related to patient safety. The final article, to be published in December, will provide a summary of the prior 11 manuscripts. This series will allow STS and its Workforces on National Databases, Research Development, and Patient Safety to convey timely information aimed at improving the quality and safety of cardiothoracic surgery. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Task Group report to the Assistant Secretary for Environment, Safety and Health on oversight of chemical safety at the Department of Energy. Volume 2, Appendices

    SciTech Connect

    Not Available

    1992-11-01

    This report presents the results of a preliminary review of chemical safety within the Department of Energy (DOE). The review was conducted by Chemical Safety Oversight Review (CSOR) Teams composed of Office of Environment, Safety and Health (EH) staff members and contractors. The primary objective of the CSOR was to assess, the safety status of DOE chemical operations and identify any significant deficiencies associated with such operations. Significant was defined as any situation posing unacceptable risk, that is, imminent danger or threat to workers, co-located workers, the general public, or the environment, that requires prompt action by EH or the line organizations. A secondary objective of the CSOR was to gather and analyze technical and programmatic information related to chemical safety to be used in conjunction with the longer-range EH Workplace Chemical Accident Risk Review (WCARR) Program. The WCARR Program is part of the ongoing EH oversight of nonnuclear safety at all DOE facilities. `` The program objective is to analyze DOE and industry chemical safety programs and performance and determine the need for additional or improved safety guidance for DOE. During the period June 6, 1992, through July 31, 1992, EH conducted CSORs at five DOE sites. The sites visited were Los Alamos National Laboratory (LANL), Savannah River Site (SRS), the Y-12 Plant (Y-12), Oak Ridge National Laboratory (ORNL), and Lawrence Livermore National Laboratory (LLNL).

  5. Measuring school climate in high schools: a focus on safety, engagement, and the environment.

    PubMed

    Bradshaw, Catherine P; Waasdorp, Tracy E; Debnam, Katrina J; Johnson, Sarah Lindstrom

    2014-09-01

    School climate has been linked to multiple student behavioral, academic, health, and social-emotional outcomes. The US Department of Education (USDOE) developed a 3-factor model of school climate comprised of safety, engagement, and environment. This article examines the factor structure and measurement invariance of the USDOE model. Drawing upon 2 consecutive waves of data from over 25,000 high school students (46% minority), a series of exploratory and confirmatory factor analyses examined the fit of the Maryland Safe and Supportive Schools Climate Survey with the USDOE model. The results indicated adequate model fit with the theorized 3-factor model of school climate, which included 13 subdomains: safety (perceived safety, bullying and aggression, and drug use); engagement (connection to teachers, student connectedness, academic engagement, school connectedness, equity, and parent engagement); environment (rules and consequences, physical comfort, and support, disorder). We also found consistent measurement invariance with regard to student sex, grade level, and ethnicity. School-level interclass correlation coefficients ranged from 0.04 to .10 for the scales. Findings supported the USDOE 3-factor model of school climate and suggest measurement invariance and high internal consistency of the 3 scales and 13 subdomains. These results suggest the 56-item measure may be a potentially efficient, yet comprehensive measure of school climate. © 2014, American School Health Association.

  6. Patient safety, quality of care, and knowledge translation in the intensive care unit.

    PubMed

    Needham, Dale M

    2010-07-01

    A large gap exists between the completion of clinical research demonstrating the benefit of new treatment interventions and improved patient outcomes resulting from implementation of these interventions as part of routine clinical practice. This gap clearly affects patient safety and quality of care. Knowledge translation is important for addressing this gap, but evaluation of the most appropriate and effective knowledge translation methods is still ongoing. Through describing one model for knowledge translation and an example of its implementation, insights can be gained into systematic methods for advancing the implementation of evidence-based interventions to improve safety, quality, and patient outcomes.

  7. Recent Developments in Hyperspectral Imaging for Assessment of Food Quality and Safety

    PubMed Central

    Huang, Hui; Liu, Li; Ngadi, Michael O.

    2014-01-01

    Hyperspectral imaging which combines imaging and spectroscopic technology is rapidly gaining ground as a non-destructive, real-time detection tool for food quality and safety assessment. Hyperspectral imaging could be used to simultaneously obtain large amounts of spatial and spectral information on the objects being studied. This paper provides a comprehensive review on the recent development of hyperspectral imaging applications in food and food products. The potential and future work of hyperspectral imaging for food quality and safety control is also discussed. PMID:24759119

  8. Water quality of hydrologic bench marks; an indicator of water quality in the natural environment

    USGS Publications Warehouse

    Biesecker, James E.; Leifeste, Donald K.

    1974-01-01

    Water-quality data, collected at 57 hydrologic bench-mark stations in 37 States, allow the definition of water quality in the 'natural' environment and the comparison of 'natural' water quality with water quality of major streams draining similar water-resources regions. Results indicate that water quality in the 'natural' environment is generally very good. Streams draining hydrologic bench-mark basins generally contain low concentrations of dissolved constituents. Water collected at the hydrologic bench-mark stations was analyzed for the following minor metals: arsenic, barium, cadmium, hexavalent chromium, cobalt, copper, lead, mercury, selenium, silver, and zinc. Of 642 analyses, about 65 percent of the observed concentrations were zero. Only three samples contained metals in excess of U.S. Public Health Service recommended drinking-water standards--two selenium concentrations and one cadmium concentration. A total of 213 samples were analyzed for 11 pesticidal compounds. Widespread but very low-level occurrence of pesticide residues in the 'natural' environment was found--about 30 percent of all samples contained low-level concentrations of pesticidal compounds. The DDT family of pesticides occurred most commonly, accounting for 75 percent of the detected occurrences. The highest observed concentration of DDT was 0.06 microgram per litre, well below the recommended maximum permissible in drinking water. Nitrate concentrations in the 'natural' environment generally varied from 0.2 to 0.5 milligram per litre. The average concentration of nitrate in many major streams is as much as 10 times greater. The relationship between dissolved-solids concentration and discharge per unit area in the 'natural' environment for the various physical divisions in the United States has been shown to be an applicable tool for approximating 'natural' water quality. The relationship between dissolved-solids concentration and discharge per unit area is applicable in all the physical

  9. Shoulder Dystocia: Quality, Safety, and Risk Management Considerations.

    PubMed

    Moni, Saila; Lee, Colleen; Goffman, Dena

    2016-12-01

    Shoulder dystocia is a term that evokes terror and fear among many physicians, midwives, and health care providers as they recollect at least 1 episode of shoulder dystocia in their careers. Shoulder dystocia can result in significant maternal and neonatal complications. Because shoulder dystocia is an urgent, unanticipated, and uncommon event with potentially catastrophic consequences, all practitioners and health care teams must be well-trained to manage this obstetric emergency. Preparation for shoulder dystocia in a systematic way, through standardization of process, practicing team-training and communication, along with technical skills, through simulation education and ongoing quality improvement initiatives will result in improved outcomes.

