Sample records for facilities improvements project

  1. Campania Region's Educational Quality Facilities Project

    ERIC Educational Resources Information Center

    Ponti, Giorgio

    2009-01-01

    This article describes the Educational Quality Facilities project undertaken by Italy's Campania Region to provide quality facilities to all of its communities basing new spaces on the "Flexible Learning Module". The objectives of the five-year project are to: build and equip new educational spaces; improve the quality of existing…

  2. Report: American Recovery and Reinvestment Act Site Visit of the Wastewater Treatment Facility Improvements Project, Perkins, Oklahoma

    EPA Pesticide Factsheets

    Report #11-R-0214, May 2, 2011. We conducted an unannounced visit of the construction site of the Perkins Public Works Authority’s wastewater treatment facility improvements project in Perkins, Oklahoma, on April 19–22, 2010.

  3. Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

    PubMed

    Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

    2015-08-01

    To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

  4. Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.

    PubMed

    Chenoweth, Carol E; Hines, Stephen C; Hall, Kendall K; Saran, Rajiv; Kalbfleisch, John D; Spencer, Teri; Frank, Kelly M; Carlson, Diane; Deane, Jan; Roys, Erik; Scholz, Natalie; Parrotte, Casey; Messana, Joseph M

    2015-07-01

    OBJECTIVE To observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. SETTING AND PARTICIPANTS Thirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban/rural status. MEASUREMENTS Trained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012. RESULTS There was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%-92%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%-100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation. CONCLUSIONS Our findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities.

  5. Congressional hearing reviews NSF major research and facilities projects

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2012-03-01

    An 8 March congressional hearing about the U.S. National Science Foundation's Major Research Equipment and Facilities Construction (NSF MREFC) account focused on fiscal management and accountability of projects in that account and reviewed concerns raised by NSF's Office of Inspector General (OIG). NSF established the MREFC account in 1995 to better plan and manage investments in major equipment and facilities projects, which can cost from tens of millions to hundreds of millions of dollars, and the foundation has funded 17 MREFC projects since then. The Obama administration's proposed fiscal year (FY) 2013 budget includes funding for four MREFC projects: Advanced Laser Gravitational-Wave Observatory (AdvLIGO), Advanced Technology Solar Telescope (ATST), National Ecological Observatory (NEON), and Ocean Observatories Initiative (OOI). The hearing, held by a subcommittee of the House of Representatives' Committee on Science, Space, and Technology, reviewed management oversight throughout the life cycles of MREFC projects and concerns raised in recent OIG reports about the use of budget contingency funds. NSF's February 2012 manual called "Risk management guide for large facilities" states that cost contingency is "that portion of the project budget required to cover `known unknowns,'" such as planning and estimating errors and omissions, minor labor or material price fluctuations, and design developments and changes within the project scope. Committee members acknowledged measures that NSF has made to improve the MREFC oversight process, but they also urged the agency to continue to take steps to ensure better project management.

  6. Improving heart failure disease management in skilled nursing facilities: lessons learned.

    PubMed

    Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S

    2013-11-01

    The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

  7. Chemical facility vulnerability assessment project.

    PubMed

    Jaeger, Calvin D

    2003-11-14

    Sandia National Laboratories, under the direction of the Office of Science and Technology, National Institute of Justice, conducted the chemical facility vulnerability assessment (CFVA) project. The primary objective of this project was to develop, test and validate a vulnerability assessment methodology (VAM) for determining the security of chemical facilities against terrorist or criminal attacks (VAM-CF). The project also included a report to the Department of Justice for Congress that in addition to describing the VAM-CF also addressed general observations related to security practices, threats and risks at chemical facilities and chemical transport. In the development of the VAM-CF Sandia leveraged the experience gained from the use and development of VAs in other areas and the input from the chemical industry and Federal agencies. The VAM-CF is a systematic, risk-based approach where risk is a function of the severity of consequences of an undesired event, the attack potential, and the likelihood of adversary success in causing the undesired event. For the purpose of the VAM-CF analyses Risk is a function of S, L(A), and L(AS), where S is the severity of consequence of an event, L(A) is the attack potential and L(AS) likelihood of adversary success in causing a catastrophic event. The VAM-CF consists of 13 basic steps. It involves an initial screening step, which helps to identify and prioritize facilities for further analysis. This step is similar to the prioritization approach developed by the American Chemistry Council (ACC). Other steps help to determine the components of the risk equation and ultimately the risk. The VAM-CF process involves identifying the hazardous chemicals and processes at a chemical facility. It helps chemical facilities to focus their attention on the most critical areas. The VAM-CF is not a quantitative analysis but, rather, compares relative security risks. If the risks are deemed too high, recommendations are developed for

  8. The South African isotope facility project

    NASA Astrophysics Data System (ADS)

    Bark, R. A.; Barnard, A. H.; Conradie, J. L.; de Villiers, J. G.; van Schalkwyk, P. A.

    2018-05-01

    The South African Isotope Facility (SAIF) is a project in which iThemba LABS plans to build a radioactive-ion beam (RIB) facility. The project is divided into the Accelerator Centre of Exotic Isotopes (ACE Isotopes) and the Accelerator Centre for Exotic Beams (ACE Beams). For ACE Isotopes, a high-current, 70 MeV cyclotron will be acquired to take radionuclide production off the existing Separated Sector Cyclotron (SSC). A freed up SSC will then be available for an increased tempo of nuclear physics research and to serve as a driver accelerator for the ACE Beams project, in which protons will be used for the direct fission of Uranium, producing beams of fission fragments. The ACE Beams project has begun with "LeRIB" - a Low Energy RIB facility, now under construction. In a collaboration with INFN Legnaro, the target/ion-source "front-end" will be a copy of the front-end developed for the SPES project. A variety of targets may be inserted into the SPES front-end; a uranium-carbide target has been designed to produce up to 2 × 1013 fission/s using a 70 MeV proton beam of 150 µA intensity.

  9. The Planning and Implementation of Test Facility Improvements

    NASA Technical Reports Server (NTRS)

    Oberlander, Larry

    2008-01-01

    As engineering programs develop, and product testing begins, ideas for process improvement soon become obvious. Engineers envision new holding and handling fixtures. Additional custom-made support equipment may be needed. Perhaps modifications to the building or modifications to facility hardware are the order of the day. This is where a flexible creative test organization is needed. We need not be content with the status quo. All of these desired test innovations can make the difficult easy and improve the work flow. At times, implementing these new ideas demands more time or specialized expertise than test team members have. Through the coordinated use of labor resources, the needed improvements can still be made and in a timely fashion that supports program schedules. This presentation provides practical advice and a method whereby test personnel can creatively develop facility improvements and manage them from start to finish. You can control just how much time you invest and what part of your concepts you will personally design. By wisely defining the requirements and presenting them to the appropriate help sources (vendors, contractors, coworkers, and support departments), you can get the help you need to bring the improvements you have conceived, into fruition. Aspects of this presentation include defining requirements for test facility improvements, choosing labor resources, writing a statement of work, determining cost and benefits, securing department approval, coordinating procurement, managing the project, and training the end users. The process of successfully implementing test facility improvements is thoroughly explained. It has been tried, proven and improved over nearly 25 years of use. Whether considering a $50 improvement or a $50 million dollar improvement, this discussion will provide helpful pointers. Examples of improvements made through this process and their illustration will be included.

  10. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

    PubMed

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

    2015-01-01

    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  11. The ISOLDE facility and the HIE-HISOLDE project: Recent highlights

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

    Borge, M. J. G.

    2014-07-23

    The ISOLDE facility at CERN has as objective the production, study and research of nuclei far from stability. The facility provides low energy radioactive beams and post-accelerated beams. In the last 45 years the ISOLDE facility has gathered unique expertise in research with radioactive beams. Over 700 isotopes of more than 70 elements have been used in a wide range of research domains, including cutting edge studies in nuclear structure, atomic physics, nuclear astrophysics, and fundamental interactions. These nuclear probes are also used to do frontier research in solid state and life sciences. There is an on-going upgrade of themore » facility, the HIE-ISOLDE project, which aims to improve the ISOLDE capabilities in a wide front, from an energy increase of the post-accelerated beam to improvements in beam quality and beam purity. The first phase of HIE-ISOLDE will start for physics in the autumn of 2015 with an upgrade of energy for all post-accelerated ISOLDE beams up to 5.5 MeV/u. In this contribution the most recent highlights of the facility are presented.« less

  12. National Ignition Facility project acquisition plan

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

    Callaghan, R.W.

    The purpose of this National Ignition Facility Acquisition Plan is to describe the overall procurement strategy planned for the National Ignition Facility (NIF) Project. The scope of the plan describes the procurement activities and acquisition strategy for the following phases of the NIF Project, each of which receives either plant and capital equipment (PACE) or other project cost (OPC) funds: Title 1 and 2 design and Title 3 engineering (PACE); Optics manufacturing facilitization and pilot production (OPC); Convention facility construction (PACE); Procurement, installation, and acceptance testing of equipment (PACE); and Start-up (OPC). Activities that are part of the base Inertialmore » Confinement Fusion (ICF) Program are not included in this plan. The University of California (UC), operating Lawrence Livermore National Laboratory (LLNL) and Los Alamos National Laboratory, and Lockheed-Martin, which operates Sandia National Laboratory (SNL) and the University of Rochester Laboratory for Laser Energetics (UR-LLE), will conduct the acquisition of needed products and services in support of their assigned responsibilities within the NIF Project structure in accordance with their prime contracts with the Department of Energy (DOE). LLNL, designated as the lead Laboratory, will have responsibility for all procurements required for construction, installation, activation, and startup of the NIF.« less

  13. Space infrared telescope facility project

    NASA Technical Reports Server (NTRS)

    Cruikshank, Dale P.

    1988-01-01

    The functions undertaken during this reporting period were: to inform the planetary science community of the progress and status of the Space Infrared Telescope Facility (SIRTF) Project; to solicit input from the planetary science community on needs and requirements of planetary science in the use of SIRTF at such time that it becomes an operational facility; and a white paper was prepared on the use of the SIRTF for solar system studies.

  14. Influence of computational fluid dynamics on experimental aerospace facilities: A fifteen year projection

    NASA Technical Reports Server (NTRS)

    1983-01-01

    An assessment was made of the impact of developments in computational fluid dynamics (CFD) on the traditional role of aerospace ground test facilities over the next fifteen years. With improvements in CFD and more powerful scientific computers projected over this period it is expected to have the capability to compute the flow over a complete aircraft at a unit cost three orders of magnitude lower than presently possible. Over the same period improvements in ground test facilities will progress by application of computational techniques including CFD to data acquisition, facility operational efficiency, and simulation of the light envelope; however, no dramatic change in unit cost is expected as greater efficiency will be countered by higher energy and labor costs.

  15. Does Nursing Facility Use of Habilitation Therapy Improve Performance on Quality Measures?

    PubMed

    Fitzler, Sandra; Raia, Paul; Buckley, Fredrick O; Wang, Mei

    2016-12-01

    The purpose of the project, Centers for Medicare & Medicaid Services (CMS) Innovation study, was to evaluate the impact on 12 quality measures including 10 Minimum Data Set (MDS) publicly reported measures and 2 nursing home process measures using habilitation therapy techniques and a behavior team to manage dementia-related behaviors. A prospective design was used to assess the changes in the measures. A total of 30 Massachusetts nursing homes participated in the project over a 12-month period. Project participation required the creation of an interdisciplinary behavior team, habilitation therapy training, facility visit by the program coordinator, attendance at bimonthly support and sharing calls, and monthly collection of process measure data. Participating facilities showed improvement in 9 of the 12 reported measures. Findings indicate potential quality improvement in having nursing homes learn habilitation therapy techniques and know how to use the interdisciplinary team to manage problem behaviors. © The Author(s) 2016.

  16. Heritage Park Facilities PV Project

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

    Hobaica, Mark

    Project Objective: To procure a photovoltaic array (PV) system which will generate approximately 256kW of power to be used for the operations of the Aquatic Complex and the adjacent Senior Facility at the Heritage Park. This project complies with the EERE’s work and objectives by promoting the development and deployment of an energy system that will provide current and future generations with clean, efficient, affordable, and reliable energy.

  17. Reducing hospital-acquired heel ulcer rates in an acute care facility: an evaluation of a nurse-driven performance improvement project.

    PubMed

    McElhinny, Mary Louise; Hooper, Christine

    2008-01-01

    A nurse-driven performance improvement project designed to reduce the incidence of hospital-acquired ulcers of the heel in an acute care setting was evaluated. This was a descriptive evaluative study using secondary data analysis. Data were collected in 2004, prior to implementation of the prevention project and compared to results obtained in 2006, after the project was implemented. Data were collected in a 172-bed, not-for-profit inpatient acute care facility in North Central California. All medical-surgical inpatients aged 18 years and older were included in the samples. Data were collected on 113 inpatients prior to implementation of the project in 2004. Data were also collected on a sample of 124 inpatients in 2006. The prevalence and incidence of heel pressure ulcers were obtained through skin surveys prior to implementation of the prevention program and following its implementation. Results from 2004 were compared to data collected in 2006 after introduction of the Braden Scale for Predicting Pressure Sore Risk. Heel pressure ulcers were staged using the National Pressure Ulcer Advisory Panel (NPUAP) staging system and recommendations provided by the Agency for Health Care Quality Research (AHRQ) clinical practice guidelines. The incidence of hospital-acquired heel pressure ulcers in 2004 was 13.5% (4 of 37 patients). After implementation of the program in 2006, the incidence of hospital-acquired heel pressure ulcers was 13.8% (5 of 36 patients). The intervention did not appear to receive adequate staff nurse support needed to make the project successful. Factors that influenced the lack of support may have included: (1) educational method used, (2) lack of organization approved, evidenced-based standardized protocols for prevention and treatment of heel ulcers, and (3) failure of facility management to convey the importance as well as their support for the project.

  18. Concentrating Solar Power Projects - National Solar Thermal Power Facility

    Science.gov Websites

    | Concentrating Solar Power | NREL National Solar Thermal Power Facility Status Date: February 13, 2014 Project Overview Project Name: National Solar Thermal Power Facility Country: India Location Capacity (Net): 1.0 MW Output Type: Steam Rankine Thermal Storage Storage Type: None

  19. Improved E-ELT subsystem and component specifications, thanks to M1 test facility

    NASA Astrophysics Data System (ADS)

    Dimmler, M.; Marrero, J.; Leveque, S.; Barriga, Pablo; Sedghi, B.; Kornweibel, N.

    2014-07-01

    During the last 2 years ESO has operated the "M1 Test Facility", a test stand consisting of a representative section of the E-ELT primary mirror equipped with 4 complete prototype segment subunits including sensors, actuators and control system. The purpose of the test facility is twofold: it serves to study and get familiar with component and system aspects like calibration, alignment and handling procedures and suitable control strategies on real hardware long before the primary mirror (hereafter M1) components are commissioned. Secondly, and of major benefit to the project, it offered the possibility to evaluate component and subsystem performance and interface issues in a system context in such detail, that issues could be identified early enough to feed back into the subsystem and component specifications. This considerably reduces risk and cost of the production units and allows refocusing the project team on important issues for the follow-up of the production contracts. Experiences are presented in which areas the results of the M1 Test Facility particularly helped to improve subsystem specifications and areas, where additional tests were adopted independent of the main test facility. Presented are the key experiences of the M1 Test Facility which lead to improved specifications or identified the need for additional testing outside of the M1 Test Facility.

  20. Report on Collaborative Facilities Projects.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Office of the Chancellor.

    California's community colleges develop their own requests in concert with their district five-year master plan. They then submit those requests to the State Chancellor's Office for review. This document discusses the current process of submitting proposals for collaborative facilities projects, and outlines and discusses five recommendations for…

  1. National Ignition Facility project acquisition plan revision 1

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

    Clobes, A.R.

    The purpose of this National Ignition Facility Acquisition Plan is to describe the overall procurement strategy planned for the National Ignition Facility M Project. It was prepared for the NIP Prood Office by the NIF Procurement Manager.

  2. Gasification Product Improvement Facility (GPIF). Final report

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

    NONE

    1995-09-01

    The gasifier selected for development under this contract is an innovative and patented hybrid technology which combines the best features of both fixed-bed and fluidized-bed types. PyGas{trademark}, meaning Pyrolysis Gasification, is well suited for integration into advanced power cycles such as IGCC. It is also well matched to hot gas clean-up technologies currently in development. Unlike other gasification technologies, PyGas can be designed into both large and small scale systems. It is expected that partial repowering with PyGas could be done at a cost of electricity of only 2.78 cents/kWh, more economical than natural gas repowering. It is extremely unfortunatemore » that Government funding for such a noble cause is becoming reduced to the point where current contracts must be canceled. The Gasification Product Improvement Facility (GPIF) project was initiated to provide a test facility to support early commercialization of advanced fixed-bed coal gasification technology at a cost approaching $1,000 per kilowatt for electric power generation applications. The project was to include an innovative, advanced, air-blown, pressurized, fixed-bed, dry-bottom gasifier and a follow-on hot metal oxide gas desulfurization sub-system. To help defray the cost of testing materials, the facility was to be located at a nearby utility coal fired generating site. The patented PyGas{trademark} technology was selected via a competitive bidding process as the candidate which best fit overall DOE objectives. The paper describes the accomplishments to date.« less

  3. Interstate Electrification Improvement Project

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

    Puckette, Margaret; Kim, Jeff

    The Interstate Electrification Improvement Project, publicly known as the Shorepower Truck Electrification Project (STEP), started in May 2011 and ended in March 2015. The project grant was awarded by the Department of Energy’s Vehicles Technology Office in the amount of $22.2 million. It had three overarching missions: 1. Reduce the idling of Class 8 tractors when parked at truck stops, to reduce diesel fuel consumption and thus U.S. dependence on foreign petroleum; 2. Stimulate job creation and economic activity as part of the American Reinvestment and Recovery Act of 2009; 3. Reduce greenhouse gas emissions (GHG) from diesel combustion andmore » the carbon footprint of the truck transportation industry. The project design was straightforward. First, build fifty Truck Stop Electrification (TSE) facilities in truck stop parking lots across the country so trucks could plug-in to 110V, 220V, or 480VAC, and shut down the engine instead of idling. These facilities were strategically located at fifty truck stops along major U.S. Interstates with heavy truck traffic. Approximately 1,350 connection points were installed, including 150 high-voltage electric standby Transport Refrigeration Unit (eTRU) plugs--eTRUs are capable of plugging in to shore power1 to cool the refrigerated trailer for loads such as produce, meats and ice cream. Second, the project provided financial incentives on idle reduction equipment to 5,000 trucks in the form of rebates, to install equipment compatible with shore power. This equipment enables drivers to shut down the main engine when parked, to heat or cool their cab, charge batteries, or use other household appliances without idling—a common practice that uses approximately 1 gallon of diesel per hour. The rebate recipients were intended to be the first fleets to plug into Shorepower to save diesel fuel and ensure there is significant population of shore power capable trucks. This two part project was designed to complement each other

  4. Integrated Framework for Patient Safety and Energy Efficiency in Healthcare Facilities Retrofit Projects.

    PubMed

    Mohammadpour, Atefeh; Anumba, Chimay J; Messner, John I

    2016-07-01

    There is a growing focus on enhancing energy efficiency in healthcare facilities, many of which are decades old. Since replacement of all aging healthcare facilities is not economically feasible, the retrofitting of these facilities is an appropriate path, which also provides an opportunity to incorporate energy efficiency measures. In undertaking energy efficiency retrofits, it is vital that the safety of the patients in these facilities is maintained or enhanced. However, the interactions between patient safety and energy efficiency have not been adequately addressed to realize the full benefits of retrofitting healthcare facilities. To address this, an innovative integrated framework, the Patient Safety and Energy Efficiency (PATSiE) framework, was developed to simultaneously enhance patient safety and energy efficiency. The framework includes a step -: by -: step procedure for enhancing both patient safety and energy efficiency. It provides a structured overview of the different stages involved in retrofitting healthcare facilities and improves understanding of the intricacies associated with integrating patient safety improvements with energy efficiency enhancements. Evaluation of the PATSiE framework was conducted through focus groups with the key stakeholders in two case study healthcare facilities. The feedback from these stakeholders was generally positive, as they considered the framework useful and applicable to retrofit projects in the healthcare industry. © The Author(s) 2016.

  5. Overview of Progress on the LANSCE Accelerator and Target Facilities Improvement Program

    NASA Astrophysics Data System (ADS)

    Macek, R. J.; Brun, T.; Donahue, J. B.; Fitzgerald, D. H.

    1997-05-01

    Three projects to improve the performance of the accelerator and target facilities for the Los Alamos Neutron Science Center have been initiated since 1994. The LANSCE Reliability Improvement Project was separated into two phases. Phase I, completed in 1995, was targeted at near-term improvements to beam availability that could be completed in a year. Phase II, now underway, consists of two projects: 1) converting the beam injection into the Proton Storage Ring (PSR) from the present two-step process H^- to H^0 to H^+) to direct injection of H^- beam in one step (H^- to H^+), and 2) an upgrade of the spallation neutron production target which will reduce the target change-out time from about a year to about three weeks. The third project, the SPSS Enhancement Project, is aimed at increasing the PSR output beam current from the present 70 μA at 20 Hz to 200 μA at 30 Hz, plus implementing seven new neutron scattering instruments. Objectives, plans, results and progress to date will be summarized.

  6. Final Design Report for the RH LLW Disposal Facility (RDF) Project

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

    Austad, Stephanie Lee

    2015-09-01

    The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.

  7. Final Design Report for the RH LLW Disposal Facility (RDF) Project

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

    Austad, S. L.

    2015-05-01

    The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.

  8. National Biomedical Tracer Facility: Project definition study

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

    Heaton, R.; Peterson, E.; Smith, P.

    The Los Alamos National Laboratory is an ideal institution and New Mexico is an ideal location for siting the National Biomedical Tracer Facility (NBTF). The essence of the Los Alamos proposal is the development of two complementary irradiation facilities that combined with our existing radiochemical processing hot cell facilities and waste handling and disposal facilities provide a low cost alternative to other proposals that seek to satisfy the objectives of the NBTF. We propose the construction of a 30 MeV cyclotron facility at the site of the radiochemical facilities, and the construction of a 100 MeV target station at LAMPFmore » to satisfy the requirements and objectives of the NBTF. We do not require any modifications to our existing radiochemical processing hot cell facilities or our waste treatment and disposal facilities to accomplish the objectives of the NBTF. The total capital cost for the facility defined by the project definition study is $15.2 M. This cost estimate includes $9.9 M for the cyclotron and associated facility, $2.0 M for the 100 MeV target station at LAMPF, and $3.3 M for design.« less

  9. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    ERIC Educational Resources Information Center

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

  10. [Interdisciplinary Cooperation as a Characteristic of Successful Rehabilitation Facilities--Results from the Project MeeR].

    PubMed

    Kleineke, V; Stamer, M; Zeisberger, M; Brandes, I; Meyer, T

    2015-08-01

    To determine if there is a difference between successful and less successful rehabilitation facilities concerning their extent and quality of interdisciplinary cooperation? This analysis is part of the project MeeR, that aims to identify characteristics of rehabilitation facilities related to successful rehabilitation. 6 facilities were recruited based on a quantitative analysis; 3 facilities that ranked as above average and 3 as below average in terms of their success in rehabilitating patients. Comprehensive qualitative data were collected on these 6 facilities. In above average rehabilitation facilities, the extent of interdisciplinary cooperation was higher than in below average facilities; the position of the medical profession was less dominant and there was a wider access to team meetings. Promotion of interdisciplinary cooperation is an important component for the improvement of the success of rehabilitation facilities. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications.

    PubMed

    Novignon, Jacob; Nonvignon, Justice

    2017-06-12

    Health centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary healthcare, it is important to understand the nature of inefficiencies that exist in these facilities. Therefore, the objectives of this study are threefold; (i) estimate efficiency among primary health facilities (health centers), (ii) examine the potential fiscal space from improved efficiency and (iii) investigate the efficiency disparities in public and private facilities. Data was from the 2015 Access Bottlenecks, Cost and Equity (ABCE) project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis (SFA) was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities was estimated using the Nopo matching decomposition procedure. Average efficiency score across all health centers included in the sample was estimated to be 0.51. Also, average efficiency was estimated to be about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, we found that, on average, facilities could save about GH₵11,450.70 (US$7633.80) if efficiency was improved. We also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. The matching decomposition showed an efficiency gap of 0.29 between private

  12. School Facility Projects in Latin America

    ERIC Educational Resources Information Center

    Berk, Jeffrey; de Cassia Alves Vaz, Rita; Honorio, Joao; Baza, Jadille; Origel, Ricardo; Gomez, Fredys

    2004-01-01

    Many Latin American countries are undertaking projects, in line with practices disseminated by PEB, to share school facilities with the local community, to adapt traditional schools for students with disabilities, and to collaborate with private companies to finance educational buildings. The articles below describe current initiatives in five…

  13. Preventing Heel Pressure Ulcers: Sustained Quality Improvement Initiative in a Canadian Acute Care Facility.

    PubMed

    Hanna-Bull, Debbie

    2016-01-01

    The setting for this quality improvement initiative designed to reduce the prevalence of facility-acquired heel pressure ulcers was a regional, acute-care, 490-bed facility in Ontario, Canada, responsible for dialysis, vascular, and orthopedic surgery. An interdisciplinary skin and wound care team designed an evidence-based quality improvement initiative based on a systematic literature review and standardization of heel offloading methods. The prevalence of heel pressure ulcers was measured at baseline (immediately prior to implementation of initiative) and at 1 and 4 years following implementation. The prevalence of facility-acquired heel pressure ulcers was 5.8% when measured before project implementation. It was 4.2% at 1 year following implementation and 1.6% when measured at the end of the 4-year initiative. Outcomes demonstrate that the initiative resulted in a continuous and sustained reduction in facility-acquired heel pressure ulcer incidence over a 4-year period.

  14. The DE-PHARM Project: A Pharmacist-Driven Deprescribing Initiative in a Nursing Facility.

    PubMed

    Pruskowski, Jennifer; Handler, Steven M

    2017-08-01

    Many residents with life-limiting illnesses are being prescribed and taking potentially inappropriate medications (PIMs) and questionably beneficial medications either near or at the end of life. These medications can contribute to adverse drug reactions, increase morbidity, and increase unnecessary burden and cost. It is crucial that the process of deprescribing be incorporated into the care of these residents. After developing a clinical pharmacist-driven deprescribing initiative in the nursing facility, the objective of this project was to reduce the number of PIMs via accepted recommendations from the clinical pharmacist to the primary team. The Discussion to Ensure the Patient-centered, Health-focused, prognosis-Appropriate, and Rational Medication regimen (DE-PHARM) quality improvement-approved project was conducted in an urban, academic nursing facility in Pittsburgh, Pennsylvania. The pilot phase occurred between October 2015 and April 2016. To be included in this study, participants had to be a custodial resident of the nursing facility with a previously documented comfort-focused treatment plan. All medications used for the management of chronic comorbid diseases were eligible for review. Forty-seven residents managed by eight different primary teams met inclusion criteria. Thirty-nine recommendations for 23 residents were made by the clinical pharmacist, with an average of 0.82 and range of 0-5 recommendations per resident, respectively. Of those, only 10 (26%) were accepted, 1 (3%) was modified, 3 (7%) were rejected, and 25 (64%) had no response within the 120-day response period. Additionally, two residents died during the project, and one resident was readmitted to the hospital for a prolonged period of time. The pilot phase of the DE-PHARM project, a clinical pharmacist-driven deprescribing initiative, was designed and assessed. This project demonstrated the feasibility of such an initiative. Because of the complexity of such a process, special

  15. US Department of Energy Grand Junction Projects Office Remedial Action Project, final report of the decontamination and decommissioning of Building 36 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also is the remedial action contractor. Building 36more » was found to be radiologically contaminated and was demolished in 1996. The soil beneath the building was remediated in accordance with identified standards and can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  16. VOCATIONAL-TECHNICAL FACILITIES PROJECT. PROGRESS REPORT.

    ERIC Educational Resources Information Center

    CONRAD, M.J.; VALENTINE, I.E.

    IN THE FIRST PHASE OF A PROJECT FOR DEVELOPING PLANNING GUIDES FOR VOCATIONAL FACILITIES, THE OVERALL DIRECTION OF A SERIES OF PLANNING GUIDES IS BEING DETERMINED. IN THE SECOND PHASE AT LEAST ONE PLANNING MANUAL WILL BE DEVELOPED TO SERVE AS A MODEL FOR THE FULL SERIES. A LOCAL WORKING GROUP COMPOSED OF THREE SPECIALISTS FROM THE CENTER FOR…

  17. Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: a quality improvement report.