  10. Public health safety and environment in inadequate hospital and healthcare settings: a review.

    PubMed

    Baguma, D

    2017-03-01

    Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. CNE article: safety culture in Australian intensive care units: establishing a baseline for quality improvement.

    PubMed

    Chaboyer, Wendy; Chamberlain, Di; Hewson-Conroy, Karena; Grealy, Bernadette; Elderkin, Tania; Brittin, Maureen; McCutcheon, Catherine; Longbottom, Paula; Thalib, Lukman

    2013-03-01

    Workplace safety culture is a crucial ingredient in patients' outcomes and is increasingly being explored as a guide for quality improvement efforts. To establish a baseline understanding of the safety culture in Australian intensive care units. In a nationwide study of physicians and nurses in 10 Australian intensive care units, the Safety Attitudes Questionnaire intensive care unit version was used to measure safety culture. Descriptive statistics were used to summarize the mean scores for the 6 subscales of the questionnaire, and generalized-estimation-equations models were used to test the hypotheses that safety culture differed between physicians and nurses and between nurse leaders and bedside nurses. A total of 672 responses (50.6% response rate) were received: 513 (76.3%) from nurses, 89 (13.2%) from physicians, and 70 (10.4%) from respondents who did not specify their professional group. Ratings were highest for teamwork climate and lowest for perceptions of hospital management and working conditions. Four subscales, job satisfaction, teamwork climate, safety climate, and working conditions, were rated significantly higher by physicians than by nurses. Two subscales, working conditions and perceptions of hospital management, were rated significantly lower by nurse leaders than by bedside nurses. Measuring the baseline safety culture of an intensive care unit allows leaders to implement targeted strategies to improve specific dimensions of safety culture. These strategies ultimately may improve the working conditions of staff and the care that patients receive.

  12. Integrating quality and safety education into clinical nursing education through a dedicated education unit.

    PubMed

    Masters, Kelli

    2016-03-01

    The Institute of Medicine and American Association of Colleges of Nursing are calling for curriculum redesign that prepares nursing students with the requisite knowledge and skills to provide safe, high quality care. The purpose of this project was to improve nursing students' knowledge of quality and safety by integrating Quality and Safety Education for Nurses into clinical nursing education through development of a dedicated education unit. This model, which pairs nursing students with front-line nursing staff for clinical experiences, was implemented on a medical floor in an acute care hospital. Prior to implementation, nurses and students were educated about the dedicated education unit and quality and safety competencies. During each clinical rotation, students collaborated with their nurses on projects related to these competencies. Students' knowledge was assessed using questions related to quality and safety. Students who participated in the dedicated education unit had higher scores than those with traditional clinical rotations. Focus groups were held mid-semester to assess nurses' perceptions of the experience. Five themes emerged from the qualitative data including thirsting for knowledge, building teamwork and collaboration, establishing trust and decreasing anxiety, mirroring organization and time management skills, and evolving confidence in the nursing role.

  13. Parameters affecting greywater quality and its safety for reuse.

    PubMed

    Maimon, Adi; Friedler, Eran; Gross, Amit

    2014-07-15

    Reusing greywater (GW) for on-site irrigation is becoming a common practice worldwide. Alongside its benefits, GW reuse might pose health and environmental risks. The current study assesses the risks associated with on-site GW reuse and the main factors affecting them. GW from 34 households in Israel was analyzed for physicochemical parameters, Escherichia coli (as an indicator for rotavirus), Pseudomonas aeruginosa and Staphylococcus aureus. Each participating household filled out a questionnaire about their GW sources, treatment and usages. Quantitative microbial risk assessment (QMRA) was performed based on the measured microbial quality, and on exposure scenarios derived from the questionnaires and literature data. The type of treatment was found to have a significant effect on the quality of the treated GW. The average E. coli counts in GW (which exclude kitchen effluent) treated by professionally-designed system resulted in acceptable risk under all exposure scenarios while the risk from inadequately-treated GW was above the accepted level as set by the WHO. In conclusion, safe GW reuse requires a suitable and well-designed treatment system. A risk-assessment approach should be used to adjust the current regulations/guidelines and to assess the performance of GW treatment and reuse systems. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. The impact of safety and quality of health care on Chinese nursing career decision-making.

    PubMed

    Zhu, Junhong; Rodgers, Sheila; Melia, Kath M

    2014-05-01

    The aim of the study was to understand why nurses leave nursing practice in China by exploring the process from recruitment to final exit. This report examines the impact of safety and quality of health care on nursing career decision-making from the leavers' perspective. The nursing shortage in China is more serious than in most developed countries, but the loss of nurses through voluntarily leaving nursing practice has not attracted much attention. This qualitative study draws on a grounded theory approach. In-depth interviews with 19 nurses who have left nursing practice and were theoretically sampled from one provincial capital city in Mainland China. 'Loss of confidence in the safety and quality of health care' became one of the main categories from all leavers' accounts of their decision to leave nursing practice. It emerged from three themes 'Perceiving risk in clinical practice', 'Recognising organisational barriers to safety' and 'Failing to meet expectations of patients'. The findings indicate that the essential work value of nursing to the leavers is the safety and quality of care for their patients. When nurses perceived that they could not fulfil this essential work value in their nursing practice, some of them could not accept the compromise to their value of nursing and left voluntarily to get away from the physical and mental stress. However, some nurses had to stay and accept the limitations on the safety and quality of health care. The study suggests that well-qualified nurses voluntarily leaving nursing practice is a danger signal for patients and hospitals, and has caused deterioration in nursing morale for both current and potential nursing workforces. It suggests that safety and quality of health care could be improved when individual nurses are empowered to exercise nursing autonomy with organisational and managerial support. The priority retention strategies need to remove organisational barriers to the safety and quality of health care