    PubMed

    Patel, Priti R; Yi, Sarah H; Booth, Stephanie; Bren, Virginia; Downham, Gemma; Hess, Sally; Kelley, Karen; Lincoln, Mary; Morrissette, Kathy; Lindberg, Curt; Jernigan, John A; Kallen, Alexander J

    2013-08-01

    Bloodstream infections (BSIs) cause substantial morbidity in hemodialysis patients. In 2009, the US Centers for Disease Control and Prevention (CDC) sponsored a collaborative project to prevent BSIs in outpatient hemodialysis facilities. We sought to assess the impact of a set of interventions on BSI and access-related BSI rates in participating facilities using data reported to the CDC's National Healthcare Safety Network (NHSN). Quality improvement project. Patients in 17 outpatient hemodialysis facilities that volunteered to participate. Facilities reported monthly event and denominator data to NHSN, received guidance from the CDC, and implemented an evidence-based intervention package that included chlorhexidine use for catheter exit-site care, staff training and competency assessments focused on catheter care and aseptic technique, hand hygiene and vascular access care audits, and feedback of infection and adherence rates to staff. Crude and modeled BSI and access-related BSI rates. Up to 12 months of preintervention (January 2009 through December 2009) and 15 months of intervention period (January 2010 through March 2011) data from participating centers were analyzed. Segmented regression analysis was used to assess changes in BSI and access-related BSI rates during the preintervention and intervention periods. Most (65%) participating facilities were hospital based. Pooled mean BSI and access-related BSI rates were 1.09 and 0.73 events per 100 patient-months during the preintervention period and 0.89 and 0.42 events per 100 patient-months during the intervention period, respectively. Modeled rates decreased 32% (P = 0.01) for BSIs and 54% (P < 0.001) for access-related BSIs at the start of the intervention period. Participating facilities were not representative of all outpatient hemodialysis centers nationally. There was no control arm to this quality improvement project. Facilities participating in a collaborative successfully decreased their BSI and

  18. Special Education Evaluation Project for University Affiliated Facilities. Final Report.

    ERIC Educational Resources Information Center

    Burrello, Leonard C.; And Others

    The final report of the Special Education Evaluation Project for 16 University Affiliated Facilities (UAF) centers provides a chronological review of the project which focused on the training of persons to work with mentally retarded or other handicapped individuals. Outlined are project objectives including the development of descriptors useful…

  19. US Department of Energy Grand Junction Projects Office Remedial Action Project. Final report of the decontamination and decommissioning of Building 52 at the Grand Junction Projects Office Facility

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

    Krabacher, J.E.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also was the remedial action contractor. Building 52more » was found to be radiologically contaminated and was demolished in 1994. The soil area within the footprint of the building has been remediated in accordance with the identified standards and the area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  20. Project Nuclotron-based Ion Collider fAcility at JINR

    NASA Astrophysics Data System (ADS)

    Kekelidze, V. D.; Matveev, V. A.; Meshkov, I. N.; Sorin, A. S.; Trubnikov, G. V.

    2017-09-01

    The project of Nuclotron-based Ion Collider fAcility (NICA) that is under development at JINR (Dubna) is presented. The general goals of the project are experimental studies of both hot and dense baryonic matter and spin physics (in collisions of polarized protons and deuterons). The first program requires providing of heavy ion collisions in the energy range of √ {{s_{NN}}} = 4-11 Gev at average luminosity of L = 1 × 1027 cm-2 s-1 for 197Au79+ nuclei. The polarized beams mode is proposed to be used in energy range of √ {{s_{NN}}} = 12-27 Gev (protons at luminosity of L ≥ 1 × 1030 cm-2 s-1. The report contains description of the facility scheme and its characteristics in heavy ion operation mode. The Collider will be equipped with two detectors—MultiPurpose Detector (MPD), which is in an active stage of construction, and Spin Physics Detector (SPD) that is in the stage of conceptual design. Fixed target experiment "Baryonic matter at Nuclotron" (BM@N) will be performed in very beginning of the project. The wide program of applied researches at NICA facility is being developed as well.

  1. Ergonomics and simulation-based approach in improving facility layout

    NASA Astrophysics Data System (ADS)

    Abad, Jocelyn D.

    2018-02-01

    The use of the simulation-based technique in facility layout has been a choice in the industry due to its convenience and efficient generation of results. Nevertheless, the solutions generated are not capable of addressing delays due to worker's health and safety which significantly impact overall operational efficiency. It is, therefore, critical to incorporate ergonomics in facility design. In this study, workstation analysis was incorporated into Promodel simulation to improve the facility layout of a garment manufacturing. To test the effectiveness of the method, existing and improved facility designs were measured using comprehensive risk level, efficiency, and productivity. Results indicated that the improved facility layout generated a decrease in comprehensive risk level and rapid upper limb assessment score; an increase of 78% in efficiency and 194% increase in productivity compared to existing design and thus proved that the approach is effective in attaining overall facility design improvement.

  2. Final report of the decontamination and decommissioning of Building 34 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7 acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the Grand Junction Projects Office Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, was also the remedialmore » action contractor. Building 34 was radiologically contaminated and the building was demolished in 1996. The soil area within the footprint of the building was analyzed and found to be not contaminated. The area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual closeout report for each contaminated GJPO building.« less

  3. Final report of the decontamination and decommissioning of Building 44 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-07-01

    The U.S. Department of Energy (DOE) Junction Projects Office (GJPO) occupies a 61.7 acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the Grand Junction Projects Office Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, is also the remedial actionmore » contractor. Building 44 was radiologically contaminated and the building was demolished in 1994. The soil area within the footprint of the building was not contaminated; it complies with the identified standards and the area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  4. Final report of the decontamination and decommissioning of the exterior land areas at the Grand Junction Projects Office facility

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

    Widdop, M.R.

    1995-09-01

    The US Department of Energy (DOE) Grand Junction Projects Office (GJPO) facility occupies approximately 56.4 acres (22.8 hectares) along the Gunnison River near Grand Junction, Colorado. The site was contaminated with uranium ore and mill tailings during uranium-refining activities conducted by the Manhattan Engineer District and during pilot-milling experiments conducted for the US Atomic Energy Commission`s (AEC`s) domestic uranium procurement program. The GJPO facility was the collection and assay point for AEC uranium and vanadium oxide purchases until the early 1970s. The DOE Decontamination and Decommissioning Program sponsored the Grand Junction Projects Office Remedial Action Project (GJPORAP) to remediate themore » facility lands, site improvements, and the underlying aquifer. The site contractor, Rust Geotech, was the Remedial Action Contractor for GJPORAP. The exterior land areas of the facility assessed as contaminated have been remediated in accordance with identified standards and can be released for unrestricted use. Restoration of the aquifer will be accomplished through the natural flushing action of the aquifer during the next 50 to 80 years. The remediation of the DOE-GJPO facility buildings is ongoing and will be described in a separate report.« less

  5. Overview of the NASA Dryden Flight Research Facility aeronautical flight projects

    NASA Technical Reports Server (NTRS)

    Meyer, Robert R., Jr.

    1992-01-01

    Several principal aerodynamics flight projects of the NASA Dryden Flight Research Facility are discussed. Key vehicle technology areas from a wide range of flight vehicles are highlighted. These areas include flight research data obtained for ground facility and computation correlation, applied research in areas not well suited to ground facilities (wind tunnels), and concept demonstration.

  6. Efficiency improvement of the investment and innovation activities in the transport facility construction field with public-private partnership involvement

    NASA Astrophysics Data System (ADS)

    Shibayeva, Marina; Serebryakova, Yelena; Shalnev, Oleg

    2017-10-01

    Growing demand to increase the investment volume in modernization and development projects for transport infrastructure define the urgency of the current study. The amount of private sector investments in the field is insufficient to implement the projects for road construction due to their significant capital intensity and long payoff period. The implementation of social significant infrastructure projects on the principles of public-private partnership is one of the key strategic directions of growth for transport facilities. The authors come up with a concept and methodology for modeling the investment and innovation activity in the transport facility construction. Furthermore, there is developed a model to find the balance between public and private sector investments in implementing construction projects for transport infrastructure with involvement of PPP (further - public-private partnership). The suggested concepts aim to improve the efficiency rate of the investment and innovation activity in the field of transport facility construction on the basis of public and private sectors collaboration.

  7. Test Activities in the Langley Transonic Dynamics Tunnel and a Summary of Recent Facility Improvements

    NASA Technical Reports Server (NTRS)

    Cole, Stanley R.; Johnson, R. Keith; Piatak, David J.; Florance, Jennifer P.; Rivera, Jose A., Jr.

    2003-01-01

    The Langley Transonic Dynamics Tunnel (TDT) has provided a unique capability for aeroelastic testing for over forty years. The facility has a rich history of significant contributions to the design of many United States commercial transports, military aircraft, launch vehicles, and spacecraft. The facility has many features that contribute to its uniqueness for aeroelasticity testing, perhaps the most important feature being the use of a heavy gas test medium to achieve higher test densities compared to testing in air. Higher test medium densities substantially improve model-building requirements and therefore simplify the fabrication process for building aeroelastically scaled wind tunnel models. This paper describes TDT capabilities that make it particularly suited for aeroelasticity testing. The paper also discusses the nature of recent test activities in the TDT, including summaries of several specific tests. Finally, the paper documents recent facility improvement projects and the continuous statistical quality assessment effort for the TDT.

  8. Advanced Energy Retrofit Guide (AERG): Practical Ways to Improve Energy Performance; Healthcare Facilities (Book)

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

    Hendron, R.; Leach, M.; Bonnema, E.

    The Advanced Energy Retrofit Guide for Healthcare Facilities is part of a series of retrofit guides commissioned by the U.S. Department of Energy. By presenting general project planning guidance as well as detailed descriptions and financial payback metrics for the most important and relevant energy efficiency measures (EEMs), the guides provide a practical roadmap for effectively planning and implementing performance improvements in existing buildings. The Advanced Energy Retrofit Guides (AERGs) are intended to address key segments of the U.S. commercial building stock: retail stores, office buildings, K-12 schools, grocery stores, and healthcare facilities. The guides' general project planning considerations aremore » applicable nationwide; the energy and cost savings estimates for recommended EEMs were developed based on energy simulations and cost estimates for an example hospital tailored to five distinct climate regions. These results can be extrapolated to other U.S. climate zones. Analysis is presented for individual EEMs, and for packages of recommended EEMs for two project types: existing building commissioning projects that apply low-cost and no-cost measures, and whole-building retrofits involving more capital-intensive measures.« less

  9. Final report of the decontamination and decommissioning of Building 1 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also is the remedial action contractor. Building 1more » was found to be radiologically contaminated and was demolished in 1996. The soil beneath and adjacent to the building was remediated in accordance with identified standards and can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  10. Project management plan, Waste Receiving and Processing Facility, Module 1, Project W-026

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

    Starkey, J.G.

    1993-05-01

    The Hanford Waste Receiving and Processing Facility Module 1 Project (WRAP 1) has been established to support the retrieval and final disposal of approximately 400K grams of plutonium and quantities of hazardous components currently stored in drums at the Hanford Site.

  11. Quality improvement nursing facilities: a nursing leadership perspective.

    PubMed

    Adams-Wendling, Linda; Lee, Robert

    2005-11-01

    The purposes of this study were to characterize the state of quality improvement (QI) in nursing facilities and to identify barriers to improvement from nursing leaders' perspectives. The study employed a non-experimental descriptive design, using closed- and open-ended survey questions in a sample of 51 nursing facilities in a midwestern state. Only two of these facilities had active QI programs. Furthermore, turnover and limited training among these nursing leaders represented major barriers to rapid implementation of such programs. This study is consistent with earlier findings that QI programs are limited in nursing homes.

  12. Work plan for the Isotopes Facilities Deactivation Project at Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

    NONE

    1995-08-01

    The purpose of the Isotopes Facilities Deactivation Project (IFDP) is to place former isotopes production facilities at the Oak Ridge National Laboratory in a safe, stable, and environmentally sound condition; suitable for an extended period of minimum surveillance and maintenance (S and M) and as quickly and economical as possible. Implementation and completion of the deactivation project will further reduce the risks to the environment and to public safety and health. Furthermore, completion of the project will result in significant S and M cost savings in future years. The IFDP work plan defines the project schedule, the cost estimate, andmore » the technical approach for the project. A companion document, the EFDP management plan, has been prepared to document the project objectives, define organizational relationships and responsibilities, and outline the management control systems to be employed in the management of the project. The project has adopted the strategy of deactivating the simple facilities first, to reduce the scope of the project and to gain experience before addressing more difficult facilities. A decision support system is being developed to identify the activities that best promote the project mission and result in the largest cost savings. This work plan will be reviewed and revised annually. Deactivation of EFDP Facilities was initiated in FY 1994 and will be completed in FY 2000. The schedule for deactivation of facilities is shown. The total cost of the project is estimated to be $51M. The costs are summarized. Upon completion of deactivation, annual S and M costs of these facilities will be reduced from the current level of $5M per year to less than $1M per year.« less

  13. Can a quality improvement project impact maternal and child health outcomes at scale in northern Ghana?

    PubMed

    Singh, Kavita; Brodish, Paul; Speizer, Ilene; Barker, Pierre; Amenga-Etego, Issac; Dasoberi, Ireneous; Kanyoke, Ernest; Boadu, Eric A; Yabang, Elma; Sodzi-Tettey, Sodzi

    2016-06-16

    Quality improvement (QI) interventions are becoming more common in low- and middle-income countries, yet few studies have presented impact evaluations of these approaches. In this paper, we present an impact evaluation of a scale-up phase of 'Project Fives Alive!', a QI intervention in Ghana that aims to improve maternal and child health outcomes. 'Project Fives Alive!' employed a QI methodology to recognize barriers to care-seeking and care provision at the facility level and then to identify, test and implement simple and low-cost local solutions that address the barriers. A quasi-experimental design, multivariable interrupted time series analysis, with data coming from 744 health facilities and controlling for potential confounding factors, was used to study the effect of the project. The key independent variables were the change categories (interventions implemented) and implementation phase - Wave 2a (early phase) versus Wave 2b (later phase). The outcomes studied were early antenatal care (ANC), skilled delivery, facility-level under-five mortality and attendance of underweight infants at child welfare clinics. We stratified the analysis by facility type, namely health posts, health centres and hospitals. Several of the specific change categories were significantly associated with improved outcomes. For example, three of five change categories (early ANC, four or more ANC visits and skilled delivery/immediate postnatal care (PNC)) for health posts and two of five change categories (health education and triage) for hospitals were associated with increased skilled delivery. These change categories were associated with increases in skilled delivery varying from 28% to 58%. PNC changes for health posts and health centres were associated with greater attendance of underweight infants at child welfare clinics. The triage change category was associated with increased early antenatal care in hospitals. Intensity, the number of change categories tested, was associated

  14. Final report of the decontamination and decommission of Building 31 at the Grand Junction Projects Office Facility

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

    Krabacher, J.E.

    1996-07-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the domestic uranium procurement program funded by the U.S. Atomic Energy Commission. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also was the remedial actionmore » contractor. Radiological contamination was identified in Building 31 and the building was demolished in 1992. The soil area within the footprint of the building has been remediated in accordance with the identified standards and the area can be released for unlimited exposure and unrestricted use. This area was addressed in the summary final report of the remediation of the exterior areas of the GJPO facility. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  15. Coupled Facility/Payload Vibration Modeling Improvements

    NASA Technical Reports Server (NTRS)

    Carnahan, Timothy M.; Kaiser, Michael

    2015-01-01

    A major phase of aerospace hardware verification is vibration testing. The standard approach for such testing is to use a shaker to induce loads into the payload. In preparation for vibration testing at NASA/GSFC there is an analysis to assess the responses of the payload. A new method of modeling the test is presented that takes into account dynamic interactions between the facility and the payload. This dynamic interaction has affected testing in the past, but been ignored or adjusted for during testing. By modeling the combination of the facility and test article (payload) it is possible to improve the prediction of hardware responses. Many aerospace test facilities work in similar way to those at NASA Goddard Space Flight Center. Lessons learned here should be applicable to other test facilities with similar setups.

  16. Optimizing charge breeding techniques for ISOL facilities in Europe: Conclusions from the EMILIE project

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

    Delahaye, P., E-mail: delahaye@ganil.fr; Jardin, P.; Maunoury, L.

    The present paper summarizes the results obtained from the past few years in the framework of the Enhanced Multi-Ionization of short-Lived Isotopes for Eurisol (EMILIE) project. The EMILIE project aims at improving the charge breeding techniques with both Electron Cyclotron Resonance Ion Sources (ECRIS) and Electron Beam Ion Sources (EBISs) for European Radioactive Ion Beam (RIB) facilities. Within EMILIE, an original technique for debunching the beam from EBIS charge breeders is being developed, for making an optimal use of the capabilities of CW post-accelerators of the future facilities. Such a debunching technique should eventually resolve duty cycle and time structuremore » issues which presently complicate the data-acquisition of experiments. The results of the first tests of this technique are reported here. In comparison with charge breeding with an EBIS, the ECRIS technique had lower performance in efficiency and attainable charge state for metallic ion beams and also suffered from issues related to beam contamination. In recent years, improvements have been made which significantly reduce the differences between the two techniques, making ECRIS charge breeding more attractive especially for CW machines producing intense beams. Upgraded versions of the Phoenix charge breeder, originally developed by LPSC, will be used at SPES and GANIL/SPIRAL. These two charge breeders have benefited from studies undertaken within EMILIE, which are also briefly summarized here.« less

  17. The Ohio School Facilities Commission. Revamping the State's School Construction Projects.

    ERIC Educational Resources Information Center

    De Patta, Joe

    2001-01-01

    Presents an interview with the Ohio School Facilities Commission's (OSFC) Executive Director who discusses the OSFC's history and its work in managing K-12 school facilities throughout the state. Topics include its efforts to help school districts get bond measures on ballets, funding projects, and its "Partnering Program" for construction…

  18. Coupled Facility-Payload Vibration Modeling Improvements

    NASA Technical Reports Server (NTRS)

    Carnahan, Timothy M.; Kaiser, Michael A.

    2015-01-01

    A major phase of aerospace hardware verification is vibration testing. The standard approach for such testing is to use a shaker to induce loads into the payload. In preparation for vibration testing at National Aeronautics and Space Administration/Goddard Space Flight Center an analysis is performed to assess the responses of the payload. A new method of modeling the test is presented that takes into account dynamic interactions between the facility and the payload. This dynamic interaction has affected testing in the past, but been ignored or adjusted for during testing. By modeling the combined dynamics of the facility and test article (payload) it is possible to improve the prediction of hardware responses. Many aerospace test facilities work in similar way to those at NASA/Goddard Space Flight Center. Lessons learned here should be applicable to other test facilities with similar setups.

  19. National Ignition Facility Project: An Update

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

    Hogan, W J; Moses, E; Warner, B

    2000-12-07

    The National Ignition Facility (NIF) consists of 192 forty-centimeter-square laser beams and a 10-m-diameter target chamber. Physical construction began in 1997. The Laser and Target Area Building and the Optics Assembly Building were the first major construction activities, and despite several unforeseen obstacles, the buildings are now 92% complete and have been done on time and within cost. Prototype component development and testing has proceeded in parallel. Optics vendors have installed full-scale production lines and have done prototype production runs. The assembly and integration of the beampath infrastructure has been reconsidered and a new approach has been developed. This papermore » will discuss the status of the NIF project and the plans for completion. It will also include summary information on Laser MegaJoule (LMJ) provided by M. Andre, LMJ Project Director.« less

  20. TA 55 Reinvestment Project II Phase C Update Project Status May 23, 2017

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

    Giordano, Anthony P.

    The TA-55 Reinvestment Project (TRP) II Phase C is a critical infrastructure project focused on improving safety and reliability of the Los Alamos National Laboratory (LANL) TA-55 Complex. The Project recapitalizes and revitalizes aging and obsolete facility and safety systems providing a sustainable nuclear facility for National Security Missions.

  1. Final report of the decontamination and decommissioning of Building 6 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-07-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the domestic uranium procurement program funded by the U.S. Atomic Energy Commission. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, is also the remedial actionmore » contractor. Radiological contamination was identified in Building 6, and the building was demolished in 1992. The soil area within the footprint of the building has been remediated in accordance with the identified standards and the area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  2. Final report of the decontamination and decommissioning of Building 39 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-07-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, is also the remedial action contractor. The soilmore » beneath Building 39 was radiologically contaminated and the building was demolished in 1992. The soil area within the footprint of the building has been remediated in accordance with the identified standards and the area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  3. Final report of the decontamination and decommissioning of Building 18 at the Grand Junction Projects Office Facility

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

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also is the remedial action contractor. The soilmore » beneath Building 18 was found to be radiologically contaminated; the building was not contaminated. The soil was remediated in accordance with identified standards. Building 18 and the underlying soil can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.« less

  4. Try Caring...For a Living. Wisconsin Child Care Improvement Project Child Care Administration Series.

    ERIC Educational Resources Information Center

    Wisconsin Early Childhood Association, Madison.

    A collection of 26 fact sheets on child care administration produced by the Wisconsin Child Care Improvement Project from 1986 through 1989 is presented. Individual fact sheets concern: national trends, center start-up, family day care start-up, site and facility acquisition, public funding, effective center operation, reporting of child abuse and…

  5. Modeling Tool to Quantify Metal Sources in Stormwater Discharges at Naval Facilities (NESDI Project 455)

    DTIC Science & Technology

    2014-06-01

    TECHNICAL REPORT 2077 June 2014 Modeling Tool to Quantify Metal Sources in Stormwater Discharges at Naval Facilities (NESDI Project 455... Stormwater Discharges at Naval Facilities (NESDI Project 455) Final Report and Guidance C. Katz K. Sorensen E. Arias SSC Pacific R. Pitt L. Talebi...demonstration/validation project to assess the use of the urban stormwater model Windows Source Loading and Management Model (WinSLAMM) to characterize

  6. Environmental Projects. Volume 9: Construction of hazardous materials storage facilities

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Activities at the Goldstone Deep Space Communications Complex (GDSCC) are carried out in support of seven parabolic dish antennas. These activities may give rise to environmental hazards. This report is one in a series of reports describing environmental projects at GDSCC. The construction of two hazardous materials and wastes storage facilities and an acid-wash facility is described. An overview of the Goldstone complex is also presented along with a description of the environmental aspects of the GDSCC site.

  7. Recent Productivity Improvements to the National Transonic Facility

    NASA Technical Reports Server (NTRS)

    Popernack, Thomas G., Jr.; Sydnor, George H.

    1998-01-01

    Productivity gains have recently been made at the National Transonic Facility wind tunnel at NASA Langley Research Center. A team was assigned to assess and set productivity goals to achieve the desired operating cost and output of the facility. Simulations have been developed to show the sensitivity of selected process productivity improvements in critical areas to reduce overall test cycle times. The improvements consist of an expanded liquid nitrogen storage system, a new fan drive, a new tunnel vent stack heater, replacement of programmable logic controllers, an increased data communications speed, automated test sequencing, and a faster model changeout system. Where possible, quantifiable results of these improvements are presented. Results show that in most cases, improvements meet the productivity gains predicted by the simulations.

  8. 76 FR 20707 - Cle Elum Dam Fish Passage Facilities and Fish Reintroduction Project; Kittitas County, WA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation [INT-FES 11-02] Cle Elum Dam Fish Passage Facilities and Fish Reintroduction Project; Kittitas County, WA AGENCY: Bureau of Reclamation, Interior... Fish Passage Facilities and Fish Reintroduction Project. SUMMARY: The Bureau of Reclamation...

  9. Evaluation of Nuclear Facility Decommissioning Projects program: a reference research reactor. Project summary report

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

    Baumann, B.L.; Miller, R.L.

    1983-10-01

    This document presents, in summary form, generic conceptual information relevant to the decommissioning of a reference research reactor (RRR). All of the data presented were extracted from NUREG/CR-1756 and arranged in a form that will provide a basis for future comparison studies for the Evaluation of Nuclear Facility Decommissioning Projects (ENFDP) program.

  10. Engaging Clinical Nurses in Quality Improvement Projects.

    PubMed

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. Copyright 2015, SLACK Incorporated.

  11. The National Ignition Facility Project: An Update

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

    Hogan, W.J.; Moses, E.; Warner, B.

    2000-12-07

    The National Ignition Facility (NIT) consists of 192 forty-centimeter-square laser beams and a 10-m-diameter target chamber. Physical construction began in 1997. The Laser and Target Area Building and the Optics Assembly Building were the first major construction activities, and despite several unforeseen obstacles, the buildings are now 92% complete and have been done on time and within cost. Prototype component development and testing has proceeded in parallel. Optics vendors have installed full-scale production lines and have done prototype production runs. The assembly and integration of the beam path infrastructure has been reconsidered and a new approach has been developed. Thismore » paper will discuss the status of the NIF project and the plans for completion. It will also include summary information on Laser MegaJoule (LMJ) provided by M. Andre, LMJ Project Director.« less

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

    PubMed Central

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

    2016-01-01

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

  13. A quality improvement program to enhance after-hours telephone communication between nurses and physicians in a long-term care facility.

    PubMed

    Whitson, Heather E; Hastings, S Nicole; Lekan, Deborah A; Sloane, Richard; White, Heidi K; McConnell, Eleanor S

    2008-06-01

    To determine whether satisfaction of on-site nurses with after-hours telephone communication with off-site physicians improved in one long-term care (LTC) facility after a nurse-oriented intervention. Longitudinal quality improvement study. Extended Care and Rehabilitation Center (ECRC), Durham Veterans Affairs Medical Center. Eighteen registered nurses. Communicating Health Assessments by Telephone (Project CHAT), a program of individualized training sessions and decision support tools to aid LTC nurses with symptom assessment and communication of health information over the telephone. Nurses completed six satisfaction surveys (three surveys in the 3 months before Project CHAT and three surveys in the 3 months after Project CHAT). The nurses' average satisfaction scores increased on several items, including those that assessed whether the nurse was pretty sure what pieces of information the physician was going to ask for (P=.04), felt that the amount of patient information the physician asked for seemed reasonable (P=.03), felt prepared to answer the questions the physician asked (P=.01), and felt that the process of gathering patient information for the physician was easy (P=.01). The percentage of calls that resulted in immediate evaluation by a physician (on-site or in the emergency department) increased from 2.0% in the period before Project CHAT to 8.6% in the period after Project CHAT (P=.01). Nurses' satisfaction with several aspects of after-hours telephone medicine improved after an inexpensive, education-based intervention in one LTC facility. Further research is needed to determine how similar interventions might affect other quality measures, including patient outcomes.

  14. Manhattan Project buildings and facilities at the Hanford Site: A construction history

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

    Gerber, M.S.

    1993-09-01

    This document thoroughly examines the role that the Hanford Engineer Works played in the Manhattan project. The historical aspects of the buildings and facilities are characterized. An in depth look at the facilities, including their functions, methods of fabrication and appearance is given for the 100 AREAS, 200 AREAS, 300 AREAS, 500, 800 and 900 AREAS, 600 AREA, 700 AREA, 1100 AREA and temporary construction structures.

  15. Feasibility study and verified design concept for new improved hot gas facility

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The MSFC Hot Gas Facility (HGF) was fabricated in 1975 as a temporary facility to provide immediate turnaround testing to support the SRB and ET TPS development. This facility proved to be very useful and was used to make more than 1300 runs, far more than ever intended in the original design. Therefore, it was in need of constant repair and needed to be replaced with a new improved design to support the continuing SRB/ET TPS product improvement and/or removal efforts. MSFC contracted with Lockheed-Huntsville to work on this improved design through contract NAS8-36304 Feasibility Study and Verified Design Concept for the New Improved Hot Gas Facility. The results of Lockheed-Huntsville's efforts under this contract are summarized.

  16. Purdue University National Biomedical Tracer Facility: Project definition phase. Final report

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

    Green, M.A.

    The proposed National Biomedical Tracer Facility (NBTF) will house a high-current accelerator dedicated to production of short-lived radionuclides for biomedical and scientific research. The NBTF will play a vital role in repairing and maintaining the United States` research infrastructure for generation of essential accelerator-based radioisotopes. If properly designed and managed, the NBTF should also achieve international recognition as a Center-of-Excellence for research on radioisotope production methods and for associated education and training. The current report documents the results of a DOE-funded NBTF Project Definition Phase study carried out to better define the technical feasibility and projected costs of establishing andmore » operating the NBTF. This report provides an overview of recommended Facility Design and Specifications, including Accelerator Design, Building Design, and the associated Construction Cost Estimates and Schedule. It is recommended that the NBTF be established as an integrated, comprehensive facility for meeting the diverse production, research, and educational missions set forth in previous documents. Based on an analysis of the projected production demands that will be placed on the NBTF, it appears that a 70 MeV, 1 mA, negative ion cyclotron will offer a good balance between production capabilities and the costs of accelerator purchase and operation. A preliminary architectural plan is presented for a facility designed specifically to fulfill the functions of the NBTF in a cost-effective manner. This report also presents a detailed analysis of the Required Federal State, and Local Permits that may be needed to establish the NBTF, along with schedules and cost estimates for obtaining these permits. The Handling, Storage, and Disposal of Radioactive Waste will pose some significant challenges in the operation of the NBTF, but at this stage of planning the associated problems do not appear to be prohibitive.« less

  17. Initial Costs vs. Operational Costs. A Study of Building Improvement Projects in Fourteen Schools in the School District of Greenville County, South Carolina.