  15. Biomedical instruments: safety, quality control, maintenance, prospects and benefits of African technology.

    PubMed

    Zubair, A R

    2010-12-01

    Biomedical instruments are fundamental to successful medical practice. Medical instruments are devices intended to diagnose, treat, or monitor the patient under medical supervision. Such devices make physical or electrical contact with the patient and/or transfer energy to or from the patient and/or detect such energy transfer to or from the patient. These devices are imported to Africa from developed countries. They are operated in tropical African hospitals where as they were designed for more temperate environment. African countries pay high prices for these devices. The result is that these devices are not available in most African hospitals. Patients have to travel to the major cities to benefit from such devices.These devices must be properly installed in an environment in which they can give accurate and uninterrupted service. Proper operation, regular care and maintenance of these devices are essential. The consequences of breakdown of biomedical instruments include unusable equipment, untreated patients, wrong diagnosis, wrong treatment, frustrated medical staff and overloaded repair shops. The important interwoven issues of safety, quality control and maintenance are discussed. To achieve the millennium development goal of health for all, it is necessary to increase the availability of these devices in Africa. The prospects and benefits of manufacturing and or assembling these devices in Africa are discussed. Can the Engineering Faculties and Industries in Africa meet this challenge? The answer is 'yes'! The design and construction of Bedside Monitor by four Electrical/Electronic Engineering Undergraduates of the University of Ibadan, Ibadan, Nigeria is presented as a case study.

  16. Identification of Patient Safety Risks Associated with Electronic Health Records: A Software Quality Perspective.

    PubMed

    Virginio, Luiz A; Ricarte, Ivan Luiz Marques

    2015-01-01

    Although Electronic Health Records (EHR) can offer benefits to the health care process, there is a growing body of evidence that these systems can also incur risks to patient safety when developed or used improperly. This work is a literature review to identify these risks from a software quality perspective. Therefore, the risks were classified based on the ISO/IEC 25010 software quality model. The risks identified were related mainly to the characteristics of "functional suitability" (i.e., software bugs) and "usability" (i.e., interface prone to user error). This work elucidates the fact that EHR quality problems can adversely affect patient safety, resulting in errors such as incorrect patient identification, incorrect calculation of medication dosages, and lack of access to patient data. Therefore, the risks presented here provide the basis for developers and EHR regulating bodies to pay attention to the quality aspects of these systems that can result in patient harm.

  17. Border safety: quality control at the nuclear envelope

    PubMed Central

    Webster, Brant M.; Lusk, C. Patrick

    2015-01-01

    The unique biochemical identity of the nuclear envelope confers its capacity to establish a barrier that protects the nuclear compartment and directly contributes to nuclear function. Recent work uncovered quality control mechanisms employing the ESCRT machinery and a new arm of ERAD to counteract the unfolding, damage or misassembly of nuclear envelope proteins and ensure the integrity of the nuclear envelope membranes. Moreover, cells have the capacity to recognize and triage defective nuclear pore complexes in order to prevent their inheritance and preserve the longevity of progeny. These mechanisms serve to highlight the diverse strategies used by cells to maintain nuclear compartmentalization; we suggest they mitigate the progression and severity of diseases associated with nuclear envelope malfunction like the laminopathies. PMID:26437591

  18. Work Placements as Learning Environments for Patient Safety: Finnish and British Preregistration Nursing Students' Important Learning Events

    ERIC Educational Resources Information Center

    Tella, Susanna; Smith, Nancy-Jane; Partanen, Pirjo; Turunen, Hannele

    2016-01-01

    Learning to ensure patient safety in complex health care environments is an internationally recognised concern. This article explores and compares Finnish (n = 22) and British (n = 32) pre-registration nursing students' important learning events about patient safety from their work placements in health care organisations. Written descriptions were…

  19. Work Placements as Learning Environments for Patient Safety: Finnish and British Preregistration Nursing Students' Important Learning Events

    ERIC Educational Resources Information Center

    Tella, Susanna; Smith, Nancy-Jane; Partanen, Pirjo; Turunen, Hannele

    2016-01-01

    Learning to ensure patient safety in complex health care environments is an internationally recognised concern. This article explores and compares Finnish (n = 22) and British (n = 32) pre-registration nursing students' important learning events about patient safety from their work placements in health care organisations. Written descriptions were…

  20. Electronic Informational and Educational Environment as a Factor of Competence-Oriented Higher Pedagogical Education in the Sphere of Health, Safety and Environment

    ERIC Educational Resources Information Center

    Kamerilova, Galina S.; Kartavykh, Marina A.; Ageeva, Elena L.; Veryaskina, Marina A.; Ruban, Elena M.

    2016-01-01

    The authors consider the question of computerisation in health, safety and environment teachers' training in the context of the general approaches and requirements of the Federal National Standard of Higher Education, which is realised through designing of electronic informational and educational environment. The researchers argue indispensability…

  1. [Efficacy and safety of endotracheal intubation performed in moving vs motionless environments].

    PubMed

    Castejón de la Encina, M ª Elena; Sanjuán Quiles, Ángela; Del Moral Vicente-Mazariegos, Ignacio; García Aracil, Noelia; José Alcaide, Lourdes; Richart Martínez, Miguel

    2017-02-01

    To compare the efficacy and safety of endotracheal intubation (ETI) in a simulated clinical environment in motion vs a motionless one. Clinical simulation trial of ETI with 3 endotracheal tubes (Airtraq, Fast-trach, Macintosh laryngoscope) in mannequins with realistic physiological responses (MetiMan) in 2 scenarios: an environment in motion vs a motionless one. Thirty-six physicians expert in prehospital ETI participated. Outcome variables were successful intubation, effective intubation, number of attempts, maximum apnea time, and total maneuver time. The safety variables were the presence of bradycardia, tachycardia, or high or low systolic blood pressures (ie, 20% variation from baseline); hypoxemia (decrease in oxygen saturation to <90% or 10% below baseline), tube placement in the esophagus or main bronchus, and dental trauma. No statistically significant differences between the 2 scenarios were found in the numbers of successful ETI (motionless, 71 [65.7%]; in motion, 67 [62.0%]; P=.277) or effective ETI (motionless, 104 [96.3%]; in motion, 105 [97.2%]; P=.108). Likewise, the number of attempts were similar (motionless, 91 [84.2%]; in motion, 90 [83.3%]; P=.305). Nor did we see differences in the mean (SD) maximum apnea times (motionless, 14.0 [5.6] seconds; in motion, 14.9 [8.1] seconds; P=.570) or mean total maneuver times (motionless, 236.7 [73.4] seconds; in motion, 210.3 [77.9] seconds; P=.164). The prevalences of bradycardia, tachycardia, high or low systolic blood pressure, hypoxemia, placements in the esophagus or bronchus, and dental trauma also did not differ significantly between the 2 scenarios. Neither efficacy nor safety variables differed significantly when ETI was performed in mannequins in a motionless environment vs one simulating ambulances in motion.

  2. Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature.

    PubMed

    Braithwaite, Jeffrey; Marks, Danielle; Taylor, Natalie

    2014-06-01

    Getting greater levels of evidence into practice is a key problem for health systems, compounded by the volume of research produced. Implementation science aims to improve the adoption and spread of research evidence. A linked problem is how to enhance quality of care and patient safety based on evidence when care settings are complex adaptive systems. Our research question was: according to the implementation science literature, which common implementation factors are associated with improving the quality and safety of care for patients? We conducted a targeted search of key journals to examine implementation science in the quality and safety domain applying PRISMA procedures. Fifty-seven out of 466 references retrieved were considered relevant following the application of exclusion criteria. Included articles were subjected to content analysis. Three reviewers extracted and documented key characteristics of the papers. Grounded theory was used to distil key features of the literature to derive emergent success factors. Eight success factors of implementation emerged: preparing for change, capacity for implementation-people, capacity for implementation-setting, types of implementation, resources, leverage, desirable implementation enabling features, and sustainability. Obstacles in implementation are the mirror image of these: for example, when people fail to prepare, have insufficient capacity for implementation or when the setting is resistant to change, then care quality is at risk, and patient safety can be compromised. This review of key studies in the quality and safety literature discusses the current state-of-play of implementation science applied to these domains. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  3. Quality, efficacy and safety of complementary medicines: fashions, facts and the future. Part II: Efficacy and safety

    PubMed Central

    Barnes, Joanne

    2003-01-01

    This is the second of two papers which review issues concerning complementary medicines. The first reviewed the extent of use of complementary medicines, and issues related to the regulation and pharmaceutical quality of these products; the second considers evidence for the efficacy of several well-known complementary medicines, and discusses complementary-medicines pharmacovigilance. The term complementary medicines describes a range of pharmaceutical-type preparations, including herbal medicines, homoeopathic remedies, essential oils and dietary supplements, which mainly sit outside conventional medicine. The use of complementary medicines is a popular healthcare approach in the UK, and there are signs that the use of such products is continuing to increase. Patients and the public use complementary medicines for health maintenance, for the treatment or prevention of minor ailments, and also for serious, chronic illnesses. There is a growing body of evidence from randomized controlled trials and systematic reviews to support the efficacy of certain herbal extracts and dietary supplements in particular conditions. However, many other preparations remain untested. Strictly speaking, evidence of efficacy (and safety) for herbal medicines should be considered to be extract specific. Pharmacovigilance for complementary medicines is in its infancy. Data are lacking in several areas relevant to safety. Standard pharmacovigilance tools have additional limitations when applied to investigating safety concerns with complementary medicines. PMID:12680880

  4. Pacific Northwest Laboratory: Annual report for 1986 to the Assistant Secretary for Environment, Safety and Health: Part 5, Nuclear and operational safety

    SciTech Connect

    Faust, L.G.; Kennedy, W.E.; Steelman, B.L.; Selby, J.M.

    1987-02-01

    Part 5 of the 1986 Annual Report to the Department of Energy's Assistant Secretary for Environment, Safety and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Nuclear Safety, the Office of Operational Safety, and for the Office of Environmental Analysis. For each project, as identified by the Field Task Proposal/Agreement, articles describe progress made during fiscal year 1986. Authors of these articles represent a broad spectrum of capabilities derived from three of the seven research departments of the Laboratory, reflecting the interdisciplinary nature of the work.

  5. Panel session on "safety, health and the environment: implications of nuclear power growth".

    PubMed

    Bilbao y León, Sama

    2011-01-01

    This paper summarizes the presentations and the insights offered by panelists John P. Winston, Robert Bernero, and Stephen LaMontagne during the Panel on Safety, Health and the Environment: Implications of Nuclear Power Growth that took place during the NCRP 2009 Annual Meeting. The paper describes the opportunities and the challenges faced in the areas of infrastructure development, radiation control, licensing and regulatory issues, and non-proliferation as a consequence of the forecasted growth in nuclear power capacity worldwide. Copyright © 2010 Health Physics Society

  6. Technology Development, Evaluation, and Application (TDEA) FY 1999 Progress Report, Environment, Safety, and Health (ESH) Division

    SciTech Connect

    Larry G. Hoffman

    2000-12-01

    This progress report presents the results of 10 projects funded ($500K) in FY99 by the Technology Development, Evaluation, and Application (TDEA) Committee of the Environment, Safety, and Health Division. Five are new projects for this year; seven projects have been completed in their third and final TDEA-funded year. As a result of their TDEA-funded projects, investigators have published thirty-four papers in professional journals, proceedings, or Los Alamos reports and presented their work at professional meetings. Supplemental funds and in-kind contributions, such as staff time, instrument use, and work space, were also provided to TDEA-funded projects by organizations external to ESH Division.