    ERIC Educational Resources Information Center

    Chan, Tak Cheung

    To determine whether initial facility improvement costs were paid back by the reduced operational costs resulting from the improvement projects, this study examined the relationship between initial costs and operational costs of fourteen school buildings improved during the 1978-79 school year in Greenville County, South Carolina. With energy…

  18. Improving water, sanitation and hygiene in health-care facilities, Liberia.

    PubMed

    Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

    2017-07-01

    The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

  19. Comparison of Prescribed and Measured Dialysate Sodium: A Quality Improvement Project.

    PubMed

    Gul, Ambreen; Miskulin, Dana C; Paine, Susan S; Narsipur, Sriram S; Arbeit, Leonard A; Harford, Antonia M; Weiner, Daniel E; Schrader, Ronald; Horowitz, Bruce L; Zager, Philip G

    2016-03-01

    There is controversy regarding the optimal dialysate sodium concentration for hemodialysis patients. Dialysate sodium concentrations of 134 to 138 mEq/L may decrease interdialytic weight gain and improve hypertension control, whereas a higher dialysate sodium concentration may offer protection to patients with low serum sodium concentrations and hypotension. We conducted a quality improvement project to explore the hypothesis that prescribed and delivered dialysate sodium concentrations may differ significantly. Cross-sectional quality improvement project. 333 hemodialysis treatments in 4 facilities operated by Dialysis Clinic, Inc. Measure dialysate sodium to assess the relationships of prescribed and measured dialysate sodium concentrations. Magnitude of differences between prescribed and measured dialysate sodium concentrations. Dialysate sodium measured pre- and late dialysis. The least square mean of the difference between prescribed minus measured dialysate sodium concentration was -2.48 (95% CI, -2.87 to -2.10) mEq/L. Clinics with a greater number of different dialysate sodium prescriptions (clinic 1, n=8; clinic 2, n=7) and that mixed dialysate concentrates on site had greater differences between prescribed and measured dialysate sodium concentrations. Overall, 57% of measured dialysate sodium concentrations were within ±2 mEq/L of the prescribed dialysate sodium concentration. Differences were greater at higher prescribed dialysate sodium concentrations. We only studied 4 facilities and dialysate delivery machines from 2 manufacturers. Because clinics using premixed dialysate used the same type of machine, we were unable to independently assess the impact of these factors. Pressures in dialysate delivery loops were not measured. There were significant differences between prescribed and measured dialysate sodium concentrations. This may have beneficial or deleterious effects on clinical outcomes, as well as confound results from studies assessing the

  20. Educational Facility Design and Project Based Learning: "The Real Connection"

    ERIC Educational Resources Information Center

    Schrader, David L.; Sole, John

    2009-01-01

    There is a case to be made for the integration of the Project Based Service Learning (PBSL) process and the design and construction of educational facilities. A growing body of research supports the notion that the formulaic educational system of the last hundred years may no longer serve the learning styles of new and future generations. Their…

  1. Improving water quality through California's Clean Beach Initiative: an assessment of 17 projects.

    PubMed

    Dorsey, John H

    2010-07-01

    California's Clean Beach Initiative (CBI) funds projects to reduce loads of fecal indicator bacteria (FIB) impacting beaches, thus providing an opportunity to judge the effectiveness of various CBI water pollution control strategies. Seventeen initial projects were selected for assessment to determine their effectiveness on reducing FIB in the receiving waters along beaches nearest to the projects. Control strategies included low-flow diversions, sterilization facilities, sewer improvements, pier best management practices (BMPs), vegetative swales, and enclosed beach BMPs. Assessments were based on statistical changes in pre- and postproject mean densities of FIB at shoreline monitoring stations targeted by the projects. Most low-flow diversions and the wetland swale project were effective in removing all contaminated runoff from beaches. UV sterilization was effective when coupled with pretreatment filtration and where effluent was released within a few hundred meters of the beach to avoid FIB regrowth. Other BMPs were less effective because they treated only a portion of contaminant sources impacting their target beach. These findings should be useful to other coastal states and agencies faced with similar pollution control problems.

  2. A single activity with a practice quality improvement project for faculty and a quality improvement project for residents.

    PubMed

    Kim, Hyun; Malatesta, Theresa M; Simone, Nicole L; Den, Robert B; McAna, John; Dicker, Adam P; Bar Ad, Voichita

    2016-01-01

    The Next Accreditation System (NAS) requires radiation oncology residents to do a formal quality improvement project during their residency. The American Board of Radiology (ABR) Maintenance of Certification (MOC) program requires certified physicians to complete a Practice Quality Improvement (PQI) project approximately every 3 years. The purpose of our project was to develop a clinical transition of care policy via a process that resulted in quality improvement project credit for residents and PQI credit for participating faculty. Approval for project implementation was obtained from the ABR MOC committee. The PQI project consisted of an initial survey to assess resident perception on resident transition of care in our department, formal sign-out training, and 2 postintervention surveys after 1 and 11 months. The primary endpoint was the percentage of questions with ≤1 unfavorable responses. Sign-test was used to determine response difference from neutral. One hundred percent of surveyed residents completed the preintervention (n = 6), postintervention 1 (n = 7), and postintervention 2 (n = 8) surveys. In the preintervention, postintervention 1, and postintervention 2 surveys, 71.4%, 57.1%, and 57.1% of questions were answered with ≤1 unfavorable response, respectively. The number of questions with ≥75% favorable response was 7 (50%), 7 (50%), and 11 (78.5%) in the preintervention, postintervention 1, and postintervention 2 surveys, respectively (P = .13). A written sign-out template and monthly protected sign-out meetings were instituted. One resident and 3 attending physicians received credit for Accreditation Council of Graduate Medical Education NAS quality improvement and ABR MOC PQI projects, respectively. This project shows the feasibility of a combined attending and resident physician effort to improve patient care and fulfill his or her respective ABR MOC PQI and Accreditation Council of Graduate Medical Education NAS requirements. Attending and

  3. Evolution of Safeguards over Time: Past, Present, and Projected Facilities, Material, and Budget

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

    Kollar, Lenka; Mathews, Caroline E.

    This study examines the past trends and evolution of safeguards over time and projects growth through 2030. The report documents the amount of nuclear material and facilities under safeguards from 1970 until present, along with the corresponding budget. Estimates for the future amount of facilities and material under safeguards are made according to non-nuclear-weapons states’ (NNWS) plans to build more nuclear capacity and sustain current nuclear infrastructure. Since nuclear energy is seen as a clean and economic option for base load electric power, many countries are seeking to either expand their current nuclear infrastructure, or introduce nuclear power. In ordermore » to feed new nuclear power plants and sustain existing ones, more nuclear facilities will need to be built, and thus more nuclear material will be introduced into the safeguards system. The projections in this study conclude that a zero real growth scenario for the IAEA safeguards budget will result in large resource gaps in the near future.« less

  4. Facilities Policies and Procedures Manual. South Carolina Commission on Higher Education. Division of Finance, Facilities, and Statistical Services.

    ERIC Educational Resources Information Center

    South Carolina Commission on Higher Education, Columbia.

    This manual outlines the policies and procedures related to the submission and review of facilities projects at South Carolina's public colleges and universities. It provides an overview of the South Carolina Commission on Higher Education's role and responsibilities and its general policy regarding permanent improvements to facilities. The report…

  5. Facility uses Six Sigma to improve quality.

    PubMed

    2006-09-01

    Initiative demonstrates a 23% improvement in first bed assignment to a private isolation room. Keys to improvement found in enhanced communication and staff training. Staff develop reporting mechanism to sustain and institutionalize project results.

  6. Naval Facilities Engineering Command Needs to Improve Controls Over Task Order Administration

    DTIC Science & Technology

    2015-07-02

    consolidated joint use Submarine Learning Center and Submarine Squadron Headquarters facility that: • includes training space for submarine crews, and...allows frequent and timely interaction between Headquarters personnel, Submarine Learning Center instructors, and waterfront operations personnel...Introduction DODIG-2015-141 │ 3 Project P-528 provides a Torpedo Exercise Support facility that: • supports submarine crew training and certification to

  7. Project C-018H, 242-A Evaporator/PUREX Plant Process Condensate Treatment Facility, functional design criteria. Revision 3

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

    Sullivan, N.

    1995-05-02

    This document provides the Functional Design Criteria (FDC) for Project C-018H, the 242-A Evaporator and Plutonium-Uranium Extraction (PUREX) Plant Condensate Treatment Facility (Also referred to as the 200 Area Effluent Treatment Facility [ETF]). The project will provide the facilities to treat and dispose of the 242-A Evaporator process condensate (PC), the Plutonium-Uranium Extraction (PUREX) Plant process condensate (PDD), and the PUREX Plant ammonia scrubber distillate (ASD).

  8. Competitiveness Improvement Project Informational Workshop

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

    Sinclair, Karin C; Preus, Robert W; Dana, Scott

    This presentation was given at the Competitiveness Improvement Project (CIP) Informational Workshop on December 6, 2017. Topics covered during the workshop include an overview of the CIP, past projects, scoring criteria, technical support opportunities, certification body requirements, standards applicable to distributed wind generators, information on the National Electric Code, certification testing requirements, test site requirements, National Environmental Policy Act, design review, levelized cost of energy, procurement/contracting, project management/deliverables, and outreach materials.

  9. The Worksite Heart Health Improvement Project (WHHIP): feasibility and efficacy.

    PubMed

    Flannery, Kelly; Resnick, Barbara; Galik, Elizabeth; Lipscomb, Jane; McPhaul, Kathleen; Shaughnessy, Marianne

    2012-01-01

    Test the feasibility and efficacy of the Worksite Heart Health Improvement Project (WHHIP). The WHHIP was a quasi-experimental 6-month pilot performed in 2 long-term care facilities. Thirty-nine female minority nursing assistants participated in this study with a mean age of 42.39 (SD = 12.79) years. Measures were collected at baseline, 3, and 6 months and included blood pressure, lipid panel, body mass index, physical activity levels, diet behaviors, depressive symptoms, and self-efficacy outcomes. The 3-month WHHIP intervention included 3 components: environmental and policy assessment; education; and on-going motivation. The control site received education only. Subject participation averaged 47% and 58% in exercise and diet related activities, respectively. Generalized estimating equations showed the treatment group showed significant improvements in depressive symptoms (p = .012), systolic blood pressure (p = .028), total cholesterol (p = .002) and triglycerides (p = .011) over time. The treatment group also showed trends for improvement in diet behaviors (p = .069) and diastolic blood pressure (p = .073). This study provided feasibility evidence for the WHHIP and preliminary evidence that the WHHIP can improve heart healthy behaviors and subsequent outcomes among nursing assistants in long-term care settings. © 2012 Wiley Periodicals, Inc.

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

    PubMed

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

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

  11. A facility specialist model for improving retention of nursing home staff: results from a randomized, controlled study.

    PubMed

    Pillemer, Karl; Meador, Rhoda; Henderson, Charles; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

    2008-07-01

    This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and Connecticut and randomly assigned to treatment and control conditions. Staff outcomes were measured through certified nursing assistant interviews, and turnover rates were measured over the course of the year. In the intervention condition, a staff member was selected to be the facility retention specialist, who would advocate for and implement programs to improve staff retention and commitment throughout the facility. Retention specialists received an intensive 3-day training in retention leadership and in a number of evidence-based retention programs. Ongoing support was provided throughout the project. Treatment facilities experienced significant declines in turnover rates compared to control facilities. As predicted, we found positive effects on certified nursing assistant assessments of the quality of retention efforts and of care provided in the facility; we did not find effects for job satisfaction or stress. The study provides evidence for the effectiveness of the retention specialist model. Findings from a detailed process evaluation suggest modifications of the program that may increase program effects.

  12. A Microsoft Project-Based Planning, Tracking, and Management Tool for the National Transonic Facility's Model Changeover Process

    NASA Technical Reports Server (NTRS)

    Vairo, Daniel M.

    1998-01-01

    The removal and installation of sting-mounted wind tunnel models in the National Transonic Facility (NTF) is a multi-task process having a large impact on the annual throughput of the facility. Approximately ten model removal and installation cycles occur annually at the NTF with each cycle requiring slightly over five days to complete. The various tasks of the model changeover process were modeled in Microsoft Project as a template to provide a planning, tracking, and management tool. The template can also be used as a tool to evaluate improvements to this process. This document describes the development of the template and provides step-by-step instructions on its use and as a planning and tracking tool. A secondary role of this document is to provide an overview of the model changeover process and briefly describe the tasks associated with it.

  13. Improving water, sanitation and hygiene in health-care facilities, Liberia

    PubMed Central

    Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

    2017-01-01

    Abstract Problem The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities’ preparedness and response to disease outbreaks and decreases the communities’ trust in the health services provided. Approach To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. Local setting In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Relevant changes Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. Lessons learnt National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability. PMID:28670017

  14. 7 CFR 3015.16 - Construction and facility improvement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Construction and facility improvement. 3015.16 Section 3015.16 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Bonding and Insurance...

  15. Elementary and middle school science improvement project

    NASA Technical Reports Server (NTRS)

    Mcguire, Saundra Yancy

    1987-01-01

    The Alabama A & M University Elementary and Middle School Science Improvement Project (Project SIP) was instituted in response to a need to improve the ability of North Alabama teachers to teach science effectively using the experimental or hands-on approach. The major component of the project was a two-week workshop. Follow-up visits were made to the classrooms of many of the participating teachers to obtain information on how the program was being implemented in the classroom. The administrative aspects of the program, the delivery of the services to participating teachers, and the project outcomes are addressed.

  16. How to Begin a Quality Improvement Project.

    PubMed

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

    2016-05-06

    Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Copyright © 2016 by the American

  17. How to Begin a Quality Improvement Project

    PubMed Central

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

    2016-01-01

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

  18. Education & Collection Facility GSHP Demonstration Project

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

    Joplin, Jeff

    The Denver Museum of Nature & Science (DMNS) designed and implemented an innovative ground source heat pump (GSHP) system for heating and cooling its new Education and Collection Facility (ECF) building addition. The project goal was to successfully design and install an open-loop GSHP system that utilized water circulating within an underground municipal recycled (non-potable) water system as the heat sink/source as a demonstration project. The expected results were to significantly reduce traditional GSHP installation costs while increasing system efficiency, reduce building energy consumption, require significantly less area and capital to install, and be economically implemented wherever access to amore » recycled water system is available. The project added to the understanding of GSHP technology by implementing the first GSHP system in the United States utilizing a municipal recycled water system as a heat sink/source. The use of this fluid through a GSHP system has not been previously documented. This use application presents a new opportunity for local municipalities to develop and expand the use of underground municipal recycled (non-potable) water systems. The installation costs for this type of technology in the building structure would be a cost savings over traditional GSHP costs, provided the local municipal infrastructure was developed. Additionally, the GSHP system functions as a viable method of heat sink/source as the thermal characteristics of the fluid are generally consistent throughout the year and are efficiently exchanged through the GSHP system and its components. The use of the recycled water system reduces the area required for bore or loop fields; therefore, presenting an application for building structures that have little to no available land use or access. This GSHP application demonstrates the viability of underground municipal recycled (non-potable) water systems as technically achievable, environmentally supportive, and an

  19. Distributed Wind Competitiveness Improvement Project

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

    The Competitiveness Improvement Project (CIP) is a periodic solicitation through the U.S. Department of Energy and its National Renewable Energy Laboratory. The Competitiveness Improvement Project (CIP) is a periodic solicitation through the U.S. Department of Energy and its National Renewable Energy Laboratory. Manufacturers of small and medium wind turbines are awarded cost-shared grants via a competitive process to optimize their designs, develop advanced manufacturing processes, and perform turbine testing. The goals of the CIP are to make wind energy cost competitive with other distributed generation technology and increase the number of wind turbine designs certified to national testing standards. Thismore » fact sheet describes the CIP and funding awarded as part of the project.ufacturers of small and medium wind turbines are awarded cost-shared grants via a competitive process to optimize their designs, develop advanced manufacturing processes, and perform turbine testing. The goals of the CIP are to make wind energy cost competitive with other distributed generation technology and increase the number of wind turbine designs certified to national testing standards. This fact sheet describes the CIP and funding awarded as part of the project.« less

  20. Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project.

    PubMed

    Ersek, Mary; Hickman, Susan E; Thomas, Anne C; Bernard, Brittany; Unroe, Kathleen T

    2017-10-17

    The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption. Nineteen nursing homes participated in OPTIMISTIC. We conducted semistructured, qualitative interviews with 63 stakeholders: 23 nursing home staff and leaders, 4 primary care providers, 10 family members, and 26 OPTIMISTIC clinical staff. We used directed content analysis to analyze the data. We found universal endorsement of the value of in-depth advance care planning (ACP) discussions in reducing hospitalizations and improving care. Similarly, all stakeholder groups emphasized that nursing home access to specially trained, project registered nurses (RNs) and nurse practitioners (NPs) with time to focus on ACP, comprehensive resident assessment, and staff education was particularly valuable in identifying residents' goals for care. Challenges to implementation included inadequately trained facility staff and resistance to changing practice. In addition, the program sometimes failed to communicate its goals and activities clearly, leaving facilities uncertain about the OPTIMISTIC clinical staff's roles in the facilities. These findings are important for dissemination efforts related to the OPTIMISTIC care model and may be applicable to other innovations in nursing homes. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  1. Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.

    PubMed

    Guillory, Charleta; Gong, Alice; Livingston, Judith; Creel, Liza; Ocampo, Elena; McKee-Garrett, Tiffany

    2017-07-01

    Objective  Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design  Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results  The nurses' knowledge assessment improved from 71 to 92.5% ( p  < 0.0001). Of 11,322 asymptomatic newborns screened after 24 hours of age, 11 had a positive screen, with 1 confirmed case of CCHD. Pulse oximetry CCHD NBS had sensitivity of 100%, specificity of 99.91%, false-positive rate of 0.088%, positive predictive value of 9.09%, and negative predictive value of 100%. Conclusion  Our educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Improving Climate Projections Using "Intelligent" Ensembles

    NASA Technical Reports Server (NTRS)

    Baker, Noel C.; Taylor, Patrick C.

    2015-01-01

    Recent changes in the climate system have led to growing concern, especially in communities which are highly vulnerable to resource shortages and weather extremes. There is an urgent need for better climate information to develop solutions and strategies for adapting to a changing climate. Climate models provide excellent tools for studying the current state of climate and making future projections. However, these models are subject to biases created by structural uncertainties. Performance metrics-or the systematic determination of model biases-succinctly quantify aspects of climate model behavior. Efforts to standardize climate model experiments and collect simulation data-such as the Coupled Model Intercomparison Project (CMIP)-provide the means to directly compare and assess model performance. Performance metrics have been used to show that some models reproduce present-day climate better than others. Simulation data from multiple models are often used to add value to projections by creating a consensus projection from the model ensemble, in which each model is given an equal weight. It has been shown that the ensemble mean generally outperforms any single model. It is possible to use unequal weights to produce ensemble means, in which models are weighted based on performance (called "intelligent" ensembles). Can performance metrics be used to improve climate projections? Previous work introduced a framework for comparing the utility of model performance metrics, showing that the best metrics are related to the variance of top-of-atmosphere outgoing longwave radiation. These metrics improve present-day climate simulations of Earth's energy budget using the "intelligent" ensemble method. The current project identifies several approaches for testing whether performance metrics can be applied to future simulations to create "intelligent" ensemble-mean climate projections. It is shown that certain performance metrics test key climate processes in the models, and

  3. Methodology of quality improvement projects for the Texas Medicare population.

    PubMed

    Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

    1998-07-01

    The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

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

    PubMed

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

    2016-01-01

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

  5. Therapeutic Use of Space: One Agency's Transformation Project

    ERIC Educational Resources Information Center

    Goelitz, Ann; Stewart-Kahn, Abigail

    2007-01-01

    The project described in this article addresses the therapeutic use of physical space in an outpatient counseling facility. It was theorized that an improved facility environment could be used as a practice tool when working with a vulnerable population. The authors undertook the project with limited time and finances. The process of the change…

  6. Benchmarking facilities providing care: An international overview of initiatives

    PubMed Central

    Thonon, Frédérique; Watson, Jonathan; Saghatchian, Mahasti

    2015-01-01

    We performed a literature review of existing benchmarking projects of health facilities to explore (1) the rationales for those projects, (2) the motivation for health facilities to participate, (3) the indicators used and (4) the success and threat factors linked to those projects. We studied both peer-reviewed and grey literature. We examined 23 benchmarking projects of different medical specialities. The majority of projects used a mix of structure, process and outcome indicators. For some projects, participants had a direct or indirect financial incentive to participate (such as reimbursement by Medicaid/Medicare or litigation costs related to quality of care). A positive impact was reported for most projects, mainly in terms of improvement of practice and adoption of guidelines and, to a lesser extent, improvement in communication. Only 1 project reported positive impact in terms of clinical outcomes. Success factors and threats are linked to both the benchmarking process (such as organisation of meetings, link with existing projects) and indicators used (such as adjustment for diagnostic-related groups). The results of this review will help coordinators of a benchmarking project to set it up successfully. PMID:26770800

  7. An improvement project within urological care.

    PubMed

    Khatami, Annelie; Rosengren, Kristina

    2015-01-01

    The purpose of this paper is to describe staff experiences in an on-going improvement project regarding patients with ureteral stones. A qualitative descriptive study based on eight group interviews and 48 narratives, was performed. Data were analysed using qualitative content analysis. Trustworthiness was ensured by using a well-documented improvement process method during six months. The results formed three categories: an absent comprehensive view; complexity; and vulnerability within the organisation. A holistic perspective regarding urological care at the micro-, meso- and macro-levels is needed to improve planning and caring processes. This study includes one team (six members, different health professionals) within the same urology department. Results show that staff need information, such as guidelines and support throughout the improvement work to deliver high-quality care. Moreover, there is a need for evidence-based guidelines at national level to support improvement work. Healthcare staff need to pay attention to all team member needs to improve urological care. Organisational and managerial aspect are needed to support clear and common goals regarding healthcare improvement work. Urological improvement projects, generally, are lacking, which is why this study is important to improve nephrolithiasis patient care.

  8. The radioactive ion beams facility project for the legnaro laboratories

    NASA Astrophysics Data System (ADS)

    Tecchio, Luigi B.

    1999-04-01

    In the frame work of the Italian participation to the project of a high intensity proton facility for the energy amplifier and nuclear waste transmutations, LNL is involving in the design and construction of prototypes of the injection system of the 1 GeV linac that consists of a RFQ (5 MeV, 30 mA) followed by a 100 MeV linac. This program has been already financially supported and the work is actually in progress. In this context, the LNL has been proposed a project for the construction of a second generation facility for the production of radioactive ion beams (RIBs) by using the ISOL method. The final goal consists in the production of neutron rich RIBs with masses ranging from 80 to 160 by using primary beams of protons, deuterons and light ions with energy of 100 MeV and 100 kW power. This project is proposed to be developed in about 10 years from now and intermediate milestones and experiments are foreseen and under consideration for the next INFN five year plan (1999-2003). In such period of time is proposed the construction of a proton/deuteron accelerator of 10 MeV energy and 10 mA current, consisting of a RFQ (5 MeV, 30 mA) and a linac (10 MeV, 10 mA), and of a neutron area dedicated to the RIBs production, to the BNCT applications and to the neutron physics. Some remarks on the production methods will be presented. The possibility of producing radioisotopes by means of the fission induced by neutrons will be investigated and the methods of production of neutrons will be discussed.

  9. 1979-1981 Vocational Education Improvement Projects.

    ERIC Educational Resources Information Center

    Connecticut State Dept. of Education, Hartford. Div. of Vocational Education.

    This brochure provides summaries of 23 exemplary, research, and curriculum projects known as the Vocational Improvement Program that share three concerns: meeting needs of underserved students, sex fairness, and excellence in vocational education. The 14 exemplary projects focus on vocational exploration and skill building in marine and related…

  10. Complementary and Integrative Healthcare in a Long-term Care Facility: A Pilot Project.

    PubMed

    Evans, Roni; Vihstadt, Corrie; Westrom, Kristine; Baldwin, Lori

    2015-01-01

    The world's population is aging quickly, leading to increased challenges of how to care for individuals who can no longer independently care for themselves. With global social and economic pressures leading to declines in family support, increased reliance is being placed on community- and government-based facilities to provide long-term care (LTC) for many of society's older citizens. Complementary and integrative healthcare (CIH) is commonly used by older adults and may offer an opportunity to enhance LTC residents' wellbeing. Little work has been done, however, rigorously examining the safety and effectiveness of CIH for LTC residents. The goal of this work is to describe a pilot project to develop and evaluate one model of CIH in an LTC facility in the Midwestern United States. A prospective, mixed-methods pilot project was conducted in two main phases: (1) preparation and (2) implementation and evaluation. The preparation phase entailed assessment, CIH model design and development, and training. A CIH model including acupuncture, chiropractic, and massage therapy, guided by principles of collaborative integration, evidence informed practice, and sustainability, was applied in the implementation and evaluation phase. CIH services were provided for 16 months in the LTC facility. Quantitative data collection included pain, quality of life, and adverse events. Qualitative interviews of LTC residents, their family members, and LTC staff members queried perceptions of CIH services. A total of 46 LTC residents received CIH care, most commonly for musculoskeletal pain (61%). Participants were predominantly female (85%) and over the age of 80 years (67%). The median number of CIH treatments was 13, with a range of 1 to 92. Residents who were able to provide self-report data demonstrated, on average, a 15% decline in pain and a 4% improvement in quality of life. No serious adverse events related to treatment were documented; the most common mild and expected side effect

  11. Space Station Furnace Facility Preliminary Project Implementation Plan (PIP). Volume 2, Appendix 2

    NASA Technical Reports Server (NTRS)

    Perkey, John K.

    1992-01-01

    The Space Station Furnace Facility (SSFF) is an advanced facility for materials research in the microgravity environment of the Space Station Freedom and will consist of Core equipment and various sets of Furnace Module (FM) equipment in a three-rack configuration. This Project Implementation Plan (PIP) document was developed to satisfy the requirements of Data Requirement Number 4 for the SSFF study (Phase B). This PIP shall address the planning of the activities required to perform the detailed design and development of the SSFF for the Phase C/D portion of this contract.

  12. Elementary and middle school science improvement project

    NASA Technical Reports Server (NTRS)

    Mcguire, Saundra Y.

    1989-01-01

    The Alabama A and M University Elementary and Middle School Science Improvement Project (Project SIP) was instituted to improve the science knowledge of elementary and middle school teachers using the experimental or hands-on approach. Summer workshops were conducted during the summers of 1986, 1987, and 1988 in the areas of biology, chemistry, physics, and electricity, and magnetism. Additionally, a manual containing 43 lessons which included background information, experiments and activities for classroom and home use was provided to each teacher. During the course of the project activities, the teachers interacted with various university faculty members, scientists, and NASA staff. The administrative aspects of the program, the delivery of the services to participating teachers, and the project outcome are addressed.

  13. Association Between Treatment at High-Volume Facilities and Improved Overall Survival in Soft Tissue Sarcomas.

    PubMed

    Venigalla, Sriram; Nead, Kevin T; Sebro, Ronnie; Guttmann, David M; Sharma, Sonam; Simone, Charles B; Levin, William P; Wilson, Robert J; Weber, Kristy L; Shabason, Jacob E

    2018-03-15

    Soft tissue sarcomas (STS) are rare malignancies that require complex multidisciplinary management. Therefore, facilities with high sarcoma case volume may demonstrate superior outcomes. We hypothesized that STS treatment at high-volume (HV) facilities would be associated with improved overall survival (OS). Patients aged ≥18 years with nonmetastatic STS treated with surgery and radiation therapy at a single facility from 2004 through 2013 were identified from the National Cancer Database. Facilities were dichotomized into HV and low-volume (LV) cohorts based on total case volume over the study period. OS was assessed using multivariable Cox regression with propensity score-matching. Patterns of care were assessed using multivariable logistic regression analysis. Of 9025 total patients, 1578 (17%) and 7447 (83%) were treated at HV and LV facilities, respectively. On multivariable analysis, high educational attainment, larger tumor size, higher grade, and negative surgical margins were statistically significantly associated with treatment at HV facilities; conversely, black race and non-metropolitan residence were negative predictors of treatment at HV facilities. On propensity score-matched multivariable analysis, treatment at HV facilities versus LV facilities was associated with improved OS (hazard ratio, 0.87, 95% confidence interval, 0.80-0.95; P = .001). Older age, lack of insurance, greater comorbidity, larger tumor size, higher tumor grade, and positive surgical margins were associated with statistically significantly worse OS. In this observational cohort study using the National Cancer Database, receipt of surgery and radiation therapy at HV facilities was associated with improved OS in patients with STS. Potential sociodemographic disparities limit access to care at HV facilities for certain populations. Our findings highlight the importance of receipt of care at HV facilities for patients with STS and warrant further study into improving access to

  14. Project Village conceptual plans. Final technical report, November 1980-May 1982. [Proposed WyCoalGas project, Converse County, Wyoming; proposed housing facilities

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

    Not Available

    1982-01-01

    The WyCoal Project Village is a housing facility proposed adjacent to the Wyoming Coal Gasification Project plant construction site that would accommodate single workers in dormitory units and singles or couples at a recreation vehicle park. Centralized services and recreational facilities are also to be provided. The provision for some mobile home units to be used in lieu of RV spaces has been considered but would be developed only if a strong demonstrated demand from singles and couples required such a provision. No children will be allowed at the Project Village as accommodations for families will be available in themore » town of Douglas. The development program for the Project Village calls for a total plan capacity of 225 living units: 1500 dormitory rooms and 750 recreational vehicle spaces. However, the total units to be developed will not exceed 1800 with peak employment, including couples at the Recreational Vehicle Park, not anticipated to exceed 2000. The flexibility within the maximum plan capacity of 2250 will allow for the development of an appropriate balance of housing units geared to the on-site project demands as plant construction occurs. At this time a mix of approximately 1200 dormitory rooms and 600 RV spaces appears appropriate for planning purposes.« less

  15. Construction Project Performance Improvement through Radio Frequency Identification Technology Application on a Project Supply Chain

    ERIC Educational Resources Information Center

    Wang, Heng

    2017-01-01

    Construction project productivity typically lags other industries and it has been the focus of numerous studies in order to improve the project performance. This research investigated the application of Radio Frequency Identification (RFID) technology on construction projects' supply chain and determined that RFID technology can improve the…

  16. [Psychiatric residential care facilities in the Puglia region. Phase 1 results of the PROGRES project].