  7. Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy

    PubMed Central

    Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dubé, Catherine; Enns, Robert; Hollingworth, Roger; MacIntosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J; Valori, Roland

    2012-01-01

    BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. OBJECTIVE: To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. METHODS: A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. RESULTS: Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. DISCUSSION: The consensus process identified a clear need for high-quality clinical and outcomes research to support quality

  8. Feedbacks between Air-Quality, Meteorology, and the Forest Environment

    NASA Astrophysics Data System (ADS)

    Makar, Paul; Akingunola, Ayodeji; Stroud, Craig; Zhang, Junhua; Gong, Wanmin; Moran, Michael; Zheng, Qiong; Brook, Jeffrey; Sills, David

    2017-04-01

    The outcome of air quality forecasts depend in part on how the local environment surrounding the emissions regions influences chemical reaction rates and transport from those regions to the larger spatial scales. Forested areas alter atmospheric chemistry through reducing photolysis rates and vertical diffusivities within the forest canopy. The emitted pollutants, and their reaction products, are in turn capable of altering meteorology, through the well-known direct and indirect effects of particulate matter on radiative transfer. The combination of these factors was examined using version 2 of the Global Environmental Multiscale - Modelling Air-quality and CHemistry (GEM-MACH) on-line air pollution model. The model configuration used for this study included 12 aerosol size bins, eight aerosol species, homogeneous core Mie scattering, the Milbrandt-Yao two-moment cloud microphysics scheme with cloud condensation nuclei generated from model aerosols using the scheme of Abdul-Razzak and Ghan, and a new parameterization for forest canopy shading and turbulence. The model was nested to 2.5km resolution for a domain encompassing the lower Great Lakes, for simulations of a period in August of 2015 during the Pan American Games, held in Toronto, Canada. Four scenarios were carried out: (1) a "Base Case" scenario (the original model, in which coupling between chemistry and weather is not permitted; instead, the meteorological model's internal climatologies for aerosol optical and cloud condensation properties are used for direct and indirect effect calculations); (2) a "Feedback" scenario (the aerosol properties were derived from the internally simulated chemistry, and coupled to the meteorological model's radiative transfer and cloud formation modules); (3) a "Forest" scenario (canopy shading and turbulence were added to the Base Case); (4) a "Combined" scenario (including both direct and indirect effect coupling between meteorology and chemistry, as well as the forest

  9. An ethical exploration of quality and safety initiatives in nurse practice.

    PubMed

    Milton, Constance L

    2011-04-01

    Current professional healthcare literature is filled with the call for quality and safety initiatives in the provision of healthcare. The popular media frequently reports on the need for healthcare reform and the need for cost-saving measures as healthcare costs skyrocket. Reported medical and nurse errors are on the rise and the discipline of nursing is responding to the call with interprofessional quality and safety initiatives that are intended to reduce errors and promote safety in cross-disciplinary healthcare practices. This column begins an ethical exploration on the topic from a humanbecoming theoretical perspective regarding the need for theory-guided nurse practice and possible meanings and implications for future disciplinary nurse practice.

  10. Construction of Traceability System for Quality Safety of Cereal and Oil Products

    NASA Astrophysics Data System (ADS)

    Zheng, Huoguo; Liu, Shihong; Meng, Hong; Hu, Haiyan

    After several significant food safety incident, global food industry and governments in many countries are putting increasing emphasis on establishment of food traceability systems. Food traceability has become an effective way in food quality and safety management. The traceability system for quality safety of cereal and oil products was designed and implemented with HACCP and FMECA method, encoding, information processing, and hardware R&D technology etc, according to the whole supply chain of cereal and oil products. Results indicated that the system provide not only the management in origin, processing, circulating and consuming for enterprise, but also tracing service for customers and supervisor by means of telephone, internet, SMS, touch machine and mobile terminal.

  11. Surface and subsurface inspection of food safety and quality using a line-scan Raman system

    USDA-ARS?s Scientific Manuscript database

    This paper presents a line-scan Raman platform for food safety and quality research, which can be configured for Raman chemical imaging (RCI) mode for surface inspection and spatially offset Raman spectroscopy (SORS) mode for subsurface inspection. In the RCI mode, macro-scale imaging was achieved u...

  12. 32 CFR 861.4 - DOD air transportation quality and safety requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... large jet aircraft. Example 2: Acme Air has been a DOD-approved cargo carrier for several years... FORCE AIRCRAFT DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM... business for the DOD, even when the aircraft involved is used exclusively for DOD missions. The...

  13. 32 CFR 861.4 - DOD air transportation quality and safety requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... large jet aircraft. Example 2: Acme Air has been a DOD-approved cargo carrier for several years... FORCE AIRCRAFT DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM... business for the DOD, even when the aircraft involved is used exclusively for DOD missions. The...

  14. 32 CFR 861.4 - DOD air transportation quality and safety requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... large jet aircraft. Example 2: Acme Air has been a DOD-approved cargo carrier for several years... FORCE AIRCRAFT DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM... business for the DOD, even when the aircraft involved is used exclusively for DOD missions. The...

  15. 32 CFR 861.4 - DOD air transportation quality and safety requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... large jet aircraft. Example 2: Acme Air has been a DOD-approved cargo carrier for several years... FORCE AIRCRAFT DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM... business for the DOD, even when the aircraft involved is used exclusively for DOD missions. The...

  16. 32 CFR 861.4 - DOD air transportation quality and safety requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... large jet aircraft. Example 2: Acme Air has been a DOD-approved cargo carrier for several years... FORCE AIRCRAFT DEPARTMENT OF DEFENSE COMMERCIAL AIR TRANSPORTATION QUALITY AND SAFETY REVIEW PROGRAM... business for the DOD, even when the aircraft involved is used exclusively for DOD missions. The...