    PubMed

    Germinario, Cinzia; Semisa, Domenico; Picoco, Fulvio; Prato, Rosa; Lopalco, Pietro Luigi; Quarto, Michele

    2004-01-01

    One of the more important aspects of the psychiatric care reform in Italy has been the opening of a great number of psychiatric Non-Hospital Residential Facilities (NHRF). However, 22 years have elapsed since the reform and there are still very scarce data regarding such facilities, the type of patients being accomodated, and the types of treatments provided. The "PROGRES" (PROGetto RESidenze - Residential Project) project is the first national study regarding NHRFs ever carried out in Italy. The objectives of "PROGRES" are to make a survey of all NHRFs in Italy (Phase 1) and to perform a detailed assessment of 20% of the surveyed facilities and of the type of patients being treated (Phase 2). This paper reports the survey (Phase 1) results for the Puglia Region. As of March 31, 2003, 113 psychiatric residential facilities were present in Puglia, with a total of 1.479 beds. This results in an average of 13,08 beds per facility and a rate of 3,86 beds per 10.000 inhabitants. The number of NHRFs present in the territory of each Local Health Unit in Puglia is very variable. Most NHRFs (57%) opened after January 1997. Eighty-three percent have a 24-hour staff coverage while only 5,3% has a 2-hour staff coverage. Eighty five percent of the residential facilities are financed by the Italian National Healthcare System, while a small percentage is privately funded. In over half (69,93%) of the NHRFs the predominant patient age group is 40-59 years; 26,4% of the residential facilities accommodate patients below age 40 and only 3,53% accommodate patients over 60 years old.

  17. 78 FR 69433 - Executive Order 13650 Improving Chemical Facility Safety and Security Listening Sessions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-19

    ... Chemical Facility Safety and Security Listening Sessions AGENCY: National Protection and Programs... from stakeholders on issues pertaining to Improving Chemical Facility Safety and Security (Executive... regulations, guidance, and policies; and identifying best practices in chemical facility safety and security...

  18. Considerations on Facilities Planning

    ERIC Educational Resources Information Center

    Baule, Steven

    2007-01-01

    Most facilities renovation projects occur because someone at the executive or board level has lobbied successfully for them. Often in public schools, the voters have agreed to the project as well via a building referendum. Therefore, facilities projects are highly visible to the community. Unlike many other issues in schools, facilities projects…

  19. Enhancing resiliency for elderly populations : Shelter-in-place planning and training at facilities serving elderly populations through the Rhode Island Senior Resiliency Project.

    PubMed

    Smith, Richard; Mozzer, Michael; Albanese, Joseph; Paturas, James; Gold, Julia

    2017-06-01

    Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters. Based on this, the Rhode Island Department of Health established the Senior Resiliency Project to bolster the level of resiliency for the types of living facilities housing older adults. The project involves performing onsite assessments of energy resources, developing site-specific sheltering-inplace and energy resiliency plans, and educating and training facility employees and residents on these plans and steps they can take to be better prepared. Based on the feasibility of conducting these activities within a variety of facilities housing older adults, the project is segmented into three phases. This paper describes survey findings, outcomes of interventions, challenges and recommendations for bridging gaps observed in phases 1 and 2 of the project.

  20. Evaluation of Nuclear Facility Decommissioning Projects program: a reference test reactor. Project summary report

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

    Boing, L.E.; Miller, R.L.

    1983-10-01

    This document presents, in summary form, generic conceptual information relevant to the decommissioning of a reference test reactor (RTR). All of the data presented were extracted from NUREG/CR-1756 and arranged in a form that will provide a basis for future comparison studies for the Evaluation of Nuclear Facility Decommissioning Projects (ENFDP) program. During the data extraction process no attempt was made to challenge any of the assumptions used in the original studies nor was any attempt made to update assumed methods or processes to state-of-the-art decommissioning techniques. In a few instances obvious errors were corrected after consultation with the studymore » author.« less

  1. The use of process mapping in healthcare quality improvement projects.

    PubMed

    Antonacci, Grazia; Reed, Julie E; Lennox, Laura; Barlow, James

    2018-05-01

    Introduction Process mapping provides insight into systems and processes in which improvement interventions are introduced and is seen as useful in healthcare quality improvement projects. There is little empirical evidence on the use of process mapping in healthcare practice. This study advances understanding of the benefits and success factors of process mapping within quality improvement projects. Methods Eight quality improvement projects were purposively selected from different healthcare settings within the UK's National Health Service. Data were gathered from multiple data-sources, including interviews exploring participants' experience of using process mapping in their projects and perceptions of benefits and challenges related to its use. These were analysed using inductive analysis. Results Eight key benefits related to process mapping use were reported by participants (gathering a shared understanding of the reality; identifying improvement opportunities; engaging stakeholders in the project; defining project's objectives; monitoring project progress; learning; increased empathy; simplicity of the method) and five factors related to successful process mapping exercises (simple and appropriate visual representation, information gathered from multiple stakeholders, facilitator's experience and soft skills, basic training, iterative use of process mapping throughout the project). Conclusions Findings highlight benefits and versatility of process mapping and provide practical suggestions to improve its use in practice.

  2. 75 FR 877 - Cancellation of the South Valley Facilities Expansion Project-Clark County, NV

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-06

    ... DEPARTMENT OF INTERIOR Bureau of Reclamation Cancellation of the South Valley Facilities Expansion Project-- Clark County, NV AGENCY: Bureau of Reclamation, Interior. ACTION: Cancellation of Notice of Intent to prepare the Environmental Impact Statement. SUMMARY: The Bureau of Reclamation, together with...

  3. The PixFEL project: Progress towards a fine pitch X-ray imaging camera for next generation FEL facilities

    NASA Astrophysics Data System (ADS)

    Rizzo, G.; Batignani, G.; Benkechkache, M. A.; Bettarini, S.; Casarosa, G.; Comotti, D.; Dalla Betta, G.-F.; Fabris, L.; Forti, F.; Grassi, M.; Lodola, L.; Malcovati, P.; Manghisoni, M.; Mendicino, R.; Morsani, F.; Paladino, A.; Pancheri, L.; Paoloni, E.; Ratti, L.; Re, V.; Traversi, G.; Vacchi, C.; Verzellesi, G.; Xu, H.

    2016-07-01

    The INFN PixFEL project is developing the fundamental building blocks for a large area X-ray imaging camera to be deployed at next generation free electron laser (FEL) facilities with unprecedented intensity. Improvement in performance beyond the state of art in imaging instrumentation will be explored adopting advanced technologies like active edge sensors, a 65 nm node CMOS process and vertical integration. These are the key ingredients of the PixFEL project to realize a seamless large area focal plane instrument composed by a matrix of multilayer four-side buttable tiles. In order to minimize the dead area and reduce ambiguities in image reconstruction, a fine pitch active edge thick sensor is being optimized to cope with very high intensity photon flux, up to 104 photons per pixel, in the range from 1 to 10 keV. A low noise analog front-end channel with this wide dynamic range and a novel dynamic compression feature, together with a low power 10 bit analog to digital conversion up to 5 MHz, has been realized in a 110 μm pitch with a 65 nm CMOS process. Vertical interconnection of two CMOS tiers will be also explored in the future to build a four-side buttable readout chip with high density memories. In the long run the objective of the PixFEL project is to build a flexible X-ray imaging camera for operation both in burst mode, like at the European X-FEL, or in continuous mode with the high frame rates anticipated for future FEL facilities.

  4. The safety improvement of Romanian radioactive waste facilities as an example for human and environmental protection

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

    Barariu, Gheorghe

    2013-07-01

    According to IAEA classification, Romania with two nuclear research centres, with 2 Nuclear Power Units in operation at Cernavoda Town and with 2 new Units envisaged to be in operation soon, can be considered as a country with an average nuclear activity. In Romania there was an extensive interest in management of radioactive wastes generated by the use of nuclear technology in industry and research. Using the most advanced technologies in the mentioned time periods, Romania successfully accomplished to solve all management issues related to radioactive wastes being addressed all safety concerns. Every step of nuclear activity development was accompaniedmore » by the suitable waste management facilities. So that, in order to improve the existing treatment and disposal capacities for institutional waste, the existing Radioactive Waste Treatment Facility (STDR) and the National Repository Radioactive Wastes (DNDR) at Baita, Bihor, will be improved to actual requirements on the occasion of VVR-S Research Reactor decommissioning. This activity is in development into the frame of a National funded project related to disposal galleries filling improvement and repository closure for DNDR Baita, Bihor. All improvements will be approved by Environmental Protection Authority and Regulatory Body, being a guaranty of human and environmental protection. Also, in accordance with national specific and international policies and taking into account decommissioning activities related to the present operating NPPs, all necessary measures were considered in order to avoid unnecessary generation of radioactive wastes, to minimize, as much as possible, waste production and accumulation and the necessity to develop optimum solutions for a new repository with the assurance of improved nuclear safety. (authors)« less

  5. Management aspects of Gemini's base facility operations project

    NASA Astrophysics Data System (ADS)

    Arriagada, Gustavo; Nitta, Atsuko; Adamson, A. J.; Nunez, Arturo; Serio, Andrew; Cordova, Martin

    2016-08-01

    Gemini's Base Facilities Operations (BFO) Project provided the capabilities to perform routine nighttime operations without anyone on the summit. The expected benefits were to achieve money savings and to become an enabler of the future development of remote operations. The project was executed using a tailored version of Prince2 project management methodology. It was schedule driven and managing it demanded flexibility and creativity to produce what was needed, taking into consideration all the constraints present at the time: Time available to implement BFO at Gemini North (GN), two years. The project had to be done in a matrix resources environment. There were only three resources assigned exclusively to BFO. The implementation of new capabilities had to be done without disrupting operations. And we needed to succeed, introducing the new operational model that implied Telescope and instrumentation Operators (Science Operations Specialists - SOS) relying on technology to assess summit conditions. To meet schedule we created a large number of concurrent smaller projects called Work Packages (WP). To be reassured that we would successfully implement BFO, we initially spent a good portion of time and effort, collecting and learning about user's needs. This was done through close interaction with SOSs, Observers, Engineers and Technicians. Once we had a clear understanding of the requirements, we took the approach of implementing the "bare minimum" necessary technology that would meet them and that would be maintainable in the long term. Another key element was the introduction of the "gradual descent" concept. In this, we increasingly provided tools to the SOSs and Observers to prevent them from going outside the control room during nighttime operations, giving them the opportunity of familiarizing themselves with the new tools over a time span of several months. Also, by using these tools at an early stage, Engineers and Technicians had more time for debugging

  6. Distributed Wind Competitiveness Improvement Project

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

    2016-05-01

    The Competitiveness Improvement Project (CIP) is a periodic solicitation through the U.S. Department of Energy and its National Renewable Energy Laboratory. Manufacturers of small and medium wind turbines are awarded cost-shared grants via a competitive process to optimize their designs, develop advanced manufacturing processes, and perform turbine testing. The goals of the CIP are to make wind energy cost competitive with other distributed generation technology and increase the number of wind turbine designs certified to national testing standards. This fact sheet describes the CIP and funding awarded as part of the project.

  7. A portfolio evaluation framework for air transportation improvement projects

    NASA Astrophysics Data System (ADS)

    Baik, Hyeoncheol

    This thesis explores the application of portfolio theory to the Air Transportation System (ATS) improvement. The ATS relies on complexly related resources and different stakeholder groups. Moreover, demand for air travel is significantly increasing relative to capacity of air transportation. In this environment, improving the ATS is challenging. Many projects, which are defined as technologies or initiatives, for improvement have been proposed and some have been demonstrated in practice. However, there is no clear understanding of how well these projects work in different conditions nor of how they interact with each other or with existing systems. These limitations make it difficult to develop good project combinations, or portfolios that maximize improvement. To help address this gap, a framework for identifying good portfolios is proposed. The framework can be applied to individual projects or portfolios of projects. Projects or portfolios are evaluated using four different groups of factors (effectiveness, time-to-implement, scope of applicability, and stakeholder impacts). Portfolios are also evaluated in terms of interaction-determining factors (prerequisites, co-requisites, limiting factors, and amplifying factors) because, while a given project might work well in isolation, interdependencies between projects or with existing systems could result in lower overall performance in combination. Ways to communicate a portfolio to decision makers are also introduced. The framework is unique because (1) it allows using a variety of available data, and (2) it covers diverse benefit metrics. For demonstrating the framework, an application to ground delay management projects serves as a case study. The portfolio evaluation approach introduced in this thesis can aid decision makers and researchers at universities and aviation agencies such as Federal Aviation Administration (FAA), National Aeronautics and Space Administration (NASA), and Department of Defense (DoD), in

  8. Recent National Transonic Facility Test Process Improvements (Invited)

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

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

  9. Recent National Transonic Facility Test Process Improvements (Invited)

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

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

  10. Improving animal research facility operations through the application of lean principles.

    PubMed

    Khan, Nabeel; Umrysh, Brian M

    2008-06-01

    Animal research is a vital component of US research and well-functioning animal research facilities are critical both to the research itself and to the housing and feeding of the animals. The Office of Animal Care (OAC) at Seattle Children's Hospital Research Institute realized it had to improve the efficiency and safety of its animal research facility (ARF) to prepare for expansion and to advance the Institute's mission. The main areas for improvement concerned excessive turnaround time to process animal housing and feeding equipment; the movement and flow of equipment and inventory; and personnel safety. To address these problems, management held two process improvement workshops to educate employees about lean principles. In this article we discuss the application of these principles and corresponding methods to advance Children's Research Institute's mission of preventing, treating, and eliminating childhood diseases.

  11. Recommendations to Improve Space Projection Models and University Space Usage

    ERIC Educational Resources Information Center

    Stigall, Sam W.

    2007-01-01

    In today"s economy, public university administrators need to reflect on current practices for reporting and projecting space requirements to government entities as the cost of constructing new facilities or renovating space rises while income from legislative appropriations diminishes. As stewards of public buildings and funds, institutions…

  12. Developing Renewable Energy Projects Larger Than 10 MWs at Federal Facilities

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

    None

    2013-03-01

    To accomplish Federal goals for renewable energy, sustainability, and energy security, large-scale renewable energy projects must be developed and constructed on Federal sites at a significant scale with significant private investment. For the purposes of this Guide, large-scale Federal renewable energy projects are defined as renewable energy facilities larger than 10 megawatts (MW) that are sited on Federal property and lands and typically financed and owned by third parties.1 The U.S. Department of Energy’s Federal Energy Management Program (FEMP) helps Federal agencies meet these goals and assists agency personnel navigate the complexities of developing such projects and attract the necessarymore » private capital to complete them. This Guide is intended to provide a general resource that will begin to develop the Federal employee’s awareness and understanding of the project developer’s operating environment and the private sector’s awareness and understanding of the Federal environment. Because the vast majority of the investment that is required to meet the goals for large-scale renewable energy projects will come from the private sector, this Guide has been organized to match Federal processes with typical phases of commercial project development. FEMP collaborated with the National Renewable Energy Laboratory (NREL) and professional project developers on this Guide to ensure that Federal projects have key elements recognizable to private sector developers and investors. The main purpose of this Guide is to provide a project development framework to allow the Federal Government, private developers, and investors to work in a coordinated fashion on large-scale renewable energy projects. The framework includes key elements that describe a successful, financially attractive large-scale renewable energy project. This framework begins the translation between the Federal and private sector operating environments. When viewing the overall« less

  13. Water quality facility investigation report : final summary of project and evaluation of monitoring plan implementation.

    DOT National Transportation Integrated Search

    2005-07-05

    The Oregon Department of Transportation (ODOT) has installed several stormwater : treatment facilities throughout the State to improve the quality of runoff discharged from : highways. These facilities include a variety of both above ground and below...

  14. Energy efficiency in California laboratory-type facilities

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

    Mills, E.; Bell, G.; Sartor, D.

    The central aim of this project is to provide knowledge and tools for increasing the energy efficiency and performance of new and existing laboratory-type facilities in California. We approach the task along three avenues: (1) identification of current energy use and savings potential, (2) development of a {ital Design guide for energy- Efficient Research Laboratories}, and (3) development of a research agenda for focused technology development and improving out understanding of the market. Laboratory-type facilities use a considerable amount of energy resources. They are also important to the local and state economy, and energy costs are a factor in themore » overall competitiveness of industries utilizing laboratory-type facilities. Although the potential for energy savings is considerable, improving energy efficiency in laboratory-type facilities is no easy task, and there are many formidable barriers to improving energy efficiency in these specialized facilities. Insufficient motivation for individual stake holders to invest in improving energy efficiency using existing technologies as well as conducting related R&D is indicative of the ``public goods`` nature of the opportunity to achieve energy savings in this sector. Due to demanding environmental control requirements and specialized processes, laboratory-type facilities epitomize the important intersection between energy demands in the buildings sector and the industrial sector. Moreover, given the high importance and value of the activities conducted in laboratory-type facilities, they represent one of the most powerful contexts in which energy efficiency improvements stand to yield abundant non-energy benefits if properly applied.« less

  15. Approaching the Practice Quality Improvement Project in Interventional Radiology.

    PubMed

    Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

    2015-12-01

    An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Life-Cycle Assessments of Selected NASA Ground-Based Test Facilities

    NASA Technical Reports Server (NTRS)

    Sydnor, George Honeycutt

    2012-01-01

    In the past two years, two separate facility-specific life cycle assessments (LCAs) have been performed as summer student projects. The first project focused on 13 facilities managed by NASA s Aeronautics Test Program (ATP), an organization responsible for large, high-energy ground test facilities that accomplish the nation s most advanced aerospace research. A facility inventory was created for each facility, and the operational-phase carbon footprint and environmental impact were calculated. The largest impacts stemmed from electricity and natural gas used directly at the facility and to generate support processes such as compressed air and steam. However, in specialized facilities that use unique inputs like R-134a, R-14, jet fuels, or nitrogen gas, these sometimes had a considerable effect on the facility s overall environmental impact. The second LCA project was conducted on the NASA Ames Arc Jet Complex and also involved creating a facility inventory and calculating the carbon footprint and environmental impact. In addition, operational alternatives were analyzed for their effectiveness at reducing impact. Overall, the Arc Jet Complex impact is dominated by the natural-gas fired boiler producing steam on-site, but alternatives were provided that could reduce the impact of the boiler operation, some of which are already being implemented. The data and results provided by these LCA projects are beneficial to both the individual facilities and NASA as a whole; the results have already been used in a proposal to reduce carbon footprint at Ames Research Center. To help future life cycle projects, several lessons learned have been recommended as simple and effective infrastructure improvements to NASA, including better utility metering and data recording and standardization of modeling choices and methods. These studies also increased sensitivity to and appreciation for quantifying the impact of NASA s activities.

  17. 78 FR 73144 - Acceleration of Broadband Deployment by Improving Wireless Facilities Siting Policies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-05

    ..., ground-based enclosures, battery back-up power systems, grounding equipment, power transfer switch, and... No. 11-59; FCC 13-122] Acceleration of Broadband Deployment by Improving Wireless Facilities Siting... of new wireless facilities and on rules to implement statutory provisions governing State and local...

  18. Improvements and Performance of the Fermilab Solenoid Test Facility

    DOE PAGES

    Orris, Darryl; Arnold, Don; Brandt, Jeffrey; ...

    2017-06-01

    Here, the Solenoid Test Facility at Fermilab was built using a large vacuum vessel for testing of conduction-cooled superconducting solenoid magnets, and was first used to determine the performance of the MICE Coupling Coil. The facility was modified recently to enable testing of solenoid magnets for the Mu2e experiment, which operate at much higher current than the Coupling Coil. One pair of low current conduction-cooled copper and NbTi leads was replaced with two pairs of 10 kA HTS leads cooled by heat exchange with liquid nitrogen and liquid helium. The new design, with additional control and monitoring capability, also providesmore » helium cooling of the superconducting magnet leads by conduction. A high current power supply with energy extraction was added, and several improvements to the quench protection and characterization system were made. Here we present details of these changes and report on performance results from a test of the Mu2e prototype Transport Solenoid (TS) module. Progress on additional improvements in preparation for production TS module testing will be presented.« less

  19. Improvements and Performance of the Fermilab Solenoid Test Facility

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

    Orris, Darryl; Arnold, Don; Brandt, Jeffrey

    Here, the Solenoid Test Facility at Fermilab was built using a large vacuum vessel for testing of conduction-cooled superconducting solenoid magnets, and was first used to determine the performance of the MICE Coupling Coil. The facility was modified recently to enable testing of solenoid magnets for the Mu2e experiment, which operate at much higher current than the Coupling Coil. One pair of low current conduction-cooled copper and NbTi leads was replaced with two pairs of 10 kA HTS leads cooled by heat exchange with liquid nitrogen and liquid helium. The new design, with additional control and monitoring capability, also providesmore » helium cooling of the superconducting magnet leads by conduction. A high current power supply with energy extraction was added, and several improvements to the quench protection and characterization system were made. Here we present details of these changes and report on performance results from a test of the Mu2e prototype Transport Solenoid (TS) module. Progress on additional improvements in preparation for production TS module testing will be presented.« less

  20. Improving compliance with diabetes clinical practice guidelines in military medical treatment facilities.

    PubMed

    McCraw, Wendy M; Kelley, Patricia Watts; Righero, Anna M; Latimer, Renee

    2010-01-01

    A multidisciplinary, multifaceted approach to disease management that incorporates the health system, the provider, and the patient is supported in the literature. There was a need to improve patient outcomes to meet or to exceed the Health Plan Employer Data and Information Set (HEDIS) benchmarks for the management of patients with diabetes. The purpose of this study was to implement a process improvement effort using practice guidelines on the basis of an evidence-based practice model for the management of type II diabetes mellitus at two primary care clinics at two military medical facilities in Hawaii. A retrospective review of charts, electronic records, and system data revealed that the clinics used as project sites were not compliant with established guidelines for diabetes management. After a literature review and an analysis of the current processes, a multidisciplinary care delivery model was developed and implemented to identify spheres of influence involving all members of the diabetes management team and the tasks that influenced patient outcomes. Improvements were seen for more than 6 months of initial practice change, including compliance with annual glycosylated hemoglobin (HbA1c), lipid, blood pressure, and foot checks. At Site 1, HEDIS measures increased for adequately controlled HbA1c and low-density lipoprotein (LDL) from 80% to 85% and from 49% to 58%, respectively. Site 2 showed an increase in adequate control of HbA1c from 77% to 79% at 6 months. After a steady increase in compliance, the percentage for adequately controlled LDL dropped to 56% at 9 months. At Site 1, HEDIS measures decreased slightly to 82% for HbA1c control and to 54% for LDL control at the 9-month mark. Inconsistent delivery of care and lack of staff and patient involvement influenced process outcomes. There were challenges with database accuracy, adequate staffing, computer software upgrades, and overseas site locations. Annual foot examinations showed the largest

  1. Manpower and project planning

    NASA Technical Reports Server (NTRS)

    Johnson, David W.

    1991-01-01

    The purpose was to study how manpower and projects are planned at the Facilities Engineering Division (FENGD) within the Systems Engineering and Operations Directorate of the LaRC and to make recommendations for improving the effectiveness and productivity ot the tools that are used. The existing manpower and project planning processes (including the management plan for the FENGD, existing manpower planning reports, project reporting to LaRC and NASA Headquarters, employee time reporting, financial reporting, and coordination/tracking reports for procurement) were discussed with several people, and project planning software was evaluated.

  2. Bioaerosol releases from compost facilities: Evaluating passive and active source terms at a green waste facility for improved risk assessments

    NASA Astrophysics Data System (ADS)

    Taha, M. P. M.; Drew, G. H.; Longhurst, P. J.; Smith, R.; Pollard, S. J. T.

    The passive and active release of bioaerosols during green waste composting, measured at source is reported for a commercial composting facility in South East (SE) England as part of a research programme focused on improving risk assessments at composting facilities. Aspergillus fumigatus and actinomycetes concentrations of 9.8-36.8×10 6 and 18.9-36.0×10 6 cfu m -3, respectively, measured during the active turning of green waste compost, were typically 3-log higher than previously reported concentrations from static compost windrows. Source depletion curves constructed for A. fumigatus during compost turning and modelled using SCREEN3 suggest that bioaerosol concentrations could reduce to background concentrations of 10 3 cfu m -3 within 100 m of this site. Authentic source term data produced from this study will help to refine the risk assessment methodologies that support improved permitting of compost facilities.

  3. Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.

    PubMed

    Furuno, Jon P; Comer, Angela C; Johnson, J Kristie; Rosenberg, Joseph H; Moore, Susan L; MacKenzie, Thomas D; Hall, Kendall K; Hirshon, Jon Mark

    2014-10-01

    Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown. To develop SNF-specific antibiograms and identify opportunities to improve antibiotic prescribing. Cross-sectional and pretest-posttest study among residents of 3 Maryland SNFs. Antibiograms were created using clinical culture data from a 6-month period in each SNF. We also used admission clinical culture data from the acute care facility primarily associated with each SNF for transferred residents. We manually collected all data from medical charts, and antibiograms were created using WHONET software. We then used a pretest-posttest study to evaluate the effectiveness of an antibiogram on changing antibiotic prescribing practices in a single SNF. Appropriate empirical antibiotic therapy was defined as an empirical antibiotic choice that sufficiently covered the infecting organism, considering antibiotic susceptibilities. We reviewed 839 patient charts from SNF and acute care facilities. During the initial assessment period, 85% of initial antibiotic use in the SNFs was empirical, and thus only 15% of initial antibiotics were based on culture results. Fluoroquinolones were the most frequently used empirical antibiotics, accounting for 54.5% of initial prescribing instances. Among patients with available culture data, only 35% of empirical antibiotic prescribing was determined to be appropriate. In the single SNF in which we evaluated antibiogram effectiveness, prevalence of appropriate antibiotic prescribing increased from 32% to 45% after antibiogram implementation; however, this was not statistically significant ([Formula: see text]). Implementation of antibiograms may be effective in improving empirical antibiotic prescribing in SNFs.

  4. The Great Plains Wind Power Test Facility

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

    Schroeder, John

    2014-01-30

    This multi-year, multi-faceted project was focused on the continued development of a nationally-recognized facility for the testing, characterization, and improvement of grid-connected wind turbines, integrated wind-water desalination systems, and related educational and outreach topics. The project involved numerous faculty and graduate students from various engineering departments, as well as others from the departments of Geosciences (in particular the Atmospheric Science Group) and Economics. It was organized through the National Wind Institute (NWI), which serves as an intellectual hub for interdisciplinary and transdisciplinary research, commercialization and education related to wind science, wind energy, wind engineering and wind hazard mitigation at Texasmore » Tech University (TTU). Largely executed by an academic based team, the project resulted in approximately 38 peer-reviewed publications, 99 conference presentations, the development/expansion of several experimental facilities, and two provisional patents.« less

  5. Quality Improvement in Skilled Nursing Facilities for Residents With Alzheimer's Disease.

    PubMed

    Farlow, Martin R; Borson, Soo; Connor, Stephen R; Grossberg, George T; Mittelman, Mary S

    2016-03-01

    This report describes a quality improvement continuing medical education activity designed to enhance the recognition and treatment of residents with Alzheimer's disease (AD) or other dementias in skilled-nursing facilities (SNFs). Charts were compared in 6 areas prior to and following (stages A and C) a live, faculty-led workshop (stage B). Four SNFs completed stages A (n = 67 residents) and B, and 3 SNFs completed stage C (n = 52 residents). All charts came from residents with AD or a diagnosis of dementia or dementia-like symptoms. The SNFs had >95% baseline performance in both the frequency of cognitive assessments and documented medication reviews. The percentage of residents who received a quality-of-life assessment and those who had a mental health care plan in place represent areas for improvement. As part of this activity, a toolkit was developed to help guide facilities and clinicians in instituting care improvements for residents with AD/dementia. © The Author(s) 2015.

  6. Realizing Improvement through Team Empowerment (RITE): A Team-based, Project-based Multidisciplinary Improvement Program.

    PubMed

    Larson, David B; Mickelsen, L Jake; Garcia, Kandice

    2016-01-01

    Performance improvement in a complex health care environment depends on the cooperation of diverse individuals and groups, allocation of time and resources, and use of effective improvement methods. To address this challenge, we developed an 18-week multidisciplinary training program that would also provide a vehicle for effecting needed improvements, by using a team- and project-based model. The program began in the radiology department and subsequently expanded to include projects from throughout the medical center. Participants were taught a specific method for team-based problem solving, which included (a) articulating the problem, (b) observing the process, (c) analyzing possible causes of problems, (d) identifying key drivers, (e) testing and refining interventions, and (f) providing for sustainment of results. Progress was formally reviewed on a weekly basis. A total of 14 teams consisting of 78 participants completed the course in two cohorts; one project was discontinued. All completed projects resulted in at least modest improvement. Mean skill scores increased from 2.5/6 to 4.5/6 (P < .01), and the mean satisfaction score was 4.7/5. Identified keys to success include (a) engagement of frontline staff, (b) teams given authority to make process changes, (c) capable improvement coaches, (d) a physician-director with improvement expertise and organizational authority, (e) capable administrative direction, (f) supportive organizational leaders, (g) weekly progress reviews, (h) timely educational material, (i) structured problem-solving methods, and ( j ) multiple projects working simultaneously. The purpose of this article is to review the program, including the methods and results, and discuss perceived keys to program success. © RSNA, 2016.