  17. Applications of emerging imaging techniques for meat quality and safety detection and evaluation: A review.

    PubMed

    Xiong, Zhenjie; Sun, Da-Wen; Pu, Hongbin; Gao, Wenhong; Dai, Qiong

    2017-03-04

    With improvement in people's living standards, many people nowadays pay more attention to quality and safety of meat. However, traditional methods for meat quality and safety detection and evaluation, such as manual inspection, mechanical methods, and chemical methods, are tedious, time-consuming, and destructive, which cannot meet the requirements of modern meat industry. Therefore, seeking out rapid, non-destructive, and accurate inspection techniques is important for the meat industry. In recent years, a number of novel and noninvasive imaging techniques, such as optical imaging, ultrasound imaging, tomographic imaging, thermal imaging, and odor imaging, have emerged and shown great potential in quality and safety assessment. In this paper, a detailed overview of advanced applications of these emerging imaging techniques for quality and safety assessment of different types of meat (pork, beef, lamb, chicken, and fish) is presented. In addition, advantages and disadvantages of each imaging technique are also summarized. Finally, future trends for these emerging imaging techniques are discussed, including integration of multiple imaging techniques, cost reduction, and developing powerful image-processing algorithms.

  18. 78 FR 55257 - Patient Safety and Quality Improvement: Civil Money Penalty Inflation Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... HUMAN SERVICES Patient Safety and Quality Improvement: Civil Money Penalty Inflation Adjustment AGENCY... Federal Civil Penalties Inflation Adjustment Act of 1990, the Office for Civil Rights has determined that... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note, as amended by the Debt...

  19. Effects of Chitosan-Essential Oil Coatings on Safety and Quality of Fresh Blueberries

    USDA-ARS?s Scientific Manuscript database

    Chitosan coating plus different essential oils was developed and applied to fresh blueberries, in order to find environmentally friendly and healthy treatments to preserve fresh fruit quality and safety during postharvest storage. Studies were first performed in vitro where wild-type Escherichia col...

  20. Language differences as a barrier to quality and safety in health care: the Joint Commission perspective.

    PubMed

    Schyve, Paul M

    2007-11-01

    Effective communication with patients is critical to the safety and quality of care. Barriers to this communication include differences in language, cultural differences, and low health literacy. Evidence-based practices that reduce these barriers must be integrated into, rather than just added to, health care work processes.

  1. Feminist Heuristics: Transforming the Foundation of Food Quality and Safety Assurance Systems

    ERIC Educational Resources Information Center

    Kimura, Aya Hirata

    2012-01-01

    Food safety and quality assurance systems have emerged as a key mechanism of food governance in recent years and are also popular among alternative agrofood movements, such as the organic and fair trade movements. Rural sociologists have identified many problems with existing systems, including corporate cooptation, the marginalization of small…

  2. Extended Editorial: Research and Education in Reliability, Maintenance, Quality Control, Risk and Safety.

    ERIC Educational Resources Information Center

    Ramalhoto, M. F.

    1999-01-01

    Introduces a special theme journal issue on research and education in quality control, maintenance, reliability, risk analysis, and safety. Discusses each of these theme concepts and their applications to naval architecture, marine engineering, and industrial engineering. Considers the effects of the rapid transfer of research results through…

  3. ONLINE MULTITASKING LINE-SCAN IMAGING TECHNIQUES FOR SIMULTANEOUS SAFETY AND QUALITY EVALUATION OF APPLES

    USDA-ARS?s Scientific Manuscript database

    The lab developed a push-broom, line-scan imaging system capable of simultaneous measurements of reflectance and fluorescence. The system allows multitasking inspections for quality and safety attributes of apples due to its dynamic capabilities in simultaneously capturing fluorescence and reflectan...

  4. Using Principles of Quality and Safety Education for Nurses in School Nurse Continuing Education

    ERIC Educational Resources Information Center

    Rosenblum, Ruth K.; Sprague-McRae, Julie

    2014-01-01

    School nurses require ongoing continuing education in a number of areas. The Quality and Safety Education for Nurses (QSEN) framework can be utilized in considering school nurses' roles and developing continuing education. Focusing on neurology continuing education, the QSEN framework is illustrated with the example of concussion management…

  5. Visible to SWIR hyperspectral imaging for produce safety and quality evaluation

    USDA-ARS?s Scientific Manuscript database

    Hyperspectral imaging techniques, combining the advantages of spectroscopy and imaging, have found wider use in food quality and safety evaluation applications during the past decade. In light of the prevalent use of hyperspectral imaging techniques in the visible to near-infrared (VNIR: 400 -1000 n...

  6. Feminist Heuristics: Transforming the Foundation of Food Quality and Safety Assurance Systems

    ERIC Educational Resources Information Center

    Kimura, Aya Hirata

    2012-01-01

    Food safety and quality assurance systems have emerged as a key mechanism of food governance in recent years and are also popular among alternative agrofood movements, such as the organic and fair trade movements. Rural sociologists have identified many problems with existing systems, including corporate cooptation, the marginalization of small…

  7. Impact of Investment in Education and Training on Performance in Production, Quality and Safety.

    ERIC Educational Resources Information Center

    Williams, J. Fred; Robinson-Horne, Jacquelyn P.

    This paper reports on a study that sought to determine the relationships between investment in education and training and performance in production, quality, and safety in manufacturing companies in northeast Alabama and northwest Georgia. The study also examined whether company size was a factor in predicting the ratio of the investment. One…

  8. Extended Editorial: Research and Education in Reliability, Maintenance, Quality Control, Risk and Safety.

    ERIC Educational Resources Information Center

    Ramalhoto, M. F.