  7. A quality improvement project to improve admission temperatures in very low birth weight infants.

    PubMed

    Lee, H C; Ho, Q T; Rhine, W D

    2008-11-01

    To review the results of a quality improvement (QI) project to improve admission temperatures of very low birth weight inborn infants. The neonatal intensive care unit at Lucile Packard Children's Hospital underwent a QI project to address hypothermic preterm newborns by staff education and implementing processes such as polyethylene wraps and chemical warming mattresses. We performed retrospective chart review of all inborn infants with birth weight <1500 g during the 18 months prior to (n=134) and 15 months after (n=170) the implementation period. Temperatures were compared between periods. Multivariable logistic regression was used to account for potential confounding variables. We compared mortality rates and grade 3 or 4 intraventricular hemorrhage rates between periods. The mean temperature rose from 35.4 to 36.2 degrees C (P<0.0001) after the QI project. The improvement was consistent and persisted over a 15-month period. After risk adjustment, the strongest predictor of hypothermia was being born in the period before implementation of the QI project (odds ratio 8.12, 95% confidence interval 4.63, 14.22). Although cesarean delivery was a strong risk factor for hypothermia prior to the project, it was no longer significant after the project. There was no significant difference in death or intraventricular hemorrhage detected between periods. There was a significant improvement in admission temperatures after a QI project, which persisted beyond the initial implementation period. Although there was no difference in mortality or intraventricular hemorrhage rates, we did not have sufficient power to detect small differences in these outcomes.

  8. How to conduct a clinical audit and quality improvement project.

    PubMed

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

    2017-07-01

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

  9. Metrology for decommissioning nuclear facilities: Partial outcomes of joint research project within the European Metrology Research Program.

    PubMed

    Suran, Jiri; Kovar, Petr; Smoldasova, Jana; Solc, Jaroslav; Van Ammel, Raf; Garcia Miranda, Maria; Russell, Ben; Arnold, Dirk; Zapata-García, Daniel; Boden, Sven; Rogiers, Bart; Sand, Johan; Peräjärvi, Kari; Holm, Philip; Hay, Bruno; Failleau, Guillaume; Plumeri, Stephane; Laurent Beck, Yves; Grisa, Tomas

    2018-04-01

    Decommissioning of nuclear facilities incurs high costs regarding the accurate characterisation and correct disposal of the decommissioned materials. Therefore, there is a need for the implementation of new and traceable measurement technologies to select the appropriate release or disposal route of radioactive wastes. This paper addresses some of the innovative outcomes of the project "Metrology for Decommissioning Nuclear Facilities" related to mapping of contamination inside nuclear facilities, waste clearance measurement, Raman distributed temperature sensing for long term repository integrity monitoring and validation of radiochemical procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Improving critical care discharge summaries: a collaborative quality improvement project using PDSA

    PubMed Central

    Goulding, Lucy; Parke, Hannah; Maharaj, Ritesh; Loveridge, Robert; McLoone, Anne; Hadfield, Sophie; Helme, Eloise; Hopkins, Philip; Sandall, Jane

    2015-01-01

    Around 110,000 people spend time in critical care units in England and Wales each year. The transition of care from the intensive care unit to the general ward exposes patients to potential harms from changes in healthcare providers and environment. Nurses working on general wards report anxiety and uncertainty when receiving patients from critical care. An innovative form of enhanced capability critical care outreach called ‘iMobile’ is being provided at King's College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries. A collaborative evidence-based quality improvement project was therefore undertaken by the iMobile team at KCH in conjunction with researchers from King's Improvement Science (KIS). Plan, Do, Study, Act (PDSA) methodology was used. Three PDSA cycles were undertaken. Methods adopted comprised: a scoping literature review to identify relevant guidelines and research evidence to inform all aspects of the quality improvement project; a process mapping exercise; informal focus groups / interviews with staff; patient story-telling work with people who had experienced critical care and subsequent discharge to a general ward; and regular audits of the quality of both medical and nursing critical care discharge summaries. The following behaviour change interventions were adopted, taking into account evidence of effectiveness from published systematic reviews and considering the local context: regular audit and feedback of the quality of discharge summaries, feedback of patient experience, and championing and education delivered by local opinion leaders. The audit results were mixed across the trajectory of the project, demonstrating the difficulty of sustaining positive change. This was particularly important as critical care bed occupancy and through-put fluctuates which then impacts on work

  11. Informational open houses for the Caldecott Improvement Project.

    DOT National Transportation Integrated Search

    2005-06-01

    The Caldecott Improvement Project proposes to alleviate traffic congestion along State : Route 24 by adding a fourth bore to the Caldecott Tunnels. Environmental studies are : being conducted to identify long-term, permanent impacts of the project as...

  12. 32 CFR 644.486 - Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or similar contracts. 644.486 Section 644.486 National... Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or similar...

  13. EERC pilot-scale CFBC evaluation facility Project CFB test results

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

    Mann, M.D.; Hajicek, D.R.; Henderson, A.K.

    Project CFB was initiated at the University of North Dakota Energy and Environmental Research Center (EERC) in May 1988. Specific goals of the project were to (1) construct a circulating fluidized-bed combustor (CFBC) facility representative of the major boiler vendors' designs with the capability of producing scalable data, (2) develop a database for use in making future evaluations of CFBC technology, and (3) provide a facility for evaluating fuels, free of vendor bias for use in the - energy industry. Five coals were test-burned in the 1-MWth unit: North Dakota and Asian lignites, a Wyoming subbituminous, and Colorado and Pennsylvaniamore » bituminous coats. A total of 54 steady-state test periods were conducted, with the key test parameters being the average combustor temperature, excess air, superficial gas velocity, calcium-to-sulfur molar ratio, and the primary air-to-secondary air split. The capture for a coal fired in a CFBC is primarily dependent upon the total alkali-to-sulfur ratio. The required alkali-to ratio for 90% sulfur retention ranged from 1.4 to 4.9, depending upon coal type. While an alkali-to-ratio of 4.9 was required to meet 90% sulfur retention for the Salt Creek coal versus 1.4 for the Asian lignite, the total amount of sorbent addition required is much less for the Salt Creek coal, 4.2 pound sorbent per million Btu coal input, versus 62 pound/million Btu for the Asian lignite. The bituminous coals tested show optimal capture at combustor temperatures of approximately 1550[degree]F, with low-rank coals having optimal sulfur capture approximately 100[degree]F lower.« less

  14. Improving Culture, One Quality Improvement Project at a Time.

    PubMed

    Vander Schaaf, Emily B; Cornett, Amanda C; Randolph, Greg D

    A culture of quality improvement (QI) values collaboration, transparency, and staff empowerment. Organizations exhibiting a culture of QI are more likely to engage in QI. We examined whether local health departments' (LHDs') participation in a longitudinal, experiential QI training program changes QI culture. Prior to and following participation in a QI training program, all employees of participating LHDs were asked to complete an 8-item survey assessing components of QI culture on a 5-point scale. From 2010 to 2015, multidisciplinary teams from North Carolina LHDs participated in sequential cohorts of a 6-month QI training program, during which the teams completed a QI project. We dichotomized culture survey responses, with 4 or 5 being "Supportive." We compared adjusted proportions, using linear regression, clustering at LHD, and controlling for cohort. Data from 42 LHDs were included. At baseline, 7.8% responded that their LHD had a supportive culture for all 8 components, compared with 12% at follow-up (P < .001), adjusted for cohort and clustering by LHD. At follow-up, the percentage of employees responding that their LHDs had supportive cultures increased for all components of culture including communication by 4.1% (95% CI: 2.0%-6.2%), problem solving by 2.9% (95% CI: 1.6%-5.5%), team work by 5.2% (95% CI: 2.5%-7.8%), vision by 4.3% (95% CI: 1.1%-7.5%), performance measures by 5.6% (95% CI: 1.6%-9.6%), recognition by 4.7% (95% CI: 1.4%-8.0%), for conflict by 5.5% (95% CI: 1.7%-9.4%), and alignment by 5.8% (95% CI: 2.3%-9.2%). Engagement with structured QI training programs-and perhaps simply completing QI projects-can cause small, but important changes in organizations' cultures, thus increasing engagement in future QI and improving overall care and services. The article demonstrates that when LHDs participate in a longitudinal, experiential QI training program, their cultures of QI improve. Local health departments participating in similar training

  15. Improving Services to Deaf-Blind/Multihandicapped Individuals in Residential Facilities.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    The 35 articles represent presentations made during a conference on improving services to deaf-blind/multihandicapped individuals in residential facilities. Among entries are the following titles and authors: "Federal Thrust of Deaf-Blind Multihandicapped Funding" (J. Franklin); "Prevocational Training for Deaf-Blind (A Research Endeavor)" (J.…

  16. Payback as an investment criterion for sawmill improvement projects

    Treesearch

    G. B. Harpole

    1983-01-01

    Methods other than presented here should be used to assess projects for likely return on investment; but, payback is simple to calculate and can be used for calculations that will indicate the relative attractiveness of alternative improvement projects. This paper illustrates how payback ratios are calculated, how they can be used to rank alternative improvement...

  17. Recent Improvements in Semi-Span Testing at the National Transonic Facility (Invited)

    NASA Technical Reports Server (NTRS)

    Gatlin, G. M.; Tomek, W. G.; Payne, F. M.; Griffiths, R. C.

    2006-01-01

    Three wind tunnel investigations of a commercial transport, high-lift, semi-span configuration have recently been conducted in the National Transonic Facility at the NASA Langley Research Center. Throughout the course of these investigations multiple improvements have been developed in the facility semi-span test capability. The primary purpose of the investigations was to assess Reynolds number scale effects on a modern commercial transport configuration up to full-scale flight test conditions (Reynolds numbers on the order of 27 million). The tests included longitudinal aerodynamic studies at subsonic takeoff and landing conditions across a range of Reynolds numbers from that available in conventional wind tunnels up to flight conditions. The purpose of this paper is to discuss lessons learned and improvements incorporated into the semi-span testing process. Topics addressed include enhanced thermal stabilization and moisture reduction procedures, assessments and improvements in model sealing techniques, compensation of model reference dimensions due to test temperature, significantly improved semi-span model access capability, and assessments of data repeatability.

  18. Evaluating Fidelity to a Modified NIATx Process Improvement Strategy for Improving HIV Services in Correctional Facilities.

    PubMed

    Pankow, Jennifer; Willett, Jennifer; Yang, Yang; Swan, Holly; Dembo, Richard; Burdon, William M; Patterson, Yvonne; Pearson, Frank S; Belenko, Steven; Frisman, Linda K

    2018-04-01

    In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.

  19. Evaluation of a quality improvement intervention for obstetric and neonatal care in selected public health facilities across six states of India.

    PubMed

    Sarin, Enisha; Kole, Subir K; Patel, Rachana; Sooden, Ankur; Kharwal, Sanchit; Singh, Rashmi; Rahimzai, Mirwais; Livesley, Nigel

    2017-05-02

    While increase in the number of women delivering in health facilities has been rapid, the quality of obstetric and neonatal care continues to be poor in India, contributing to high maternal and neonatal mortality. The USAID ASSIST Project supported health workers in 125 public health facilities (delivering approximately 180,000 babies per year) across six states to use quality improvement (QI) approaches to provide better care to women and babies before, during and immediately after delivery. As part of this intervention, each month, health workers recorded data related to nine elements of routine care alongside data on perinatal mortality. We aggregated facility level data and conducted segmented regression to analyse the effect of the intervention over time. Care improved to 90-99% significantly (p < 0.001) for eight of the nine process elements. A significant (p < 0.001) positive change of 30-70% points was observed during post intervention for all the indicators and 3-17% points month-to-month progress shown from the segmented results. Perinatal mortality declined from 26.7 to 22.9 deaths/1000 live births (p < 0.01) over time, however, it is not clear that the intervention had any significant effect on it. These results demonstrate the effectiveness of QI approaches in improving provision of routine care, yet these approaches are underused in the Indian health system. We discuss the implications of this for policy makers.

  20. Strategic facility planning improves capital decision making.

    PubMed

    Reeve, J R

    2001-03-01

    A large, Midwestern IDS undertook a strategic facility-planning process to evaluate its facility portfolio and determine how best to allocate future investments in facility development. The IDS assembled a facility-planning team, which initiated the planning process with a market analysis to determine future market demands and identify service areas that warranted facility expansion. The team then analyzed each of the IDS's facilities from the perspective of uniform capacity measurements, highest and best use compared with needs, building condition and investment-worthiness, and facility growth and site development opportunities. Based on results of the analysis, the strategy adopted entailed, in part, shifting some space from inpatient care to ambulatory care services and demolishing and replacing the 11 percent of facilities deemed to be in the worst condition.

  1. FY 2011 Educational Facilities Master Plan & the FY 2011-2016 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2010

    2010-01-01

    The FY 2011 Educational Facilities Master Plan (Master Plan) and FY 2011-2016 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the Board of Education…

  2. Lessons Learned from the 200 West Pump and Treatment Facility Construction Project at the US DOE Hanford Site - A Leadership for Energy and Environmental Design (LEED) Gold-Certified Facility - 13113

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

    Dorr, Kent A.; Freeman-Pollard, Jhivaun R.; Ostrom, Michael J.

    CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy's (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built to an accelerated schedule with American Recovery and Reinvestment Act (ARRA) funds. There were many contractual, technical, configuration management, quality, safety, and Leadership in Energy and Environmental Design (LEED) challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility tomore » meet DOE's mission objective of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012. The project team's successful integration of the project's core values and green energy technology throughout design, procurement, construction, and start-up of this complex, first-of-its-kind Bio Process facility resulted in successful achievement of DOE's mission objective, as well as attainment of LEED GOLD certification (Figure 1), which makes this Bio Process facility the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award. (authors)« less

  3. Quality improvement in neonatal care - a new paradigm for developing countries.

    PubMed

    Chawla, Deepak; Suresh, Gautham K

    2014-12-01

    Infrastructure for facility-based neonatal care has rapidly grown in India over last few years. Experience from developed countries indicates that different health facilities have varying clinical outcomes despite accounting for differences in illness severity of admitted neonates and random variation. Variation in quality of care provided at different neonatal units may account for variable clinical outcomes. Monitoring quality of care, comparing outcomes across different centers and conducting collaborative quality improvement projects can improve outcome of neonates in health facilities. Top priority should be given to establishing quality monitoring and improvement procedures at special care neonatal units and neonatal intensive care units of the country. This article presents an overview of methods of quality improvement. Literature reports of successful collaborative quality improvement projects in neonatal health are also reviewed.

  4. Installation of a Low Flow Unit at the Abiquiu Hydroelectric Facility

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

    Jack Q. Richardson

    2012-06-28

    Final Technical Report for the Recovery Act Project for the Installation of a Low Flow Unit at the Abiquiu Hydroelectric Facility. The Abiquiu hydroelectric facility existed with two each 6.9 MW vertical flow Francis turbine-generators. This project installed a new 3.1 MW horizontal flow low flow turbine-generator. The total plant flow range to capture energy and generate power increased from between 250 and 1,300 cfs to between 75 and 1,550 cfs. Fifty full time equivalent (FTE) construction jobs were created for this project - 50% (or 25 FTE) were credited to ARRA funding due to the ARRA 50% project costmore » match. The Abiquiu facility has increased capacity, increased efficiency and provides for an improved aquatic environment owing to installed dissolved oxygen capabilities during traditional low flow periods in the Rio Chama. A new powerhouse addition was constructed to house the new turbine-generator equipment.« less

  5. Using a contingent valuation approach for improved solid waste management facility: Evidence from Kuala Lumpur, Malaysia

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

    Afroz, Rafia, E-mail: rafia_afroz@yahoo.com; Masud, Muhammad Mehedi

    2011-04-15

    This study employed contingent valuation method to estimate the willingness to pay (WTP) of the households to improve the waste collection system in Kuala Lumpur, Malaysia. The objective of this study is to evaluate how household WTP changes when recycling and waste separation at source is made mandatory. The methodology consisted of asking people directly about their WTP for an additional waste collection service charge to cover the costs of a new waste management project. The new waste management project consisted of two versions: version A (recycling and waste separation is mandatory) and version B (recycling and waste separation ismore » not mandatory). The households declined their WTP for version A when they were asked to separate the waste at source although all the facilities would be given to them for waste separation. The result of this study indicates that the households were not conscious about the benefits of recycling and waste separation. Concerted efforts should be taken to raise environmental consciousness of the households through education and more publicity regarding waste separation, reducing and recycling.« less

  6. Improving the completion of Quality Improvement projects amongst psychiatry core trainees.

    PubMed

    Ewins, Liz

    2015-01-01

    Quality Improvement (QI) projects are seen increasingly as more valuable and effective in developing services than traditional audit. However, the development of this methodology has been slower in the mental health field and QI projects are new to most psychiatrists. This project describes a way of engaging trainees across Avon and Wiltshire Mental Health Partnership (AWP) Trust and the Severn School of Psychiatry in QI projects, using QI methodology itself. Through the implementation and development of training sessions and simple, low cost and sustainable interventions over a 10 month period, two thirds of core trainees and over a half of the advanced psychiatry trainees in the School are now participating in 28 individual QI projects and QI project methodology is to become embedded in the core psychiatry training course. As an additional positive outcome, specialty doctors, consultants, foundation doctors, GP trainees, medical students, as well as the wider multidisciplinary team, have all become engaged in QI projects alongside trainees, working with service users and their families to identify problems to tackle and ideas to test.

  7. A case study of collaborative facilities use in engineering design

    NASA Astrophysics Data System (ADS)

    Monroe, Laura; Pugmire, David

    2010-01-01

    In this paper we describe the use of visualization tools and facilities in the collaborative design of a replacement weapons system, the Reliable Replacement Warhead (RRW). We used not only standard collaboration methods but also a range of visualization software and facilities to bring together domain specialists from laboratories across the country to collaborate on the design and integrate this disparate input early in the design. This was the first time in U.S. weapons history that a weapon had been designed in this collaborative manner. Benefits included projected cost savings, design improvements and increased understanding across the project.

  8. Improvement of the cost-benefit analysis algorithm for high-rise construction projects

    NASA Astrophysics Data System (ADS)

    Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

    2018-03-01

    The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

  9. Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

    PubMed

    Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

  10. Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

    PubMed Central

    Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

  11. Improving Project Management Using Formal Models and Architectures

    NASA Technical Reports Server (NTRS)

    Kahn, Theodore; Sturken, Ian

    2011-01-01

    This talk discusses the advantages formal modeling and architecture brings to project management. These emerging technologies have both great potential and challenges for improving information available for decision-making. The presentation covers standards, tools and cultural issues needing consideration, and includes lessons learned from projects the presenters have worked on.

  12. Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement.

    PubMed

    Ovretveit, John; Mittman, Brian; Rubenstein, Lisa; Ganz, David A

    2017-10-09

    Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.

  13. Improving children's nutrition environments: A survey of adoption and implementation of nutrition guidelines in recreational facilities

    PubMed Central

    2011-01-01

    Background Although the mandate of recreational facilities is to enhance well-being, many offer foods inconsistent with recommendations for healthy eating. Little is known regarding recreational facility food environments and how they might be improved, as few studies exist. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are intended to ensure access to healthy food choices in schools, childcare and recreational facilities. This study investigated awareness, adoption and implementation of the ANGCY among recreational facilities in Alberta, Canada, one year following their release. Methods A cross-sectional telephone survey was conducted from June - December, 2009 (n = 151) with managers of publicly funded recreational facilities that served food. The questionnaire included 10 closed and 7 open ended questions to assess the organizational priority for healthy eating, awareness, adoption and implementation of the ANGCY. Chi-squared tests examined quantitative variables, while qualitative data were analysed using directed content analysis. Greenhalgh's model of diffusion of complex innovations within health service organizations constituted the theoretical framework for the study. Results One half of respondents had heard of the ANGCY, however their knowledge of them was limited. Although 51% of facilities had made changes to improve the nutritional quality of foods offered in the past year, only a small fraction (11%) of these changes were motivated by the ANGCY. At the time of the survey, 14% of facilities had adopted the ANGCY and 6% had implemented them. Barriers to adoption and implementation were primarily related to perceived negative attributes of the ANGCY, the inner (organizational) context, and negative feedback received during the implementation process. Managers strongly perceived that implementing nutrition guidelines would limit their profit-making ability. Conclusions If fully adopted and implemented, the ANGCY have the potential to

  14. I-25 truck safety improvements project : local evaluation report

    DOT National Transportation Integrated Search

    2004-12-29

    The I-25 Truck Safety Improvements project (I-25 TSIP) is the result of a FY98 congressionally designated earmark to support improvements in transportation efficiency, promote safety, increase traffic flow, reduce emissions, improve traveler informat...

  15. Implementing clinical process management of vascular wounds in a tertiary facility: impact evaluation of a performance improvement project.

    PubMed

    Avruscio, Giampiero; Tocco-Tussardi, Ilaria; Bordignon, Greta; Vindigni, Vincenzo

    2017-01-01

    Chronic vascular wounds have a significant economic and social impact on our society calling for allocation of a great deal of attention and resources. Efforts should be oriented toward the achievement of the most effective and efficient clinical management. The Angiology Unit at the University Hospital of Padova, Italy, developed a performance improvement project to enhance the quality of practice for vascular ulcers. The project consisted in a multistep process comprising a critical revision of the previous clinical process management, staff education, tightening connections between operators and services, and creation of a position for a wound care nurse. The previous standard of practice was modified according to the results of revision and the current evidence-based practice. The new standard of practice reached its full application in September 2015. The number of patients treated and the number of visits in 2015 remained almost unvaried from 2014. However, the total annual expenditure for treating vascular ulcers was reduced by ~60% from the previous year. Standardization of guidelines and practice is effective in creating an efficient clinical management and in reducing the economic burden of vascular ulcers.

  16. Generic project definitions for improvement of health care delivery: a case-based approach.

    PubMed

    Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap

    2011-01-01

    The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.

  17. Improving Project Management with Simulation and Completion Distribution Functions

    NASA Technical Reports Server (NTRS)

    Cates, Grant R.

    2004-01-01

    million per month is being spent on this project, which is scheduled to complete by 2010. NASA project stakeholders participated in determining and managing completion distribution functions produced from PAST. The first result was that project stakeholders improved project completion risk awareness. Secondly, using PAST, mitigation options were analyzed to improve project completion performance and reduce total project cost.

  18. Modernizing sports facilities

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

    Dustin, R.

    Modernization and renovation of sports facilities challenge the design team to balance a number of requirements: spectator and owner expectations, existing building and site conditions, architectural layouts, code and legislation issues, time constraints and budget issues. System alternatives are evaluated and selected based on the relative priorities of these requirements. These priorities are unique to each project. At Alexander Memorial Coliseum, project schedules, construction funds and facility usage became the priorities. The ACC basketball schedule and arrival of the Centennial Olympics dictated the construction schedule. Initiation and success of the project depended on the commitment of the design team tomore » meet coliseum funding levels established three years ago. Analysis of facility usage and system alternative capabilities drove the design team to select a system that met the project requirements and will maximize the benefits to the owner and spectators for many years to come.« less

  19. Energy Savings and Sustainability Opportunities at US Army Corps of Engineers Facilities: A Guide to Identify, Prioritize, and Estimate Projects at Complexes That Have Not Conducted a Facility-Level Energy and Water Evaluation

    DTIC Science & Technology

    2012-06-16

    Engineers to help identify and develop energy and water conservation projects in the facilities for which they are responsible. DISCLAIMER: The...and water throughout their facility. To identify energy and water conservation measures (ECMs), an energy manager would generally start by performing...an Energy and Water Conservation Assessment, essentially a facility-level evaluation of the en- ergy and water consuming equipment and systems that

  20. National Biomedical Tracer Facility. Project definition study

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

    Schafer, R.

    We request a $25 million government-guaranteed, interest-free loan to be repaid over a 30-year period for construction and initial operations of a cyclotron-based National Biomedical Tracer Facility (NBTF) in North Central Texas. The NBTF will be co-located with a linear accelerator-based commercial radioisotope production facility, funded by the private sector at approximately $28 million. In addition, research radioisotope production by the NBTF will be coordinated through an association with an existing U.S. nuclear reactor center that will produce research and commercial radioisotopes through neutron reactions. The combined facilities will provide the full range of technology for radioisotope production and research:more » fast neutrons, thermal neutrons, and particle beams (H{sup -}, H{sup +}, and D{sup +}). The proposed NBTF facility includes an 80 MeV, 1 mA H{sup -} cyclotron that will produce proton-induced (neutron deficient) research isotopes.« less

  1. FY 2013 Educational Facilities Master Plan and the FY 2013-2018 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2012

    2012-01-01

    The FY 2013 Educational Facilities Master Plan (Master Plan) and the FY 2013-2018 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the Board of…

  2. FY 2007 Educational Facilities Master Plan and the FY 2007-2012 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2006

    2006-01-01

    The FY 2007 Educational Facilities Master Plan (Master Plan) and FY 2007-2012 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the Board of Education…

  3. Improving patient care through student leadership in team quality improvement projects.

    PubMed

    Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

    2015-01-01

    In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.

  4. Using Six Sigma and Lean methodologies to improve OR throughput.

    PubMed

    Fairbanks, Catharine B

    2007-07-01

    Improving patient flow in the perioperative environment is challenging, but it has positive implications for both staff members and for the facility. One facility in vermont improved patient throughput by incorporating Six Sigma and Lean methodologies for patients undergoing elective procedures. The results of the project were significantly improved patient flow and increased teamwork and pride among perioperative staff members. (c) AORN, Inc, 2007.

  5. Factors predictive of increased influenza and pneumococcal vaccination coverage in long-term care facilities: the CMS-CDC standing orders program Project.

    PubMed

    Bardenheier, Barbara H; Shefer, Abigail; McKibben, Linda; Roberts, Henry; Rhew, David; Bratzler, Dale

    2005-01-01

    Between 1999 and 2002, a multistate demonstration project was conducted in long-term care facilities (LTCFs) to encourage implementation of standing orders programs (SOP) as evidence-based vaccine delivery strategies to increase influenza and pneumococcal vaccination coverage in LTCFs. Examine predictors of increase in influenza and pneumococcal vaccination coverage in LTCFs. Intervention study. Self-administered surveys of LTCFs merged with data from OSCAR (On-line Survey Certification and Reporting System) and immunization coverage was abstracted from residents' medical charts in LTCFs. Twenty LTCFs were sampled from 9 intervention and 5 control states in the 2000 to 2001 influenza season for baseline and during the 2001 to 2002 influenza season for postintervention. Each state's quality improvement organization (QIO) promoted the use of standing orders for immunizations as well as other strategies to increase immunization coverage among LTCF residents. Multivariate analysis included Poisson regression to determine independent predictors of at least a 10 percentage-point increase in facility influenza and pneumococcal vaccination coverage. Forty-two (20%) and 59 (28%) of the facilities had at least a 10 percentage-point increase in influenza and pneumococcal immunizations, respectively. In the multivariate analysis, predictors associated with increase in influenza vaccination coverage included adoption of requirement in written immunization protocol to document refusals, less-demanding consent requirements, lower baseline influenza coverage, and small facility size. Factors associated with increase in pneumococcal vaccination coverage included adoption of recording pneumococcal immunizations in a consistent place, affiliation with a multifacility chain, and provision of resource materials. To improve the health of LTCF residents, strategies should be considered that increase immunization coverage, including written protocol for immunizations and documentation of

  6. Environmental Assessment of the Prather Water Line Improvement Project Otero County, New Mexico

    DTIC Science & Technology

    2009-04-01

    concrete pipe currently in place. Placing a new pipeline along: (2) the Old El Paso Highway from the BWWSA to CoA facilities on Panorama Drive, or (3...Placing a new pipeline along: (2) the Old El Paso Highway from the BWWSA to CoA facilities on Panorama Drive, or (3) along the La Luz Gate Road from...grandeur of large panoramas and natural landscapes. Noise levels in the vicinity of the proposed project originate primarily from highway and railroad

  7. A residency clinic chronic condition management quality improvement project.

    PubMed

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

    2007-02-01

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

  8. Regional Interstate Planning Project Program . . . Vol. IX. California Program Evaluation Improvement Project. Seminar Report.

    ERIC Educational Resources Information Center

    Dearmin, Evalyn, Ed.; And Others

    Program evaluation strategies and techniques based on materials developed by the California Evaluation Improvement Project were discussed at this meeting of the Regional Interstate Planning Project (RIPP). RIPP members represent the State Departments of Education of ten western states, and have met periodically over the past nine years to discuss…

  9. Improving Long-Term Care Facility Disaster Preparedness and Response: A Literature Review.

    PubMed

    Pierce, J Rush; Morley, Sarah K; West, Theresa A; Pentecost, Percy; Upton, Lori A; Banks, Laura

    2017-02-01

    Long-term care facilities (LTCFs) and their residents are especially susceptible to disruptions associated with natural disasters and often have limited experience and resources for disaster planning and response. Previous reports have offered disaster planning and response recommendations. We could not find a comprehensive review of studied interventions or facility attributes that affect disaster outcomes in LTCFs and their residents. We reviewed articles published from 1974 through September 30, 2015, that studied disaster characteristics, facility characteristics, patient characteristics, or an intervention that affected outcomes for LTCFs experiencing or preparing for a disaster. Twenty-one articles were included in the review. All of the articles fell into 1 of the following categories: facility or disaster characteristics that predicted preparedness or response, interventions to improve preparedness, and health effects of disaster response, most often related to facility evacuation. All of the articles described observational studies that were heterogeneous in design and metrics. We believe that the evidence-based literature supports 6 specific recommendations for facilities, governmental agencies, health care communities and academia. These include integrated and coordinated disaster planning, staff training, careful consideration before governments order mandatory evacuations, anticipation of the increased medical needs of LTCF residents following a disaster, and the need for more outcomes research. (Disaster Med Public Health Preparedness. 2017;11:140-149).

  10. Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people

    PubMed Central

    Sutton, Elizabeth; Dixon-Woods, Mary; Tarrant, Carolyn

    2016-01-01

    Objectives Quality improvement projects to address transitions of care across care boundaries are increasingly common but meet with mixed success for reasons that are poorly understood. We aimed to characterise challenges in a project to improve transitions for older people between hospital and care homes. Design Independent process evaluation, using ethnographic observations and interviews, of a quality improvement project. Setting and participants An English hospital and two residential care homes for older people. Data 32 hours of non-participant observations and 12 semistructured interviews with project members, hospital and care home staff. Results A hospital-based improvement team sought to reduce unplanned readmissions from residential care homes using interventions including a community-based geriatric team that could be accessed directly by care homes and a communication tool intended to facilitate transfer of information between homes and hospital. Only very modest (if any) impacts of these interventions on readmission rates could be detected. The process evaluation identified multiple challenges in implementing interventions and securing improvement. Many of these arose because of lack of consensus on the nature of the problem and the proper solutions: while the hospital team was keen to reduce readmissions and saw the problems as lying in poor communication and lack of community-based support for care homes, the care home staff had different priorities. Care home staff were unconvinced that the improvement interventions were aligned with their needs or addressed their concerns, resulting in compromised implementation. Conclusions Process evaluations have a valuable role in quality improvement. Our study suggests that a key task for quality improvement projects aimed at transitions of care is that of developing a shared view of the problem to be addressed. A more participatory approach could help to surface assumptions, interpretations and interests

  11. The NTF as a national facility. [project planning

    NASA Technical Reports Server (NTRS)

    Nicks, O. W.

    1977-01-01

    Activities which led to the definition of the National Transonic Facility and the general agreements reached regarding its use and operations are reviewed. Topics discussed include: redefinition of test requirements, development of low cost options, consideration of a single transonic facility using existing hardware if feasible, facility concept recommendations, and acquisition schedule proposals.

  12. 41 CFR 102-74.310 - What measures must Federal agencies take to improve the utilization of parking facilities?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What measures must Federal agencies take to improve the utilization of parking facilities? 102-74.310 Section 102-74.310...

  13. 7 CFR Appendix D to Subpart E of... - Alcohol Production Facilities Planning, Performing, Development and Project Control

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... imposed by construction, equipment, material or service contracts, penalty payments, damage claims, awards... consultants with suitable experience, training and professional competence in the design and construction of... engineering services for design and construction inspection for all project facilities. Resident inspection by...

  14. 7 CFR Appendix D to Subpart E of... - Alcohol Production Facilities Planning, Performing, Development and Project Control

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... imposed by construction, equipment, material or service contracts, penalty payments, damage claims, awards... consultants with suitable experience, training and professional competence in the design and construction of... engineering services for design and construction inspection for all project facilities. Resident inspection by...

  15. Management of Excess Material in the Navys Real Time Reutilization Asset Management Facilities Needs Improvement

    DTIC Science & Technology

    2017-01-23

    operations for financial and supply chain management . ii │ DODIG-2017-043 ( Project No. D2016-D000RD-0052.000) Results in Brief Management of Excess...following page. Recommendations (cont’d) DODIG-2017-043 ( Project No. D2016-D000RD-0052.000) │ iii Recommendations Table Management Recommendations...No. DODIG-2017-043 J A N U A R Y 2 3 , 2 0 1 7 Management of Excess Material in the Navy’s Real-Time Reutilization Asset Management Facilities

  16. Defense Facility Condition: Revised Guidance Needed to Improve Oversight of Assessments and Ratings

    DTIC Science & Technology

    2016-06-01

    are to implement the standardized process in part by assessing the condition of buildings, pavement , and rail using the same set of software tools...facility to current standards; costs for labor, equipment, materials, and currency exchange rates overseas; costs for project planning and design ...example, the services are to assess the condition of buildings, pavement , and rail using Sustainment Management System software tools developed by the

  17. Waste receiving and processing facility module 1 data management system software project management plan

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

    Clark, R.E.

    1994-11-02

    This document provides the software development plan for the Waste Receiving and Processing (WRAP) Module 1 Data Management System (DMS). The DMS is one of the plant computer systems for the new WRAP 1 facility (Project W-026). The DMS will collect, store, and report data required to certify the low level waste (LLW) and transuranic (TRU) waste items processed at WRAP 1 as acceptable for shipment, storage, or disposal.

  18. Improving the management of warfarin in aged-care facilities utilising innovative technology: a proof-of-concept study.

    PubMed

    Bereznicki, Luke R E; Jackson, Shane L; Kromdijk, Wiete; Gee, Peter; Fitzmaurice, Kimbra; Bereznicki, Bonnie J; Peterson, Gregory M

    2014-02-01

    In aged-care facilities (ACFs) monitoring of warfarin can be logistically challenging and International Normalised Ratio (INR control) is often suboptimal. We aimed to determine whether an integrated information and communications technology system and the use of point-of-care (POC) monitors by nursing staff could improve the INR control of aged-care facility residents who take warfarin. Nursing staff identified residents who were prescribed warfarin in participating ACFs. A computer program (MedePOC) was developed to store and transmit INR results from the ACFs to general practitioners (GPs) for dosage adjustment. Nursing staff received training in the use of the CoaguChek XS point-of-care INR monitor and the MedePOC software. Following a run-in phase, eligible patients were monitored weekly for up to 12 weeks. The primary outcome was the change in the time in therapeutic range (TTR) in the intervention phase compared to the TTR in the 12 months preceding the study. All GPs, nursing staff and patients were surveyed for their experiences and opinions of the project. Twenty-four patients and 19 GPs completed the trial across six ACFs. The mean TTR for all patients improved non-significantly from 58.9 to 60.6% (P=0.79) and the proportion of INR tests in range improved non-significantly from 57.1 to 64.1% (P=0.21). The mean TTR improved in 14 patients (58%) and in these patients the mean absolute improvement in TTR was 23.1%. A post hoc analysis of the INR data using modified therapeutic INR ranges to reflect the dosage adjustment practices of GPs suggested that the intervention did lead to improved INR control. The MedePOC program and POC monitoring was well received by nursing staff. Weekly POC INR monitoring conducted in ACFs and electronic communication of the results and warfarin doses resulted in non-significant improvements in INR control in a small cohort of elderly residents. Further research involving modification to the communication strategy and a longer

  19. Standards Improvement Project-Phase II. Final rule.

    PubMed

    2005-01-05

    The Occupational Safety and Health Administration (OSHA) through this final rule is continuing to remove and revise provisions of its standards that are outdated, duplicative, unnecessary, or inconsistent, or can be clarified or simplified by being written in plain language. The Agency completed Phase I of the Standards Improvement Project in June 1998. In this Phase II of the Standards Improvement Project, OSHA is again revising or removing a number of health provisions in its standards for general industry, shipyard employment, and construction. The Agency believes that the changes streamline and make more consistent the regulatory requirements in OSHA health and safety standards. In some cases, OSHA has made substantive revisions to requirements because they are outdated, duplicative, unnecessary, or inconsistent with more recently promulgated health standards. The Agency believes these revisions will reduce regulatory requirements for employers without reducing employee protection.

  20. SF Bay Water Quality Improvement Fund: Projects and Accomplishments

    EPA Pesticide Factsheets

    San Francisco Bay Water Quality Improvement Fund (SFBWQIF) projects listed here are part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  1. Nuclear Rocket Facility Decommissioning Project: Controlled Explosive Demolition of Neutron Activated Shield Wall

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

    Michael R. Kruzic

    2007-09-16

    Located in Area 25 of the Nevada Test Site (NTS), the Test Cell A (TCA) Facility was used in the early to mid-1960s for the testing of nuclear rocket engines, as part of the Nuclear Rocket Development Program, to further space travel. Nuclear rocket testing resulted in the activation of materials around the reactors and the release of fission products and fuel particles in the immediate area. Identified as Corrective Action Unit 115, the TCA facility was decontaminated and decommissioned (D&D) from December 2004 to July 2005 using the Streamlined Approach for Environmental Restoration (SAFER) process, under the ''Federal Facilitymore » Agreement and Consent Order''. The SAFER process allows environmental remediation and facility closure activities (i.e., decommissioning) to occur simultaneously provided technical decisions are made by an experienced decision maker within the site conceptual site model, identified in the Data Quality Objective process. Facility closure involved a seven-step decommissioning strategy. Key lessons learned from the project included: (1) Targeted preliminary investigation activities provided a more solid technical approach, reduced surprises and scope creep, and made the working environment safer for the D&D worker. (2) Early identification of risks and uncertainties provided opportunities for risk management and mitigation planning to address challenges and unanticipated conditions. (3) Team reviews provided an excellent mechanism to consider all aspects of the task, integrated safety into activity performance, increase team unity and ''buy-in'' and promoted innovative and time saving ideas. (4) Development of CED protocols ensured safety and control. (5) The same proven D&D strategy is now being employed on the larger ''sister'' facility, Test Cell C.« less

  2. Improve services project -- Republic of the Marshall Islands.

    PubMed

    Langidrik, J

    1995-01-01

    The Republic of the Marshall Islands has 60 dispensary sites, each staffed by 1 health assistant, to cover 80-800 people/site on 34 atolls. Until the spring of 1994, only curative services were available on a regular basis, and preventive services were provided by traveling health teams from the urban centers. In 1994, the health assistants in selected outer islands were trained to administer immunizations from vaccines which are sent regularly by air. Additional project sites are being selected. In 1993, 2 dispensaries initiated a project to 1) increase the number of women with access to prenatal care during the first trimester, 2) increase immunization levels, 3) improve access to preventive services, and 4) improve reporting and record-keeping systems. This project includes an important training component for the health assistant, the wife of the health assistant, the traditional birth attendant, the youth peer educator, community leaders, and a member of the local council. By 1994, this project was expanded to 13 dispensaries on 2 atolls. In 1995, 18 more dispensaries on 4 more atolls will be able to offer these additional services.

  3. Financing Facility Improvements for Out-of-School Time and Community School Programs. Strategy Brief. Vol. 1 No. 4.

    ERIC Educational Resources Information Center

    Flynn, Margaret

    This strategy brief presents general principles and strategies for financing facility improvements and highlights five examples of innovative strategies found throughout the United States. The strategies described concern facility improvements for out-of-school time and community school programs and include the following: (1) accessing school…

  4. 30 CFR 285.651 - When may I construct complex or significant OCS facilities on my limited lease or any facilities...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... RENEWABLE ENERGY ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information... facilities on my limited lease or any facilities on my project easement proposed under my GAP? 285.651... facilities on my limited lease or any facilities on my project easement proposed under my GAP? If you are...

  5. How can innovative project delivery systems improve the overall efficiency of GDOT in transportation project delivery?

    DOT National Transportation Integrated Search

    2013-04-01

    The USDOT and Federal Highway Administration (FHWA) recommend the smart use of innovative project : delivery systems, such as design-build, to improve efficiency and effectiveness of developing transportation : projects. Although design-build provide...

  6. 76 FR 33589 - Standards Improvement Project-Phase III

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    ... rule: I. Background A. Introduction B. Regulatory History II. Legal Considerations III. Summary and... without diminishing worker protections. B. Regulatory History The Standards Improvement Project (SIP...

  7. Ninety to Nothing: a PDSA quality improvement project.

    PubMed

    Prybutok, Gayle Linda

    2018-05-14

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

  8. Regulatory approaches for addressing dissolved oxygen concerns at hydropower facilities

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

    Peterson, Mark J.; Cada, Glenn F.; Sale, Michael J.

    Low dissolved oxygen (DO) concentrations are a common water quality problem downstream of hydropower facilities. At some facilities, structural improvements (e.g. installation of weir dams or aerating turbines) or operational changes (e.g., spilling water over the dam) can be made to improve DO levels. In other cases, structural and operational approaches are too costly for the project to implement or are likely to be of limited effectiveness. Despite improvements in overall water quality below dams in recent years, many hydropower projects are unable to meet state water quality standards for DO. Regulatory agencies in the U.S. are considering or implementingmore » dramatic changes in their approach to protecting the quality of the Nation’s waters. New policies and initiatives have emphasized flexibility, increased collaboration and shared responsibility among all parties, and market-based, economic incentives. The use of new regulatory approaches may now be a viable option for addressing the DO problem at some hydropower facilities. This report summarizes some of the regulatory-related options available to hydropower projects, including negotiation of site-specific water quality criteria, use of biological monitoring, watershed-based strategies for the management of water quality, and watershed-based trading. Key decision points center on the health of the local biological communities and whether there are contributing impacts (i.e., other sources of low DO effluents) in the watershed. If the biological communities downstream of the hydropower project are healthy, negotiation for site-specific water quality standards or biocriteria (discharge performance criteria based on characteristics of the aquatic biota) might be pursued. If there are other effluent dischargers in the watershed that contribute to low DO problems, watershed-scale strategies and effluent trading may be effective. This report examines the value of regulatory approaches by reviewing their use

  9. Avoiding failure: tools for successful and sustainable quality-improvement projects.

    PubMed

    Donnelly, Lane F

    2017-06-01

    Involvement in successful and sustained quality improvement can be a very rewarding experience. However, it can be very difficult work. Up to 70% of attempted organizational change is not sustained. There are many reasons why quality-improvement projects might not be successful. In this article, the author reviews items associated with an increased or decreased likelihood of success. Such items have been categorized as structural issues, human issues and environmental context. This paper is intended to serve those embarking on quality-improvement projects as a resource to help position them for success.

  10. Improvements in Ice-Sheet Sea-Level Projections

    NASA Technical Reports Server (NTRS)

    Shepherd, Andrew; Nowicki, Sophie

    2017-01-01

    Ice losses from Antarctica and Greenland are the largest uncertainty in sea-level projections. Nevertheless, improvements in ice-sheet models over recent decades have led to closer agreement with satellite observations, keeping track with their increasing contribution to global sea-level rise.

  11. Homeless Veterans: Management Improvements Could Help VA Better Identify Supportive Housing Projects

    DTIC Science & Technology

    2016-12-01

    HOMELESS VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects Report to...VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects What GAO Found As of September 2016, for veterans who...disabled veterans. These supportive-housing EULs receive project -based HUD-VASH vouchers, which provide housing subsidies, on-site case management

  12. Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people.

    PubMed

    Sutton, Elizabeth; Dixon-Woods, Mary; Tarrant, Carolyn

    2016-08-04

    Quality improvement projects to address transitions of care across care boundaries are increasingly common but meet with mixed success for reasons that are poorly understood. We aimed to characterise challenges in a project to improve transitions for older people between hospital and care homes. Independent process evaluation, using ethnographic observations and interviews, of a quality improvement project. An English hospital and two residential care homes for older people. 32 hours of non-participant observations and 12 semistructured interviews with project members, hospital and care home staff. A hospital-based improvement team sought to reduce unplanned readmissions from residential care homes using interventions including a community-based geriatric team that could be accessed directly by care homes and a communication tool intended to facilitate transfer of information between homes and hospital. Only very modest (if any) impacts of these interventions on readmission rates could be detected. The process evaluation identified multiple challenges in implementing interventions and securing improvement. Many of these arose because of lack of consensus on the nature of the problem and the proper solutions: while the hospital team was keen to reduce readmissions and saw the problems as lying in poor communication and lack of community-based support for care homes, the care home staff had different priorities. Care home staff were unconvinced that the improvement interventions were aligned with their needs or addressed their concerns, resulting in compromised implementation. Process evaluations have a valuable role in quality improvement. Our study suggests that a key task for quality improvement projects aimed at transitions of care is that of developing a shared view of the problem to be addressed. A more participatory approach could help to surface assumptions, interpretations and interests and could facilitate the coproduction of solutions. This finding is

  13. United States Advanced Ultra-Supercritical Component Test Facility for 760°C Steam Power Plants ComTest Project

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

    Hack, Horst; Purgert, Robert Michael

    Following the successful completion of a 15-year effort to develop and test materials that would allow coal-fired power plants to be operated at advanced ultra-supercritical (A-USC) steam conditions, a United States-based consortium is presently engaged in a project to build an A-USC component test facility (ComTest). A-USC steam cycles have the potential to improve cycle efficiency, reduce fuel costs, and reduce greenhouse gas emissions. Current development and demonstration efforts are focused on enabling the construction of A-USC plants, operating with steam temperatures as high as 1400°F (760°C) and steam pressures up to 5000 psi (35 MPa), which can potentially increasemore » cycle efficiencies to 47% HHV (higher heating value), or approximately 50% LHV (lower heating value), and reduce CO 2 emissions by roughly 25%, compared to today’s U.S. fleet. A-USC technology provides a lower-cost method to reduce CO 2 emissions, compared to CO 2 capture technologies, while retaining a viable coal option for owners of coal generation assets. Among the goals of the ComTest facility are to validate that components made from advanced nickel-based alloys can operate and perform under A-USC conditions, to accelerate the development of a U.S.-based supply chain for the full complement of A-USC components, and to decrease the uncertainty of cost estimates for future A-USC power plants. The configuration of the ComTest facility would include the key A-USC technology components that were identified for expanded operational testing, including a gas-fired superheater, high-temperature steam piping, steam turbine valve, and cycling header component. Membrane walls in the superheater have been designed to operate at the full temperatures expected in a commercial A-USC boiler, but at a lower (intermediate) operating pressure. This superheater has been designed to increase the temperature of the steam supplied by the host utility boiler up to 1400°F (760°C). The steam turbine

  14. Making of the NSTX Facility

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

    C. Neumeyer; M. Ono; S.M. Kaye

    1999-11-01

    The NSTX (National Spherical Torus Experiment) facility located at Princeton Plasma Physics Laboratory is the newest national fusion science experimental facility for the restructured US Fusion Energy Science Program. The NSTX project was approved in FY 97 as the first proof-of-principle national fusion facility dedicated to the spherical torus research. On Feb. 15, 1999, the first plasma was achieved 10 weeks ahead of schedule. The project was completed on budget and with an outstanding safety record. This paper gives an overview of the NSTX facility construction and the initial plasma operations.

  15. FY 2012 Educational Facilities Master Plan and the Amended FY 2011-2016 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2011

    2011-01-01

    The FY 2012 Educational Facilities Master Plan (Master Plan) and Amendments to the FY 2011-2016 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the…

  16. Impact of a quality improvement project on deceased organ donor management

    PubMed Central

    Olmos, Andrea; Feiner, John; Hirose, Ryutaro; Swain, Sharon; Blasi, Annabel; Roberts, John P.; Niemann, Claus U.

    2017-01-01

    Context Donors showed poor glucose control in the period between declaration of brain death and organ recovery. The level of hyperglycemia in the donors was associated with a decline in terminal renal function. Objective To determine whether implementation of a quality improvement project improved glucose control and preserved renal function in deceased organ donors. Methods Data collected retrospectively included demographics, medical history, mechanism of death, laboratory values, and data from the United Network for Organ Sharing. Results After implementation of the quality improvement project, deceased donors had significantly lower mean glucose concentrations (mean [SD], 162 [44] vs 212 [42] mg/dL; P < .001) and prerecovery glucose concentration (143 [66] vs 241 [69] mg/dL; P < .001). When the donor cohorts from before and after the quality improvement project were analyzed together, mean glucose concentration remained a significant predictor of terminal creatinine level (P < .001). Multivariate analysis of delayed graft function in kidney recipients matched to donors indicated that higher terminal creatinine level was associated with delayed graft function in recipients (P < .001). Conclusion The quality improvement project improved donor glucose homeostasis, and the data confirm that poor glucose homeostasis is associated with worsening terminal renal function. PMID:26645930

  17. Project Plan: The MEDARP Documentation Unit to the School Improvement and Local School Development Projects.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

    The Metropolitan Educational Development and Research Project (MEDARP) Documentation Unit, located in the Office of Educational Evaluation (OEE) at the New York City Board of Education, is funded by the Ford Foundation to document, evaluate and provide technical assistance to the School Improvement and Local School Development Projects; these are…

  18. Sound Waste Management Plan environmental operations, and used oil management system: Restoration project 97115. Exxon Valdez oil spill restoration project final report: Volumes 1 and 2

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

    NONE

    1998-06-01

    This project constitutes Phase 2 of the Sound Waste Management Plan and created waste oil collection and disposal facilities, bilge water collection and disposal facilities, recycling storage, and household hazardous waste collection and storage, and household hazardous waste collection and storage facilities in Prince William Sound. A wide range of waste streams are generated within communities in the Sound including used oil generated from vehicles and vessels, and hazardous wastes generated by households. This project included the design and construction of Environmental Operations Stations buildings in Valdez, Cordova, Whittier, Chenega Bay and Tatitlek to improve the overall management of oilymore » wastes. They will house new equipment to facilitate oily waste collection, treatment and disposal. This project also included completion of used oil management manuals.« less

  19. A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

    PubMed

    Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

    2015-07-01

    The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P < 0.01) and PMTCT services (from 58 to 73%; P = 0.003); there was no significant change at comparison sites. Providers' perceptions of the work environment generally improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

  20. [Educational Facilities for Pregnant School-Age Girls in Districts 3, 4, 12, 13, and 18. Project No. 1369. Evaluation of ESEA Title I Projects in New York City 1968-69.

    ERIC Educational Resources Information Center

    Appel, Yetta; Berken, Ruth R.

    This project for pregnant school age girls is an ESEA Title I program operating in five facilities in Manhattan, Bronx, and Brooklyn. The primary objective of the project was to assist pregnant school age girls complete their education by being able to attend school. Additional objectives included provision of information and training in personal…

  1. Maintaining Perioperative Normothermia: Sustaining an Evidence-Based Practice Improvement Project.

    PubMed

    Levin, Rona F; Wright, Fay; Pecoraro, Kathleen; Kopec, Wendy

    2016-02-01

    Unintentional perioperative hypothermia has been shown to cause serious patient complications and, thus, to increase health care costs. In 2009, an evidence-based practice improvement project produced a significant decrease in unintentional perioperative hypothermia in colorectal surgical patients through monitoring of OR ambient room temperature. Project leaders engaged all interdisciplinary stakeholders in the original project, which facilitated the sustainability of the intervention method. An important aspect of sustainability is ongoing monitoring and evaluation of a new intervention method. Therefore, continued evaluation of outcomes of the protocol developed in 2009 was scheduled at specific time points after the initial small test of change with colorectal patients. This article focuses on how attention to sustainability factors during implementation of an improvement project led to the sustainability of a protocol for monitoring OR ambient room temperature with all types of surgical patients five years after the initial project. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  2. Field Review of Fish Habitat Improvement Projects in Central Idaho.

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

    Beschta, Robert L.; Griffith, Jack; Wesche, Thomas A.

    1993-05-01

    The goal of this field review was to provide information to the Bonneville Power Administration (BPA) regarding previous and ongoing fish habitat improvement projects in central Idaho. On July 14, 1992, the review team met at the Sawtooth National Recreation Area office near Ketchum, Idaho, for a slide presentation illustrating several habitat projects during their construction phases. Following the slide presentation, the review team inspected fish habitat projects that have been implemented in the last several years in the Stanley Basin and adjacent valleys. At each site the habitat project was described to the field team and a brief periodmore » for project inspection followed. The review team visited approximately a dozen sites on the Challis, Sawtooth, and Boise National Forests over a period of approximately two and a half days. There are two objectives of this review namely to summarize observations for specific field sites and to provide overview commentary regarding the BPA habitat improvement program in central Idaho.« less

  3. Materials sciences research. [research facilities, research projects, and technical reports of materials tests

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Research projects involving materials research conducted by various international test facilities are reported. Much of the materials research is classified in the following areas: (1) acousto-optic, acousto-electric, and ultrasonic research, (2) research for elucidating transport phenomena in well characterized oxides, (3) research in semiconductor materials and semiconductor devices, (4) the study of interfaces and interfacial phenomena, and (5) materials research relevant to natural resources. Descriptions of the individual research programs are listed alphabetically by the name of the author and show all personnel involved, resulting publications, and associated meeting speeches.

  4. The TAME Project: Towards improvement-oriented software environments

    NASA Technical Reports Server (NTRS)

    Basili, Victor R.; Rombach, H. Dieter

    1988-01-01

    Experience from a dozen years of analyzing software engineering processes and products is summarized as a set of software engineering and measurement principles that argue for software engineering process models that integrate sound planning and analysis into the construction process. In the TAME (Tailoring A Measurement Environment) project at the University of Maryland, such an improvement-oriented software engineering process model was developed that uses the goal/question/metric paradigm to integrate the constructive and analytic aspects of software development. The model provides a mechanism for formalizing the characterization and planning tasks, controlling and improving projects based on quantitative analysis, learning in a deeper and more systematic way about the software process and product, and feeding the appropriate experience back into the current and future projects. The TAME system is an instantiation of the TAME software engineering process model as an ISEE (integrated software engineering environment). The first in a series of TAME system prototypes has been developed. An assessment of experience with this first limited prototype is presented including a reassessment of its initial architecture.

  5. Project for the development of the linac based NCT facility in University of Tsukuba.

    PubMed

    Kumada, H; Matsumura, A; Sakurai, H; Sakae, T; Yoshioka, M; Kobayashi, H; Matsumoto, H; Kiyanagi, Y; Shibata, T; Nakashima, H

    2014-06-01

    A project team headed by University of Tsukuba launched the development of a new accelerator based BNCT facility. In the project, we have adopted Radio-Frequency Quadrupole (RFQ)+Drift Tube Linac (DTL) type linac as proton accelerators. Proton energy generated from the linac was set to 8MeV and average current was 10mA. The linac tube has been constructed by Mitsubishi Heavy Industry Co. For neutron generator device, beryllium is selected as neutron target material; high intensity neutrons are generated by the reaction with beryllium and the 80kW proton beam. Our team chose beryllium as the neutron target material. At present beryllium target system is being designed with Monte-Carlo estimations and heat analysis with ANSYS. The neutron generator consists of moderator, collimator and shielding. It is being designed together with the beryllium target system. We also acquired a building in Tokai village; the building has been renovated for use as BNCT treatment facility. It is noteworthy that the linac tube had been installed in the facility in September 2012. In BNCT procedure, several medical devices are required for BNCT treatment such as treatment planning system, patient positioning device and radiation monitors. Thus these are being developed together with the linac based neutron source. For treatment planning system, we are now developing a new multi-modal Monte-Carlo treatment planning system based on JCDS. The system allows us to perform dose estimation for BNCT as well as particle radiotherapy and X-ray therapy. And the patient positioning device can navigate a patient to irradiation position quickly and properly. Furthermore the device is able to monitor movement of the patient׳s position during irradiation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings

    PubMed Central

    2014-01-01

    Most of the maternal and newborn deaths occur at birth or within 24 hours of birth. Therefore, essential lifesaving interventions need to be delivered at basic or comprehensive emergency obstetric care facilities. Facilities provide complex interventions including advice on referrals, post discharge care, long-term management of chronic conditions along with staff training, managerial and administrative support to other facilities. This paper reviews the effectiveness of facility level inputs for improving maternal and newborn health outcomes. We considered all available systematic reviews published before May 2013 on the pre-defined facility level interventions and included 32 systematic reviews. Findings suggest that additional social support during pregnancy and labour significantly decreased the risk of antenatal hospital admission, intrapartum analgesia, dissatisfaction, labour duration, cesarean delivery and instrumental vaginal birth. However, it did not have any impact on pregnancy outcomes. Continued midwifery care from early pregnancy to postpartum period was associated with reduced medical procedures during labour and shorter length of stay. Facility based stress training and management interventions to maintain well performing and motivated workforce, significantly reduced job stress and improved job satisfaction while the interventions tailored to address identified barriers to change improved the desired practice. We found limited and inconclusive evidence for the impacts of physical environment, exit interviews and organizational culture modifications. At the facility level, specialized midwifery teams and social support during pregnancy and labour have demonstrated conclusive benefits in improving maternal newborn health outcomes. However, the generalizability of these findings is limited to high income countries. Future programs in resource limited settings should utilize these findings to implement relevant interventions tailored to their needs

  7. A Program Management Framework for Facilities Managers

    ERIC Educational Resources Information Center

    King, Dan

    2012-01-01

    The challenge faced by senior facility leaders is not how to execute a single project, but rather, how to successfully execute a large program consisting of hundreds of projects. Senior facilities officers at universities, school districts, hospitals, airports, and other organizations with extensive facility inventories, typically manage project…

  8. Planning and managing future space facility projects. [management by objectives and group dynamics

    NASA Technical Reports Server (NTRS)

    Sieber, J. E.; Wilhelm, J. A.; Tanner, T. A.; Helmreich, R. L.; Burgenbauch, S. F.