    1999-01-01

    Introduces a special theme journal issue on research and education in quality control, maintenance, reliability, risk analysis, and safety. Discusses each of these theme concepts and their applications to naval architecture, marine engineering, and industrial engineering. Considers the effects of the rapid transfer of research results through…

  9. (Mis)Perceptions of Continuing Education: Insights from Knowledge Translation, Quality Improvement, and Patient Safety Leaders

    ERIC Educational Resources Information Center

    Kitto, Simon C.; Bell, Mary; Goldman, Joanne; Peller, Jennifer; Silver, Ivan; Sargeant, Joan; Reeves, Scott

    2013-01-01

    Introduction: Minimal attention has been given to the intersection and potential collaboration among the domains of continuing education (CE), knowledge translation (KT), quality improvement (QI), and patient safety (PS), despite their overlapping objectives. A study was undertaken to examine leaders' perspectives of these 4 domains and their…

  10. (Mis)Perceptions of Continuing Education: Insights from Knowledge Translation, Quality Improvement, and Patient Safety Leaders

    ERIC Educational Resources Information Center

    Kitto, Simon C.; Bell, Mary; Goldman, Joanne; Peller, Jennifer; Silver, Ivan; Sargeant, Joan; Reeves, Scott

    2013-01-01

    Introduction: Minimal attention has been given to the intersection and potential collaboration among the domains of continuing education (CE), knowledge translation (KT), quality improvement (QI), and patient safety (PS), despite their overlapping objectives. A study was undertaken to examine leaders' perspectives of these 4 domains and their…

  11. Using Principles of Quality and Safety Education for Nurses in School Nurse Continuing Education

    ERIC Educational Resources Information Center

    Rosenblum, Ruth K.; Sprague-McRae, Julie

    2014-01-01

    School nurses require ongoing continuing education in a number of areas. The Quality and Safety Education for Nurses (QSEN) framework can be utilized in considering school nurses' roles and developing continuing education. Focusing on neurology continuing education, the QSEN framework is illustrated with the example of concussion management…

  12. Simulation-based mask quality control in a production environment

    NASA Astrophysics Data System (ADS)

    Pang, Linyong; Chen, Jiunn-Hung; Cai, Lynn; Lee, Don; Chu, Brian; Huang, Vinsent; Fang, Te-Yang

    2004-05-01

    Traditionally, mask defect analysis has been done through a visual inspection review. As the semiconductor industry moves into smaller process generations and the complexity of mask exponentially increases, "Mask" issues have emerged as one of the main production problems due to their rising cost and long turn-around time. Mask-making specifications related to defects found on advanced masks also becomes more difficult to define due to the complex features involved [e.g. OPC (Optical Proximity Correction), SRAF (Sub Resolution Assist Features), etc.]. The Automatic Defect Severity Scoring (ADSS) module of i-Virtual Stepper System from Synopsys offers a fast and highly accurate software solution for defect printability analysis of advanced masks in a real production environment. In this paper, we present our case study of production pilot run in which the ADSS is used to automatically quantify the impact of a given defect on the surrounding features, basically filtering out killer defects and nuisance defects in terms of production viewpoints to reduce operators" intervention. In addition, an automation workflow is also tested, in which the production issues, such as the communication feasibility of mask quality control between mask house and wafer fab, are also considered.

  13. A cross-sectional study of medical students' knowledge of patient safety and quality improvement.

    PubMed

    Blasiak, Rachel C; Stokes, Claire L; Meyerhoff, Karen L; Hines, Rachel E; Wilson, Lindsay A; Viera, Anthony J

    2014-01-01

    The Association of American Medical Colleges and the World Health Organization have endorsed formal patient safety and quality improvement (QI) education for medical students. We surveyed medical students to assess their current level of patient safety and QI knowledge and to identify factors associated with increased knowledge. A literature review, focus groups with medical students, and local expert interviews were used to develop an electronic survey, which was distributed to all medical students at a single medical school in the spring of 2012. Fifty-seven percent of the medical school student body (N = 790) participated in the survey. A greater proportion of students reported previous exposure to patient safety education than to QI education (79% vs 47%). Students scored an average of 56% and 58% on the patient safety and QI knowledge tests, respectively. Having or pursuing an advanced degree (P = .02) and previous exposure to patient safety education (P = .02) were associated with higher knowledge scores. After adjusting for confounding variables, only previous exposure to QI education (P = .02) was associated with higher QI knowledge scores. There is a risk of measurement bias due to the use of an unvalidated instrument. Students who have greater knowledge of patient safety or QI might recall exposure at a greater frequency, inflating the association between exposure and knowledge. Also, this is a cross-sectional study, so we cannot draw conclusions about causality. Medical students' knowledge of patient safety and QI is low. Previous formal or informal education about these topics is associated with increased knowledge.

  14. The role of the private sector in monitoring health care quality and patient safety.

    PubMed

    Blewett, Lynn A; Parente, Stephen T; Peterson, Eileen; Finch, Michael D

    2003-08-01

    As payers, purchasers, and providers, both the public and private sectors have a stake in developing sound methods of measuring health care quality and patient safety. However, the role of the private sector in a national quality monitoring system remains largely underdeveloped. There have been some attempts to pool private-sector data through health care industry efforts to measure and monitor the quality of health care services. Yet despite a number of public/private partnerships, no standard method exists for measuring and monitoring health care quality and safety across public and private payers. THE AHRQ WORKSHOP ON PRIVATE-SECTOR QUALITY MONITORING: The Agency for Healthcare Research and Quality (AHRQ) sponsored a workshop in fall 2000 to address the private sector's role in monitoring quality in the health care system. National experts developed a conceptual framework and recommendations on the design and scope of a private-sector data monitoring system. Ten key attributes of the monitoring system, such as timeliness of reports, flexibility, efficiency, and linkability, were identified. Barriers and gaps to the development of such a system include the cost of data collection, the diversity of the units of data collection, data privacy, and limitations of administrative data elements. A comprehensive, public/private data collection system would address the multidimensional nature of quality and use data to effectively represent this complexity to the extent possible.

  15. Development and Piloting of a Food Safety Audit Tool for the Domestic Environment

    PubMed Central

    Borrusso, Patricia; Quinlan, Jennifer J.