    1979-01-01

    To learn how ground-based personnel of a space project plan and organize their work and how such planning and organizing relate to work outcomes, longitudinal study of the management and execution of the Space Lab Mission Development Test 3 (SMD 3) was performed at NASA Ames Research Center. A view of the problems likely to arise in organizations and some methods of coping with these problems are presented as well as the conclusions and recommendations that pertain strictly to SMD 3 management. Emphasis is placed on the broader context of future space facility projects and additional problems that may be anticipated. A model of management that may be used to facilitate problem solving and communication - management by objectives (MBO) is presented. Some problems of communication and emotion management that MBO does not address directly are considered. Models for promoting mature, constructive and satisfying emotional relationships among group members are discussed.

  9. Improving Student Teamwork in a Collaborative Project-Based Course

    ERIC Educational Resources Information Center

    Kapp, Edward

    2009-01-01

    While collaborative student projects can be effective in improving student learning, the failure of students to work together effectively remains a widely reported problem in collaborative learning. This article describes a team-building intervention designed to improve the students' abilities to work together in teams successfully. The…

  10. 76 FR 58840 - Central Valley Project Improvement Act; Refuge Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act; Refuge Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: To meet the requirements of the Central Valley Project Improvement Act of 1992 (CVPIA) and subsequent...

  11. What drives continuous improvement project success in healthcare?

    PubMed

    Stelson, Paul; Hille, Joshua; Eseonu, Chinweike; Doolen, Toni

    2017-02-13

    Purpose The purpose of this paper is to present findings from a study of factors that affect continuous improvement (CI) project success in hospitals. Design/methodology/approach Quantitative regression analysis was performed on Likert scale survey responses. Qualitative thematic analysis was performed on open-ended survey responses and written reports on CI projects. Findings The paper identifies managerial and employee factors that affect project success. These factors include managerial support, communication, and affective commitment. Affective commitment is the extent to which employees perceive the change as being needed or necessary. Practical implications The results highlight how managerial decisions, approaches to communication - including communication before, during and after CI projects affect project success. The results also show that success depends on the way employees perceive proposed changes. This suggests the need for a more individualized approach to CI, lean, and broader change initiatives. Originality/value This research is the first to fuse project success and sustainability theory to CI projects, beyond Kaizen events, in healthcare environments. The research is particularly important at a time when healthcare organizations are required to make rapid changes with limited resources as they work toward outcome-based assessment and reimbursement rules.

  12. Cost-effectiveness of a quality improvement collaborative for obstetric and newborn care in Niger.

    PubMed

    Broughton, Edward; Saley, Zakari; Boucar, Maina; Alagane, Dondi; Hill, Kathleen; Marafa, Aicha; Asma, Yaroh; Sani, Karimou

    2013-01-01

    The purpose of this paper is to describe a quality improvement collaborative conducted in 33 Nigerian facilities to improve maternal and newborn care outcomes by increasing compliance with high-impact, evidence-based care standards. Intervention costs and cost-effectiveness were examined and costs to the Niger Health Ministry (MoH) were estimated if they were to scale-up the intervention to additional sites. Facility-based maternal care outcomes and costs from pre-quality improvement collaborative baseline monitoring data in participating facilities from January to May 2006 were compared with outcomes and costs from the same facilities from June 2008 to September 2008. Cost data were collected from project accounting records. The MoH costs were determined from interviews with clinic managers and quality improvement teams. Effectiveness data were obtained from facilities' records. The average delivery-cost decreased from $35 before to $28 after the collaborative. The USAID/HCI project's incremental cost was $2.43/delivery. The collaborative incremental cost-effectiveness was $147/disability-adjusted life year averted. If the MoH spread the intervention to other facilities, substantive cost-savings and improved health outcomes can be predicted. The intervention achieved significant positive health benefits for a low cost. The Niger MoH can expect approximately 50 per cent return on its investment if it implements the collaborative in new facilities. The improvement collaborative approach can improve health and save health care resources. This is one of the first studies known to examine collaborative quality improvement and economic efficiency in a developing country.

  13. [A project to improve the validity rate for nursing staff operating single door autoclave sterilizers].

    PubMed

    Chen, Chun-Hung; Li, Cheng-Chang; Chou, Chuan-Yu; Chen, Shu-Hwa

    2009-08-01

    This project was designed to improve the low validity rate for nurses responsible to operate single door autoclave sterilizers in the operating room. By investigating the current status, we found that the nursing staff validity rate of cognition on the autoclave sterilizer was 85%, and the practice operating check validity rate was only 80%. Such was due to a lack of in-service education. Problems with operation included: 1. Unsafe behaviors - not following standard procedure, lacking relevant operating knowledge and absence of a check form; 2. Unsafe environment - the conveying steam piping was typically not covered and lacked operation marks. Recommended improvement measures included: 1. holding in-service education; 2. generating an operation procedure flow chart; 3. implementing obstacle eliminating procedures; 4. covering piping to prevent fire and burns; 5. performing regular checks to ensure all procedures are followed. Following intervention, nursing staff cognition rose from 85% to 100%, while the operation validity rate rose from 80% to 100%. These changes ensure a safer operating room environment, and helps facilities move toward a zero accident rate in the healthcare environment.

  14. [Quality Improvement Project: Increasing the Rate of Proper Use of Infant Transferring Warmers].

    PubMed

    Huang, Hsiu-Yu; Fann, Guei-Ling

    2015-10-01

    Infant-transferring warmers provide a warm environment and emergency care facilities such ventilators for high-risk infants during transport. Accurate use of this warmer has been demonstrated to reduce rates of neonatal complications and increase rates of survival. This project found that, despite the complaints of nurses that warmers occasionally malfunctioned during the transfer process, warmer functions nearly always tested normal after use. Therefore, the researchers surveyed ward nurses to better understand the underlying reasons for these complaints. Results found that only 68.4% of those surveyed operated the warmer correctly. The reasons for improper use were analyzed and categorized as: Nurse-related factors - lack of warmer operating knowledge and experience in the clinic; System-related factors - lack of a standard operating procedure (SOP) and monitor/audit practices and an incomplete training protocol; Equipment-related factors - lack of an equipment preparation SOP and difficulties in setting the ventilator properly. The purpose of this project was to achieve a 100% rate of proper warmer use among nurses. Through continuous clinical education, we created a standard operating procedure for warmer operation, created a video and poster for warmer users, simplified the equipment preparation SOP, and periodically monitored and checked results. After the intervention, 100% of the nurses were able to use the warmers correctly. Additionally, the rate of satisfaction for nursing-warmer use among the participating nurses increased from 51.4% to 80.6%. This project effectively increased the rate for correctly using transferring warmers among participating nurses and improved the quality of medical care.

  15. Facilities for US Radioastronomy.

    ERIC Educational Resources Information Center

    Thaddeus, Patrick

    1982-01-01

    Discusses major developments in radioastronomy since 1945. Topics include proposed facilities, very-long-baseline interferometric array, millimeter-wave telescope, submillimeter-wave telescope, and funding for radioastronomy facilities and projects. (JN)

  16. Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department.

    PubMed

    Chartier, Lucas B; Cheng, Amy H Y; Stang, Antonia S; Vaillancourt, Samuel

    2018-01-01

    Emergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses-Ishikawa diagrams, Pareto charts and process mapping-and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

  17. Improving Tanzanian childbirth service quality.

    PubMed

    Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

    2018-04-16

    Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

  18. A process improvement model for software verification and validation

    NASA Technical Reports Server (NTRS)

    Callahan, John; Sabolish, George

    1994-01-01

    We describe ongoing work at the NASA Independent Verification and Validation (IV&V) Facility to establish a process improvement model for software verification and validation (V&V) organizations. This model, similar to those used by some software development organizations, uses measurement-based techniques to identify problem areas and introduce incremental improvements. We seek to replicate this model for organizations involved in V&V on large-scale software development projects such as EOS and space station. At the IV&V Facility, a university research group and V&V contractors are working together to collect metrics across projects in order to determine the effectiveness of V&V and improve its application. Since V&V processes are intimately tied to development processes, this paper also examines the repercussions for development organizations in large-scale efforts.

  19. A process improvement model for software verification and validation

    NASA Technical Reports Server (NTRS)

    Callahan, John; Sabolish, George

    1994-01-01

    We describe ongoing work at the NASA Independent Verification and Validation (IV&V) Facility to establish a process improvement model for software verification and validation (V&V) organizations. This model, similar to those used by some software development organizations, uses measurement-based techniques to identify problem areas and introduce incremental improvements. We seek to replicate this model for organizations involved in V&V on large-scale software development projects such as EOS and Space Station. At the IV&V Facility, a university research group and V&V contractors are working together to collect metrics across projects in order to determine the effectiveness of V&V and improve its application. Since V&V processes are intimately tied to development processes, this paper also examines the repercussions for development organizations in large-scale efforts.

  20. Retaining caregivers, improving care.

    PubMed

    Bodwell, Wendy; Dent, Sara; Grant, Tracie; Hammerly, Milt; Mamula, Jeanie

    2006-01-01

    Text Summary In 2004, Centura Health's long-term care centers took part in a pilot project, sponsored by the Centers for Medicare & Medicaid Services, called "Improving Nursing Home Culture through Workforce Retention." A 30-member team comprising Centura leaders and long-term facility staff looked at Centura's eight participating facilities through residents' and employees' eyes. The goal of the team's reflection and subsequent changes was to create a culture in which decisions are focused on resident care and organizational policies are based on respect for employees. At the end of the first year, residents seemed happier and employee satisfaction and involvement increased at all eight Centura facilities.

  1. Empowering Facilities Teams through Technology

    ERIC Educational Resources Information Center

    Cormier, Scott

    2013-01-01

    Facilities departments at colleges and universities are facing the same challenge: how not to do just the most projects, but also the right projects with the limited funds they are given. In order to make the best decisions, they need more control over the capital planning process, which requires accurate, current facility condition data. Each…

  2. Improved Methodology for Benefit Estimation of Preservation Projects

    DOT National Transportation Integrated Search

    2018-04-01

    This research report presents an improved process for evaluating the benefits and economic tradeoffs associated with a variety of highway preservation projects. It includes a summary of results from a comprehensive phone survey concerning the use and...

  3. Pilot projects for improving product tracing along the food supply system.

    PubMed

    Bhatt, Tejas; Hickey, Caitlin; McEntire, Jennifer C

    2013-12-01

    In September 2011, the U.S. Food and Drug Administration (FDA) asked the Institute of Food Technologists (IFT) to execute product tracing pilot projects as described in Section 204 of the FDA Food Safety Modernization Act (FSMA). IFT collaborated with representatives from more than 100 organizations-including the U.S. Dept. of Agriculture, state departments of agriculture and public health, industry, and consumer groups, as well as not-for-profit organizations-to implement the pilots. The objectives of the pilot projects were 1) to identify and gather information on methods to improve product tracing of foods in the supply chain and 2) to explore and evaluate methods to rapidly and effectively identify the recipient of food to prevent or mitigate a foodborne illness outbreak and to address credible threats of serious adverse health consequences or death to humans or animals as a result of such food being adulterated or misbranded. IFT conducted evaluations to determine the impact of currently available technologies, types of data and formats, and the data acquisition process, as well as the use of technology on the ability to follow product movement through the supply chain. Results from the pilots found inconsistencies in the terminology, numbering systems, formatting, legibility, and occasionally the language that sometimes required IFT to contact the submitting firm to gain clarity, thus increasing the time required to capture data before any meaningful analysis could begin. However, the pilot participants appeared to have many of the tools and processes in place which are required to allow the capture and communication of critical track and trace information (such as, key data elements) at critical points of product transfer and transformation (such as, critical tracking events). IFT determined that costs associated with implementing a product tracing system can vary widely as determined by numerous factors: the size of the firm/facility, the method of product

  4. The practical problem of improving quality in multicenter dialysis facilities.

    PubMed

    Balter, Paul

    2003-01-01

    Multifacility dialysis groups are frequently interested in improving overall quality and find that there are major differences between individual units. Upper management must consider what strategy is needed for the whole company and what strategy must be formulated by individual facilities. To make substantive changes, management must decide to adopt a new culture of true teamwork, drive out fear, and emphasize leadership and education both at the management level and in the individual unit. Both at the corporate and unit levels, leaders must be chosen who are able to recognize people who have the ability, the educational background, the enthusiasm, and the time to direct change. Empowering the individual units and individual employees to make changes and be enthusiastic about improvement is the key to success.

  5. An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

    PubMed

    Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

    2014-03-20

    To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, p<0.001). There was an improvement in the number of clinicians reporting satisfactory practice when diagnosing AKI, 50% vs 68% (χ²=12.1, p<0.001) and investigating patients with AKI, 48% vs 64% (χ²=9.5, p=0.002). Clinical audit makers showed a trend towards better clinical practice. This quality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.

  6. Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda.

    PubMed

    Iyer, Hari S; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R; Drobac, Peter C

    2015-01-01

    While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility

  7. Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

    PubMed Central

    Iyer, Hari S.; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R.; Drobac, Peter C.

    2015-01-01

    Background While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use

  8. The Microgravity Isolation Mount (MGIM): A Columbus facility for improving the microgravity quality of payloads

    NASA Technical Reports Server (NTRS)

    Owen, R. G.; Jones, D. I.; Owens, A. R.; Roberts, G.; Hadfield, P.

    1992-01-01

    The Microgravity Isolation Mount (MGIM) is a facility for providing active vibration isolation for sensitive experiments on the Columbus Attached Laboratory and the Columbus Free-Flying Laboratory. The facility is designed to be accommodated in a standard Columbus rack, and it iterfaces with existing rack utility services. The design is based on a non-contact strategy, whereby the payload 'floats' inside the rack, and its position is controlled by a number of magnetic actuators. The main advantage of using this non-contact strategy is the improved microgravity quality available. The overall design of the facility and a description of its elements are given.

  9. Rebuilding Habitat and Shoreline Resilience through Improved Flood Control Project

    EPA Pesticide Factsheets

    Information about the SFBWQP Rebuilding Habitat and Shoreline Resilience through Improved Flood Control Project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  10. 23 CFR 771.111 - Early coordination, public involvement, and project development.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., substantially changes the layout or functions of connecting roadways or of the facility being improved, has a... planning, (B) The project's alternatives, and major design features, (C) The social, economic...

  11. 23 CFR 771.111 - Early coordination, public involvement, and project development.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., substantially changes the layout or functions of connecting roadways or of the facility being improved, has a... planning, (B) The project's alternatives, and major design features, (C) The social, economic...

  12. 23 CFR 771.111 - Early coordination, public involvement, and project development.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., substantially changes the layout or functions of connecting roadways or of the facility being improved, has a... planning, (B) The project's alternatives, and major design features, (C) The social, economic...

  13. Teaching a Systems Approach: An Innovative Quality Improvement Project.

    PubMed

    Hamrin, Vanya; Vick, Rose; Brame, Cynthia; Simmons, Megan; Smith, Letizia; Vanderhoef, Dawn

    2016-04-01

    Nurse practitioners are required to navigate complex health care systems. Quality improvement (QI) projects provide the opportunity for nurse practitioner students to learn systems knowledge and improve health care outcomes in patient populations. A gap in the literature exists around how to systematically teach, apply, and measure QI curricular objectives at the master's level. Six faculty evaluated the QI project for the psychiatric nurse practitioner master's program by identifying the most challenging QI concepts for students to apply, revising their teaching strategies to address gaps, and retrospectively evaluating the outcomes of these curriculum changes by comparing student outcomes before and after the curricular changes. A significant difference was noted on QI project performance between students in the 2014 and 2015 graduating classes, measured by the scores earned on students' final papers (t[92] = 1.66, p = .05, d = .34, r(2) = .0289). Theoretical principles of adult and cooperative learning were used to inform curricular changes to enhance student's acquisition of QI skills. Copyright 2016, SLACK Incorporated.

  14. Force Measurement Improvements to the National Transonic Facility Sidewall Model Support System

    NASA Technical Reports Server (NTRS)

    Goodliff, Scott L.; Balakrishna, Sundareswara; Butler, David; Cagle, C. Mark; Chan, David; Jones, Gregory S.; Milholen, William E., II

    2016-01-01

    The National Transonic Facility is a transonic pressurized cryogenic facility. The development of the high Reynolds number semi-span capability has advanced over the years to include transonic active flow control and powered testing using the sidewall model support system. While this system can be used in total temperatures down to -250Â F for conventional unpowered configurations, it is limited to temperatures above -60Â F when used with powered models that require the use of the high-pressure air delivery system. Thermal instabilities and non-repeatable mechanical arrangements revealed several data quality shortfalls by the force and moment measurement system. Recent modifications to the balance cavity recirculation system have improved the temperature stability of the balance and metric model-to-balance hardware. Changes to the mechanical assembly of the high-pressure air delivery system, particularly hardware that interfaces directly with the model and balance, have improved the repeatability of the force and moment measurement system. Drag comparisons with the high-pressure air system removed will also be presented in this paper.

  15. Making hospitals healthier: how to improve sustainability in healthcare facilities.

    PubMed

    Buffoli, M; Gola, M; Rostagno, M; Capolongo, S; Nachiero, D

    2014-01-01

    Debate about sustainable development has reached a peak, as it is now recognized worldwide by public opinion and, in general, by governments' political agendas. New hospitals need to be made more sustainable and existing ones must improve their standards: e.g. in Italy, more than 50% of all healthcare facilities were built before the Nineties, without any attention to environmental, social or economic sustainability. Thanks to a sustainability evaluating system (environmental, social and economic) designed by the Milanese University 'Politecnico di Milano', two healthcare facilities were analyzed and compared. Both structures have approximately 600 beds and are located in the Lombardy region but they were built in different decades: one was built in the Sixties while the other one was built very recently. The analysis focused on underlining criticalities, implementing redevelopment measures for sustainability and eventually understanding whether attention was truly being given to those topics. A need to evaluate the sustainability parameters emerged from the comparison between the two case-studies. This is the only way of identifying strategic non-invasive and cheaper solutions that could directly influence sustainability. Following the above-mentioned comparison, a first look - albeit not an adequate one - was given to sustainability aspects. The assessment tool turned out to be efficient and could also prove effective in resource management and operational planning, whenever applied to any territorial facility.

  16. Reducing Plug Loads in Office Spaces: Hawaii and Guam Energy Improvement Technology Demonstration Project

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

    Sheppy, M.; Metzger, I.; Cutler, D.

    2014-01-01

    As part of its overall strategy to meet its energy goals, the Naval Facilities Engineering Command (NAVFAC) partnered with the Department of Energy's National Renewable Energy Laboratory (NREL) to rapidly demonstrate and deploy cost-effective renewable energy and energy efficiency technologies. This project was one of several demonstrations of new or underutilized commercial energy technologies. The common goal was to demonstrate and measure the performance and economic benefit of the system while monitoring any ancillary impacts to related standards of service and operation and maintenance (O&M) practices. In short, demonstrations at naval facilities simultaneously evaluate the benefits and compatibility of themore » technology with the U.S. Department of Defense (DOD) mission, and with NAVFAC's design, construction, operations, and maintenance practices, in particular. This project demonstrated the performance of commercially available advanced power strips (APSs) for plug load energy reductions in building A4 at Joint Base Pearl Harbor-Hickam (JBPHH), Hawaii.« less

  17. Sustainability in the AAP Bronchiolitis Quality Improvement Project.

    PubMed

    Shadman, Kristin A; Ralston, Shawn L; Garber, Matthew D; Eickhoff, Jens; Mussman, Grant M; Walley, Susan C; Rice-Conboy, Elizabeth; Coller, Ryan J

    2017-11-01

    Adherence to American Academy of Pediatrics (AAP) bronchiolitis clinical practice guideline recommendations improved significantly through the AAP's multiinstitutional collaborative, the Bronchiolitis Quality Improvement Project (BQIP). We assessed sustainability of improvements at participating institutions for 1 year following completion of the collaborative. Twenty-one multidisciplinary hospital-based teams provided monthly data for key inpatient bronchiolitis measures during baseline and intervention bronchiolitis seasons. Nine sites provided data in the season following completion of the collaborative. Encounters included children younger than 24 months who were hospitalized for bronchiolitis without comorbid chronic illness, prematurity, or intensive care. Changes between baseline-, intervention-, and sustainability-season data were assessed using generalized linear mixed-effects models with site-specific random effects. Differences between hospital characteristics, baseline performance, and initial improvement between sites that did and did not participate in the sustainability season were compared. A total of 2275 discharges were reviewed, comprising 995 baseline, 877 intervention, and 403 sustainability- season encounters. Improvements in all key bronchiolitis quality measures achieved during the intervention season were maintained during the sustainability season, and orders for intermittent pulse oximetry increased from 40.6% (95% confidence interval [CI], 22.8-61.1) to 79.2% (95% CI, 58.0- 91.3). Sites that did and did not participate in the sustainability season had similar characteristics. BQIP participating sites maintained improvements in key bronchiolitis quality measures for 1 year following the project's completion. This approach, which provided an evidence-based best-practice toolkit while building the quality-improvement capacity of local interdisciplinary teams, may support performance gains that persist beyond the active phase of the

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

    PubMed

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

    2009-08-01

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

  19. Evaluation of an institutional project to improve venous thromboembolism prevention.

    PubMed

    Minami, Christina A; Yang, Anthony D; Ju, Mila; Culver, Eckford; Seifert, Kathryn; Kreutzer, Lindsey; Halverson, Terri; O'Leary, Kevin J; Bilimoria, Karl Y

    2016-12-01

    Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures. A retrospective observational study. NMH, an 885-bed academic medical center in Chicago, Illinois PATIENTS: Inpatients admitted to NMH from January 1, 2013 to May 1, 2013 and from October 1, 2014 to April 1, 2015 were eligible for evaluation. Using the define-measure-analyze-improve-control (DMAIC) process-improvement methodology, a multidisciplinary team implemented and iteratively improved 15 data-driven interventions in 4 broad areas: (1) electronic medical record (EMR) alerts, (2) education initiatives, (3) new EMR order sets, and (4) other EMR changes. The Joint Commission's 6 core measures and the Surgical Care Improvement Project (SCIP) SCIP-VTE-2 measure. Based on 3103 observations (1679 from January 1, 2013 to May 1, 2013, and 1424 from October 1, 2014 to April 1, 2015), performance on the core measures improved. Performance on measure 1 (chemoprophylaxis) improved from 82.5% to 90.2% on medicine services, and from 94.4% to 97.6% on surgical services. The largest improvements were seen in measure 4 (platelet monitoring), with a performance increase from 76.7% adherence to 100%, and measure 5 (warfarin discharge instructions), with a performance increase from 27.4% to 88.8%. A systematic hospital-wide DMAIC project improved VTE prophylaxis measure performance. Sustained performance has been observed, and novel control mechanisms for continued performance surveillance have been embedded in the hospital system. Journal of Hospital Medicine 2016;11:S29-S37. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital

  20. Why is continuum of care from home to health facilities essential to improve perinatal survival?

    PubMed

    Bahl, Rajiv; Qazi, Shamim; Darmstadt, Gary L; Martines, Jose

    2010-12-01

    The period around the time of delivery is extremely hazardous for infants in developing countries. After the first week the risk drops sharply, and survival improves markedly. To reduce perinatal mortality, a continuum of care between the home and the various facilities is essential during pregnancy, childbirth and the newborn period. This paper reviews strategies to promote the establishment of this continuum: providing health care within or close to home by frontline workers and increasing the use of services in health facilities through community mobilization and financing strategies. As perinatal care and care for seriously sick children face common challenges and lessons could be learned from successful strategies for management of other illnesses, this paper also reviews intervention models involving community health workers (CHWs) to improve case management of sick children at the household and community levels. Available evidence suggests that the community strategy with the greatest impact on neonatal mortality is home visits by CHWs combined with community mobilization. The same strategy appears to be effective in increasing health facility utilization. An equally effective strategy for increasing health facility utilization seems to be financing health care to remove financial access barriers, particularly using conditional cash transfers or vouchers. Although the availability of information on the effect of community interventions to improve newborn health has increased in the recent past, significant gaps remain. Information on the effectiveness of strategies in different settings, particularly in sub-Saharan Africa, cost-effectiveness and sustainability are particularly needed and should be gathered in future studies. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. "India Population Projects" in Karnataka.

    PubMed

    Reddy, P H; Badari, V S

    1991-12-01

    An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in

  2. Designing Facilities for Collaborative Operations

    NASA Technical Reports Server (NTRS)

    Norris, Jeffrey; Powell, Mark; Backes, Paul; Steinke, Robert; Tso, Kam; Wales, Roxana

    2003-01-01

    A methodology for designing operational facilities for collaboration by multiple experts has begun to take shape as an outgrowth of a project to design such facilities for scientific operations of the planned 2003 Mars Exploration Rover (MER) mission. The methodology could also be applicable to the design of military "situation rooms" and other facilities for terrestrial missions. It was recognized in this project that modern mission operations depend heavily upon the collaborative use of computers. It was further recognized that tests have shown that layout of a facility exerts a dramatic effect on the efficiency and endurance of the operations staff. The facility designs (for example, see figure) and the methodology developed during the project reflect this recognition. One element of the methodology is a metric, called effective capacity, that was created for use in evaluating proposed MER operational facilities and may also be useful for evaluating other collaboration spaces, including meeting rooms and military situation rooms. The effective capacity of a facility is defined as the number of people in the facility who can be meaningfully engaged in its operations. A person is considered to be meaningfully engaged if the person can (1) see, hear, and communicate with everyone else present; (2) see the material under discussion (typically data on a piece of paper, computer monitor, or projection screen); and (3) provide input to the product under development by the group. The effective capacity of a facility is less than the number of people that can physically fit in the facility. For example, a typical office that contains a desktop computer has an effective capacity of .4, while a small conference room that contains a projection screen has an effective capacity of around 10. Little or no benefit would be derived from allowing the number of persons in an operational facility to exceed its effective capacity: At best, the operations staff would be underutilized

  3. Profit versus public health: the need to improve the food environment in recreational facilities.

    PubMed

    Olstad, Dana Lee; Raine, Kim D

    2013-01-08

    Despite their wellness mandate, many publicly funded recreational facilities offer primarily unhealthy foods. Governments have developed programs and resources to assist facilities to improve their food offerings, however the challenge to incent preferential sale of healthier foods remains substantial. In the Canadian province of Alberta, uptake of government-issued voluntary nutrition guidelines for recreational facilities has been limited, and offers of free assistance to implement them as part of a research study were not embraced. Financial constraints appear to be the most important barrier to offering healthier items in Alberta's recreational facilities, as facility and food service managers perceive that selling healthier foods is unprofitable and might jeopardize sponsorship agreements. Mandatory government regulation may therefore be required to overcome the barriers to offering healthier foods in this setting. The advantages of a regulatory approach appear to outweigh any disadvantages, with benefits for population health, more effective use of public funds, and greater equity for the public and industry. Adverse effects on corporate profitability and freedom of choice are expected to be limited. Regulation may offer an efficient, effective and equitable means of ensuring that recreational facilities support child health and do not undermine it by exposing children to unhealthy food environments.

  4. Developing the Muon Facilities at ISIS

    NASA Astrophysics Data System (ADS)

    Hillier, A. D.; Aramini, M.; Baker, P. J.; Berlie, A.; Biswas, P. K.; Cottrell, S. P.; Ishida, K.; Loe, T.; Lord, J. S.; Pooley, D. E.; Pratt, F. L.; Rhodes, N. J.; da Silva Afonso, R. J.; Telling, M. T. F.; Yokoyama, K.

    For the last 30 years, muon experiments at ISIS have been making a significant contribution to a number of scientific fields. However, as a community of researchers, we are always aiming to improve and extend the instruments' capabilities. In this paper, we will review key developments at the ISIS muon facility, the primary beamline upgrade and recent technique developments, before taking a forward look to new projects, such as: the upgrade for MuSR, e-learning, detector development and sample environment.

  5. The Facilities Audit. A Process for Improving Facilities Conditions.

    ERIC Educational Resources Information Center

    Kaiser, Harvey H.

    The problems of deferred maintenance and decaying campus infrastructure have troubled higher education for the past two decades. This book, designed to be a tool for facilities managers, describes a process for inspecting and reporting conditions of buildings and infrastructure. The audit process is meant to be a routine part of maintenance…

  6. Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship

    PubMed Central

    Ford, Bradley A.; Klutts, J. Stacey; Jensen, Chris S.; Briggs, Angela S.; Robinson, Robert A.; Bruch, Leslie A.; Karandikar, Nitin J.

    2017-01-01

    Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output. PMID:28913416

  7. Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship.

    PubMed

    Krasowski, Matthew D; Ford, Bradley A; Klutts, J Stacey; Jensen, Chris S; Briggs, Angela S; Robinson, Robert A; Bruch, Leslie A; Karandikar, Nitin J

    2017-01-01

    Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output.