    2013-01-01

    Research suggests that consumers often mishandle food in the home based on survey and observation studies. There is a need for a standardized tool for researchers to objectively evaluate the prevalence and identify the nature of food safety risks in the domestic environment. An audit tool was developed to measure compliance with recommended sanitation, refrigeration and food storage conditions in the domestic kitchen. The tool was piloted by four researchers who independently completed the inspection in 22 homes. Audit tool questions were evaluated for reliability using the κ statistic. Questions that were not sufficiently reliable (κ < 0.5) or did not provide direct evidence of risk were revised or eliminated from the final tool. Piloting the audit tool found good reliability among 18 questions, 6 questions were revised and 28 eliminated, resulting in a final 24 question tool. The audit tool was able to identify potential food safety risks, including evidence of pest infestation (27%), incorrect refrigeration temperature (73%), and lack of hot water (>43 °C, 32%). The audit tool developed here provides an objective measure for researchers to observe and record the most prevalent food safety risks in consumer’s kitchens and potentially compare risks among consumers of different demographics. PMID:28239139

  16. Design of the environment of care for safety of patients and personnel: does form follow function or vice versa in the intensive care unit?

    PubMed

    Bartley, Judene; Streifel, Andrew J

    2010-08-01

    We review the context of the environment of care in the intensive care unit setting in relation to patient safety and quality, specifically addressing healthcare-associated infection issues and solutions involving interdisciplinary teams. Issues addressed include current and future architectural design and layout trends, construction trends affecting intensive care units, and prevention of construction-associated healthcare-associated infections related to airborne and waterborne risks and design solutions. Specific elements include single-occupancy, acuity-scalable intensive care unit rooms; environmental aspects of hand hygiene, such as water risks, sink design/location, human waste management, surface selection (floor covering, countertops, furniture, and equipment) and cleaning, antimicrobial-treated or similar materials, ultraviolet germicidal irradiation, specialized rooms (airborne infection isolation and protective environments), and water system design and strategies for safe use of potable water and mitigation of water intrusion. Effective design and operational use of the intensive care unit environment of care must engage critical care personnel from initial planning and design through occupancy of the new/renovated intensive care unit as part of the infection control risk assessment team. The interdisciplinary infection control risk assessment team can address key environment of care design features to enhance the safety of intensive care unit patients, personnel, and visitors. This perspective will ensure the environment of care supports human factors and behavioral aspects of the interaction between the environment of care and its occupants.

  17. Perceived neighborhood safety and sleep quality: a global analysis of six countries.

    PubMed

    Hill, Terrence D; Trinh, Ha Ngoc; Wen, Ming; Hale, Lauren

    2016-02-01

    Building on previous North American and European studies of neighborhood context and sleep quality, we tested whether several self-reported sleep outcomes (sleep duration, insomnia symptoms, sleepiness, lethargy, and overall sleep quality) vary according to the level of perceived neighborhood safety in six countries: Mexico, Ghana, South Africa, India, China, and Russia. Using data (n = 39,590) from Wave I of the World Health Organization's Longitudinal Study on Global Ageing and Adult Health (2007-2010), we estimated a series of multinomial and binary logistic regression equations to model each sleep outcome within each country. Taken together, our results show that respondents who feel safe from crime and violence in their neighborhoods tend to exhibit more favorable sleep outcomes than respondents who feel less safe. This general pattern is especially pronounced in China and Russia, moderately evident in Mexico, Ghana, and South Africa, and sporadic in India. Perceptions of neighborhood safety are strongly associated with insomnia symptoms and poor sleep quality (past 30 days), moderately associated with sleepiness, lethargy, and poor sleep quality (past 2 days), and inconsistently associated with sleep duration (past two days). We show that perceived neighborhood safety is associated with more favorable self-reported sleep outcomes in six understudied countries. Additional research is needed to replicate our findings using longitudinal data, more reliable neighborhood measures, and more direct measures of sleep quality in these and other regions of the world. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Impact of electronic health record systems on information integrity: quality and safety implications.

    PubMed

    Bowman, Sue

    2013-01-01

    While the adoption of electronic health record (EHR) systems promises a number of substantial benefits, including better care and decreased healthcare costs, serious unintended consequences from the implementation of these systems have emerged. Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care. These unintended consequences also may increase fraud and abuse and can have serious legal implications. This literature review examines the impact of unintended consequences of the use of EHR systems on the quality of care and proposed solutions to address EHR-related errors. This analysis of the literature on EHR risks is intended to serve as an impetus for further research on the prevalence of these risks, their impact on quality and safety of patient care, and strategies for reducing them.

  19. Impact of Electronic Health Record Systems on Information Integrity: Quality and Safety Implications

    PubMed Central

    Bowman, Sue

    2013-01-01

    While the adoption of electronic health record (EHR) systems promises a number of substantial benefits, including better care and decreased healthcare costs, serious unintended consequences from the implementation of these systems have emerged. Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care. These unintended consequences also may increase fraud and abuse and can have serious legal implications. This literature review examines the impact of unintended consequences of the use of EHR systems on the quality of care and proposed solutions to address EHR-related errors. This analysis of the literature on EHR risks is intended to serve as an impetus for further research on the prevalence of these risks, their impact on quality and safety of patient care, and strategies for reducing them. PMID:24159271

  20. Quality and safety attributes of afghan raisins before and after processing

    PubMed Central

    McCoy, Stacy; Chang, Jun Won; McNamara, Kevin T; Oliver, Haley F; Deering, Amanda J

    2015-01-01

    Raisins are an important export commodity for Afghanistan; however, Afghan packers are unable to export to markets seeking high-quality products due to limited knowledge regarding their quality and safety. To evaluate this, Afghan raisin samples from pre-, semi-, and postprocessed raisins were obtained from a raisin packer in Kabul, Afghanistan. The raisins were analyzed and compared to U.S. standards for processed raisins. The samples tested did not meet U.S. industry standards for embedded sand and pieces of stem, total soluble solids, and titratable acidity. The Afghan raisins did meet or exceed U.S. Grade A standard for the number of cap-stems, percent damaged, crystallization levels, moisture content, and color. Following processing, the number of total aerobic bacteria, yeasts, molds, and total coliforms were within the acceptable limits. Although quality issues are present in the Afghan raisins, the process used to clean the raisins is suitable to maintain food safety standards. PMID:25650241