  8. Project Management Life Cycle Models to Improve Management in High-rise Construction

    NASA Astrophysics Data System (ADS)

    Burmistrov, Andrey; Siniavina, Maria; Iliashenko, Oksana

    2018-03-01

    The paper describes a possibility to improve project management in high-rise buildings construction through the use of various Project Management Life Cycle Models (PMLC models) based on traditional and agile project management approaches. Moreover, the paper describes, how the split the whole large-scale project to the "project chain" will create the factor for better manageability of the large-scale buildings project and increase the efficiency of the activities of all participants in such projects.

  9. Phased Demolition of an Occupied Facility

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

    Brede, Lawrence M.; Lauterbach, Merl J.; Witt, Brandon W.

    2008-01-15

    The U.S. government constructed the K-1401 facility in the late 1940's as a support building for various projects supporting the uranium gaseous diffusion process. In 2004 the U.S. Department of Energy authorized Bechtel Jacobs Company, LLC (BJC) to decontaminate and demolish the facility. The K-1401 facility was used for a variety of industrial purposes supporting the gaseous diffusion process. Many different substances were used to support these processes over the years and as a result different parts of the facility were contaminated with fluorine, chlorine trifluoride, uranium and technetium radiological contamination, asbestos, and mercury. The total facility area is 46,015more » m{sup 2} (495,000 sf) including a 6,800 m{sup 2} basement (73,200 sf). In addition to the contamination areas in the facility, a large portion was leased to businesses for re-industrialization when the D and D activities began. The work scope associated with the facility included purging and steam cleaning the former fluorine and chlorine trifluoride systems, decontaminating loose radiologically contaminated and mercury spill areas, dismantling former radiological lines contaminated with uranium oxide compounds and technetium, abating all asbestos containing material, and demolishing the facility. These various situations contributed to the challenge of successfully conducting D and D tasks on the facility. In order to efficiently utilize the work force, demolition equipment, and waste hauling trucks the normal approach of decontaminating the facility of the hazardous materials, and then conducting demolition in series required a project schedule of five years, which is not cost effective. The entire project was planned with continuous demolition as the goal end state. As a result, the first activities, Phase 1, required to prepare sections for demolition, including steam cleaning fluorine and chlorine trifluoride process lines in basement and facility asbestos abatement, were

  10. Risk-based Prioritization of Facility Decommissioning and Environmental Restoration Projects in the National Nuclear Legacy Liabilities Program at the Chalk River Laboratory - 13564

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

    Nelson, Jerel G.; Kruzic, Michael; Castillo, Carlos

    2013-07-01

    Chalk River Laboratory (CRL), located in Ontario Canada, has a large number of remediation projects currently in the Nuclear Legacy Liabilities Program (NLLP), including hundreds of facility decommissioning projects and over one hundred environmental remediation projects, all to be executed over the next 70 years. Atomic Energy of Canada Limited (AECL) utilized WorleyParsons to prioritize the NLLP projects at the CRL through a risk-based prioritization and ranking process, using the WorleyParsons Sequencing Unit Prioritization and Estimating Risk Model (SUPERmodel). The prioritization project made use of the SUPERmodel which has been previously used for other large-scale site prioritization and sequencing ofmore » facilities at nuclear laboratories in the United States. The process included development and vetting of risk parameter matrices as well as confirmation/validation of project risks. Detailed sensitivity studies were also conducted to understand the impacts that risk parameter weighting and scoring had on prioritization. The repeatable prioritization process yielded an objective, risk-based and technically defendable process for prioritization that gained concurrence from all stakeholders, including Natural Resources Canada (NRCan) who is responsible for the oversight of the NLLP. (authors)« less

  11. Hot Corrosion Test Facility at the NASA Lewis Special Projects Laboratory

    NASA Technical Reports Server (NTRS)

    Robinson, Raymond C.; Cuy, Michael D.

    1994-01-01

    The Hot Corrosion Test Facility (HCTF) at the NASA Lewis Special Projects Laboratory (SPL) is a high-velocity, pressurized burner rig currently used to evaluate the environmental durability of advanced ceramic materials such as SiC and Si3N4. The HCTF uses laboratory service air which is preheated, mixed with jet fuel, and ignited to simulate the conditions of a gas turbine engine. Air, fuel, and water systems are computer-controlled to maintain test conditions which include maximum air flows of 250 kg/hr (550 lbm/hr), pressures of 100-600 kPa (1-6 atm), and gas temperatures exceeding 1500 C (2732 F). The HCTF provides a relatively inexpensive, yet sophisticated means for researchers to study the high-temperature oxidation of advanced materials, and the injection of a salt solution provides the added capability of conducting hot corrosion studies.

  12. Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.

    PubMed

    Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca; Mhlanga, Fortune

    2014-01-01

    Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. ISTC projects devoted to improving laser beam quality

    NASA Astrophysics Data System (ADS)

    Malakhov, Yu. I.

    2007-05-01

    Short overview is done about the activity of ISTC in a direction concerned with improving powerful laser beam quality by means of nonlinear and linear adaptive optics methods. Completed projects #0591 and #1929 resulted in the development of a stimulated Brillouin scattering (SBS) phase conjugation mirror of superhigh fidelity employing the kinoform optical elements (rasters of small lenses) of new generation designed for pulsed or pulse-periodic lasers with nanosecond scale pulse duration. Project #2631 is devoted to development of an adaptive optical system for phase registration and correction of laser beams with wave front vortices. The principles of operation of conventional adaptive systems are based on the assumption that the phase is a smooth continuous function in space. Therefore the solution of the Project tasks will assume a new step in adaptive optics.

  14. 77 FR 33240 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... Project water conservation best management practices that shall ``develop criteria for evaluating the... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

  15. 75 FR 70020 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... office on Central Valley Project water conservation best management practices that shall ``* * * develop... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior ACTION: Notice of Availability. SUMMARY: The...

  16. 77 FR 64544 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... Central Valley Project water conservation best management practices that shall ``develop criteria for... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

  17. 76 FR 12756 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-08

    ... office on Central Valley Project water conservation best management practices that shall ``* * * develop... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

  18. Program Improvement Project for Industrial Education. Annual Report.

    ERIC Educational Resources Information Center

    Shaeffer, Bruce W.

    Designed to improve industrial education programs through the development of minimum uniform quality standards, a project developed a task list, educationally sequenced the identified tasks, and developed a recommended shop layout and equipment list for four occupational areas: diesel repair, appliance repair, office machine repair, and small…

  19. Restoration of the Hypersonic Tunnel Facility at NASA Glenn Research Center, Plum Brook Station

    NASA Technical Reports Server (NTRS)

    Woodling, Mark A.

    2000-01-01

    The NASA Glenn Research Center's Hypersonic Tunnel Facility (HTF), located at the Plum Brook Station in Sandusky, Ohio, is a non-vitiated, free-jet facility, capable of testing large-scale propulsion systems at Mach Numbers from 5 to 7. As a result of a component failure in September of 1996, a restoration project was initiated in mid- 1997 to repair the damage to the facility. Following the 2-1/2 year effort, the HTF has been returned to an operational condition. Significant repairs and operational improvements have been implemented in order to ensure facility reliability and personnel safety. As of January 2000, this unique, state-of-the-art facility was ready for integrated systems testing.

  20. Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

    PubMed

    Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

    2017-06-01

    Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

  1. 76 FR 54251 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-31

    ... and administer an office on Central Valley Project water conservation best management practices that... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

  2. 78 FR 63491 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The following Water Management Plans are available for review: Westside... project contractors using best available cost-effective technology and best management practices.'' These...

  3. 78 FR 21414 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The following Water Management Plans are available for review... establish and administer an office on Central Valley Project water conservation best management practices...

  4. 75 FR 38538 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... to establish and administer an office on Central Valley Project water conservation best management... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

  5. Analysis of renewable energy projects' implementation in Russia

    NASA Astrophysics Data System (ADS)

    Ratner, S. V.; Nizhegorodtsev, R. M.

    2017-06-01

    With the enactment in 2013 of a renewable energy scheme by contracting qualified power generation facilities working on renewable energy sources (RES), the process of construction and connection of such facilities to the Federal Grid Company has intensified in Russia. In 2013-2015, 93 projects of solar, wind, and small hydropower energy were selected on the basis of competitive bidding in the country with the purpose of subsequent support. Despite some technical and organizational problems and a time delay of some RES projects, in 2014-2015 five solar generating facilities with total capacity of 50 MW were commissioned, including 30 MW in Orenburg oblast. However, the proportion of successful projects is low and amounts to approximately 30% of the total number of announced projects. The purpose of this paper is to analyze the experience of implementation of renewable energy projects that passed through a competitive selection and gained the right to get a partial compensation for the construction and commissioning costs of RES generating facilities in the electric power wholesale market zone. The informational background for the study is corporate reports of project promoters, analytical and information materials of the Association NP Market Council, and legal documents for the development of renewable energy. The methodological base of the study is a theory of learning curves that assumes that cost savings in the production of high-tech products depends on the production growth rate (economy of scale) and gaining manufacturing experience (learning by doing). The study has identified factors that have a positive and a negative impact on the implementation of RES projects. Improvement of promotion measures in the renewable energy development in Russia corresponding to the current socio-economic situation is proposed.

  6. Housing improvement projects in Indonesia: responding to local demand.

    PubMed

    Josodipoero, R I

    2003-06-01

    For more than three decades, environmental health programmes in Indonesia have emphasized prevention and treatment of the high incidence of disease among villagers. One of the main causes of disease is the unhygienic conditions of typical rural houses - two-room constructions with dirt floors and walls of lightly fired bricks or woven bamboo skins. While most houses have few or no windows, the occupants frequently cook, eat, sleep and even keep animals in a single room. The main objective of the housing improvement programme was to improve air circulation and introduce more sunlight to kill bacteria, avoid dampness and eliminate smoke from cooking. The programme encourages villagers to construct a permanent floor, enlarge existing windows or insert new windows for good ventilation. This presentation will share the 'success stories' of housing improvement projects in Indonesia that adopted demand-responsive approaches instead of the conventional 'supply approach'. Through exercises like Wealth Classification and Social Mapping, a demand-responsive approach lets the community decide who is eligible for assistance, resulting in higher participation and accurate information on community demand and on materials needed. In addition to the successes, the failures will be discussed at field level. This presentation will discuss the lessons learned from: the World Bank-funded Kalisemut Case Study; government's Family Welfare Movement; Plan International's project in Yogyakarta, and AusAID-funded Sustainable Development through Community Participation Project in Lombok.

  7. Proposed Facility Modifications to Support Propulsion Systems Testing Under Simulated Space Conditions at Plum Brook Station's Spacecraft Propulsion Research Facility (B-2)

    NASA Technical Reports Server (NTRS)

    Edwards, Daryl A.

    2008-01-01

    Preparing NASA's Plum Brook Station's Spacecraft Propulsion Research Facility (B-2) to support NASA's new generation of launch vehicles has raised many challenges for B-2's support staff. The facility provides a unique capability to test chemical propulsion systems/vehicles while simulating space thermal and vacuum environments. Designed and constructed in the early 1960s to support upper stage cryogenic engine/vehicle system development, the Plum Brook Station B-2 facility will require modifications to support the larger, more powerful, and more advanced engine systems for the next generation of vehicles leaving earth's orbit. Engine design improvements over the years have included large area expansion ratio nozzles, greater combustion chamber pressures, and advanced materials. Consequently, it has become necessary to determine what facility changes are required and how the facility can be adapted to support varying customers and their specific test needs. Exhaust system performance, including understanding the present facility capabilities, is the primary focus of this work. A variety of approaches and analytical tools are being employed to gain this understanding. This presentation discusses some of the challenges in applying these tools to this project and expected facility configuration to support the varying customer needs.

  8. Proposed Facility Modifications to Support Propulsion Systems Testing Under Simulated Space Conditions at Plum Brook Station's Spacecraft Propulsion Research Facility (B-2)

    NASA Technical Reports Server (NTRS)

    Edwards, Daryl A.

    2007-01-01

    Preparing NASA's Plum Brook Station's Spacecraft Propulsion Research Facility (B-2) to support NASA's new generation of launch vehicles has raised many challenges for B-2 s support staff. The facility provides a unique capability to test chemical propulsion systems/vehicles while simulating space thermal and vacuum environments. Designed and constructed 4 decades ago to support upper stage cryogenic engine/vehicle system development, the Plum Brook Station B-2 facility will require modifications to support the larger, more powerful, and more advanced engine systems for the next generation of vehicles leaving earth's orbit. Engine design improvements over the years have included large area expansion ratio nozzles, greater combustion chamber pressures, and advanced materials. Consequently, it has become necessary to determine what facility changes are required and how the facility can be adapted to support varying customers and their specific test needs. Instrumental in this task is understanding the present facility capabilities and identifying what reasonable changes can be implemented. A variety of approaches and analytical tools are being employed to gain this understanding. This paper discusses some of the challenges in applying these tools to this project and expected facility configuration to support the varying customer needs.

  9. Agricultural model intercomparison and improvement project: Overview of model intercomparisons

    USDA-ARS?s Scientific Manuscript database

    Improvement of crop simulation models to better estimate growth and yield is one of the objectives of the Agricultural Model Intercomparison and Improvement Project (AgMIP). The overall goal of AgMIP is to provide an assessment of crop model through rigorous intercomparisons and evaluate future clim...

  10. ENGINEERING STUDY FOR THE 200 AREA EFFLUENT TREATMENT FACILITY (ETF) SECONDARY WASTE TREATMENT OF PROJECTED FUTURE WASTE FEEDS

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

    LUECK, K.J.

    2004-10-18

    This report documents an engineering study conducted to evaluate alternatives for treating secondary waste in the secondary treatment train (STT) of the Hanford Site 200 Area Effluent Treatment Facility (ETF). The study evaluates ETF STT treatment alternatives and recommends preferred alternatives for meeting the projected future missions of the ETF. The preferred alternative(s) will process projected future ETF influents to produce a solid waste acceptable for final disposal on the Hanford Site. The main text of this report summarizes the ETF past and projected operations, lists the assumptions about projected operations that provide the basis for the engineering evaluation, andmore » summarizes the evaluation process. The evaluation process includes identification of available modifications to the current ETF process, screens those modifications for technical viability, evaluates the technically viable alternatives, and provides conclusions and recommendations based on that evaluation.« less

  11. Refurbishment and Automation of Thermal Vacuum Facilities at NASA/GSFC

    NASA Technical Reports Server (NTRS)

    Dunn, Jamie; Gomez, Carlos; Donohue, John; Johnson, Chris; Palmer, John; Sushon, Janet

    1999-01-01

    The thermal vacuum facilities located at the Goddard Space Flight Center (GSFC) have supported both manned and unmanned space flight since the 1960s. Of the eleven facilities, currently ten of the systems are scheduled for refurbishment or replacement as part of a five-year implementation. Expected return on investment includes the reduction in test schedules, improvements in safety of facility operations, and reduction in the personnel support required for a test. Additionally, GSFC will become a global resource renowned for expertise in thermal engineering, mechanical engineering, and for the automation of thermal vacuum facilities and tests. Automation of the thermal vacuum facilities includes the utilization of Programmable Logic Controllers (PLCs), the use of Supervisory Control and Data Acquisition (SCADA) systems, and the development of a centralized Test Data Management System. These components allow the computer control and automation of mechanical components such as valves and pumps. The project of refurbishment and automation began in 1996 and has resulted in complete computer control of one facility (Facility 281), and the integration of electronically controlled devices and PLCs in multiple others.

  12. Refurbishment and Automation of Thermal Vacuum Facilities at NASA/GSFC

    NASA Technical Reports Server (NTRS)

    Dunn, Jamie; Gomez, Carlos; Donohue, John; Johnson, Chris; Palmer, John; Sushon, Janet

    1998-01-01

    The thermal vacuum facilities located at the Goddard Space Flight Center (GSFC) have supported both manned and unmanned space flight since the 1960s. Of the eleven facilities, currently ten of the systems are scheduled for refurbishment or replacement as part of a five-year implementation. Expected return on investment includes the reduction in test schedules, improvements in safety of facility operations, and reduction in the personnel support required for a test. Additionally, GSFC will become a global resource renowned for expertise in thermal engineering, mechanical engineering, and for the automation of thermal vacuum facilities and tests. Automation of the thermal vacuum facilities includes the utilization of Programmable Logic Controllers (PLCs), the use of Supervisory Control and Data Acquisition (SCADA) systems, and the development of a centralized Test Data Management System. These components allow the computer control and automation of mechanical components such as valves and pumps. The project of refurbishment and automation began in 1996 and has resulted in complete computer control of one facility (Facility 281), and the integration of electronically controlled devices and PLCs in multiple others.

  13. MDSplus quality improvement project

    DOE PAGES

    Fredian, Thomas W.; Stillerman, Joshua; Manduchi, Gabriele; ...

    2016-05-31

    MDSplus is a data acquisition and analysis system used worldwide predominantly in the fusion research community. Development began 29 years ago on the OpenVMS operating system. Since that time there have been many new features added and the code has been ported to many different operating systems. There have been contributions to the MDSplus development from the fusion community in the way of feature suggestions, feature implementations, documentation and porting to different operating systems. The bulk of the development and support of MDSplus, however, has been provided by a relatively small core developer group of three or four members. Givenmore » the size of the development team and the large number of users much more effort was focused on providing new features for the community than on keeping the underlying code and documentation up to date with the evolving software development standards. To ensure that MDSplus will continue to provide the needs of the community in the future, the MDSplus development team along with other members of the MDSplus user community has commenced on a major quality improvement project. The planned improvements include changes to software build scripts to better use GNU Autoconf and Automake tools, refactoring many of the source code modules using new language features available in modern compilers, using GNU MinGW-w64 to create MS Windows distributions, migrating to a more modern source code management system, improvement of source documentation as well as improvements to the www.mdsplus.org web site documentation and layout, and the addition of more comprehensive test suites to apply to MDSplus code builds prior to releasing installation kits to the community. This paper should lead to a much more robust product and establish a framework to maintain stability as more enhancements and features are added. Finally, this paper will describe these efforts that are either in progress or planned for the near future.« less

  14. Measurement Requirements for Improved Modeling of Arcjet Facility Flows

    NASA Technical Reports Server (NTRS)

    Fletcher, Douglas G.

    2000-01-01

    Current efforts to develop new reusable launch vehicles and to pursue low-cost robotic planetary missions have led to a renewed interest in understanding arc-jet flows. Part of this renewed interest is concerned with improving the understanding of arc-jet test results and the potential use of available computational-fluid- dynamic (CFD) codes to aid in this effort. These CFD codes have been extensively developed and tested for application to nonequilibrium, hypersonic flow modeling. It is envisioned, perhaps naively, that the application of these CFD codes to the simulation of arc-jet flows would serve two purposes: first. the codes would help to characterize the nonequilibrium nature of the arc-jet flows; and second. arc-jet experiments could potentially be used to validate the flow models. These two objectives are, to some extent, mutually exclusive. However, the purpose of the present discussion is to address what role CFD codes can play in the current arc-jet flow characterization effort, and whether or not the simulation of arc-jet facility tests can be used to eva1uate some of the modeling that is used to formu1ate these codes. This presentation is organized into several sections. In the introductory section, the development of large-scale, constricted-arc test facilities within NASA is reviewed, and the current state of flow diagnostics using conventional instrumentation is summarized. The motivation for using CFD to simulate arc-jet flows is addressed in the next section, and the basic requirements for CFD models that would be used for these simulations are briefly discussed. This section is followed by a more detailed description of experimental measurements that are needed to initiate credible simulations and to evaluate their fidelity in the different flow regions of an arc-jet facility. Observations from a recent combined computational and experiment.al investigation of shock-layer flows in a large-scale arc-jet facility are then used to illustrate the

  15. Improved dense trajectories for action recognition based on random projection and Fisher vectors

    NASA Astrophysics Data System (ADS)

    Ai, Shihui; Lu, Tongwei; Xiong, Yudian

    2018-03-01

    As an important application of intelligent monitoring system, the action recognition in video has become a very important research area of computer vision. In order to improve the accuracy rate of the action recognition in video with improved dense trajectories, one advanced vector method is introduced. Improved dense trajectories combine Fisher Vector with Random Projection. The method realizes the reduction of the characteristic trajectory though projecting the high-dimensional trajectory descriptor into the low-dimensional subspace based on defining and analyzing Gaussian mixture model by Random Projection. And a GMM-FV hybrid model is introduced to encode the trajectory feature vector and reduce dimension. The computational complexity is reduced by Random Projection which can drop Fisher coding vector. Finally, a Linear SVM is used to classifier to predict labels. We tested the algorithm in UCF101 dataset and KTH dataset. Compared with existed some others algorithm, the result showed that the method not only reduce the computational complexity but also improved the accuracy of action recognition.

  16. Vulnerability Assessments and Resilience Planning at Federal Facilities. Preliminary Synthesis of Project

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

    Moss, R. H.; Blohm, A. J.; Delgado, A.

    2015-08-15

    infrastructure; (4) Vulnerability assessments can be connected to efforts to improve facility resilience to motivate participation; and (5) Efficient, scalable methods for vulnerability assessment can be developed, but additional case studies and evaluation are required.« less

  17. Quality initiatives: planning, setting up, and carrying out radiology process improvement projects.

    PubMed

    Tamm, Eric P; Szklaruk, Janio; Puthooran, Leejo; Stone, Danna; Stevens, Brian L; Modaro, Cathy

    2012-01-01

    In the coming decades, those who provide radiologic imaging services will be increasingly challenged by the economic, demographic, and political forces affecting healthcare to improve their efficiency, enhance the value of their services, and achieve greater customer satisfaction. It is essential that radiologists master and consistently apply basic process improvement skills that have allowed professionals in many other fields to thrive in a competitive environment. The authors provide a step-by-step overview of process improvement from the perspective of a radiologic imaging practice by describing their experience in conducting a process improvement project: to increase the daily volume of body magnetic resonance imaging examinations performed at their institution. The first step in any process improvement project is to identify and prioritize opportunities for improvement in the work process. Next, an effective project team must be formed that includes representatives of all participants in the process. An achievable aim must be formulated, appropriate measures selected, and baseline data collected to determine the effects of subsequent efforts to achieve the aim. Each aspect of the process in question is then analyzed by using appropriate tools (eg, flowcharts, fishbone diagrams, Pareto diagrams) to identify opportunities for beneficial change. Plans for change are then established and implemented with regular measurements and review followed by necessary adjustments in course. These so-called PDSA (planning, doing, studying, and acting) cycles are repeated until the aim is achieved or modified and the project closed.

  18. Supporting the Future Air Traffic Control Projection Process

    NASA Technical Reports Server (NTRS)

    Davison, Hayley J.; Hansman, R. John, Jr.

    2002-01-01

    In air traffic control, projecting what the air traffic situation will be over the next 30 seconds to 30 minutes is a key process in identifying conflicts that may arise so that evasive action can be taken upon discovery of these conflicts. A series of field visits in the Boston and New York terminal radar approach control (TRACON) facilities and in the oceanic air traffic control facilities in New York and Reykjavik, Iceland were conducted to investigate the projection process in two different ATC domains. The results from the site visits suggest that two types of projection are currently used in ATC tasks, depending on the type of separation minima and/or traffic restriction and information display used by the controller. As technologies improve and procedures change, care should be taken by designers to support projection through displays, automation, and procedures. It is critical to prevent time/space mismatches between interfaces and restrictions. Existing structure in traffic dynamics could be utilized to provide controllers with useful behavioral models on which to build projections. Subtle structure that the controllers are unable to internalize could be incorporated into an ATC projection aid.

  19. 78 FR 26807 - Vista Grande Drainage Basin Improvement Project, Fort Funston, Golden Gate National Recreation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-08

    ... Village, in northwestern San Mateo County. This watershed is approximately 2.5 square miles in area and is... diversion and discharge structures to route some stormwater (and authorized non-storm water) flows from the... water detention structures, lake level scenarios, and groundwater recharge facilities. The Project would...

  20. Evaluating building performance in healthcare facilities: an organizational perspective.

    PubMed

    Steinke, Claudia; Webster, Lynn; Fontaine, Marie

    2010-01-01

    Using the environment as a strategic tool is one of the most cost-effective and enduring approaches for improving public health; however, it is one that requires multiple perspectives. The purpose of this article is to highlight an innovative methodology that has been developed for conducting comprehensive performance evaluations in public sector health facilities in Canada. The building performance evaluation methodology described in this paper is a government initiative. The project team developed a comprehensive building evaluation process for all new capital health projects that would respond to the aforementioned need for stakeholders to be more accountable and to better integrate the larger organizational strategy of facilities. The Balanced Scorecard, which is a multiparadigmatic, performance-based business framework, serves as the underlying theoretical framework for this initiative. It was applied in the development of the conceptual model entitled the Building Performance Evaluation Scorecard, which provides the following benefits: (1) It illustrates a process to link facilities more effectively to the overall mission and goals of an organization; (2) It is both a measurement and a management system that has the ability to link regional facilities to measures of success and larger business goals; (3) It provides a standardized methodology that ensures consistency in assessing building performance; and (4) It is more comprehensive than traditional building evaluations. The methodology presented in this paper is both a measurement and management system that integrates the principles of evidence-based design with the practices of pre- and post-occupancy evaluation. It promotes accountability and continues throughout the life cycle of a project. The advantage of applying this framework is that it engages health organizations in clarifying a vision and strategy for their facilities and helps translate those strategies into action and measurable performance

  1. Maintenance of Certification Part IV Quality-Improvement Project for Hypertension Control: A Preliminary Retrospective Analysis

    PubMed Central

    Kolasinski, Vallerie A; Price, David W

    2015-01-01

    Context: A Maintenance of Certification Part IV project was created on the basis of an existing, multifaceted hypertension improvement program. Objective: To evaluate the impact of the Maintenance of Certification project, the effects of the improvement options on blood pressure control in hypertensive patients, and the participants’ perception of the workload related to participation in the project. Design: Nonexperimental retrospective analysis. Setting: Kaiser Permanente hospitals and medical office buildings in Northern California. Intervention: Participants used one or more options from a defined menu of strategies to attempt to increase the percentage of hypertensive patients on their patient panels who had controlled blood pressure. Main Outcome Measure: Proportion of hypertensive patients with blood pressure ≤ 139/89 mm Hg. Results: Fifty-two American Board of Family Medicine and 19 American Board of Internal Medicine certified physicians completed projects. Mean panel blood pressure control improved from 79.49% (standard deviation [SD] = 11.32) to 84.64% (SD = 7.80). The choice of improvement option was not associated with the level of improvement or with the participants’ perception of the workload related to completing the project. Conclusion: Project participants improved the care of their patients without an increased perceived burden to their practice. We found no association between the choice of improvement option and either the level of improvement or the perception of workload. PMID:25785642

  2. Telepsychiatry in correctional facilities: using technology to improve access and decrease costs of mental health care in underserved populations.

    PubMed

    Deslich, Stacie Anne; Thistlethwaite, Timothy; Coustasse, Alberto

    2013-01-01

    It is unclear if telepsychiatry, a subset of telemedicine, increases access to mental health care for inmates in correctional facilities or decreases costs for clinicians or facility administrators. The purpose of this investigation was to determine how utilization of telepsychiatry affected access to care and costs of providing mental health care in correctional facilities. A literature review complemented by a semistructured interview with a telepsychiatry practitioner. Five electronic databases, the National Bureau of Justice, and the American Psychiatric Association Web sites were searched for this research, and 49 sources were referenced. The literature review examined implementation of telepsychiatry in correctional facilities in Arizona, California, Georgia, Kansas, Ohio, Texas, and West Virginia to determine the effect of telepsychiatry on inmate access to mental health services and the costs of providing mental health care in correctional facilities. Telepsychiatry provided improved access to mental health services for inmates, and this increase in access is through the continuum of mental health care, which has been instrumental in increasing quality of care for inmates. Use of telepsychiatry saved correctional facilities from $12,000 to more than $1 million. The semistructured interview with the telepsychiatry practitioner supported utilization of telepsychiatry to increase access and lower costs of providing mental health care in correctional facilities. Increasing access to mental health care for this underserved group through telepsychiatry may improve living conditions and safety inside correctional facilities. Providers, facilities, and state and federal governments can expect increased savings with utilization of telepsychiatry.

  3. 78 FR 48029 - Improving Chemical Facility Safety and Security

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... responding to risks in chemical facilities (including during pre-inspection, inspection execution, post.... Sec. 2. Establishment of the Chemical Facility Safety and Security Working Group. (a) There is established a Chemical Facility Safety and Security Working Group (Working Group) co-chaired by the Secretary...

  4. MINIMUM AREAS FOR ELEMENTARY SCHOOL BUILDING FACILITIES.

    ERIC Educational Resources Information Center

    Pennsylvania State Dept. of Public Instruction, Harrisburg.

    MINIMUM AREA SPACE REQUIREMENTS IN SQUARE FOOTAGE FOR ELEMENTARY SCHOOL BUILDING FACILITIES ARE PRESENTED, INCLUDING FACILITIES FOR INSTRUCTIONAL USE, GENERAL USE, AND SERVICE USE. LIBRARY, CAFETERIA, KITCHEN, STORAGE, AND MULTIPURPOSE ROOMS SHOULD BE SIZED FOR THE PROJECTED ENROLLMENT OF THE BUILDING IN ACCORDANCE WITH THE PROJECTION UNDER THE…

  5. San Pablo Bay Tidal Marsh Enhancement and Water Quality Improvement Project

    EPA Pesticide Factsheets

    Information about the SFBWQP San Pablo Bay Tidal Marsh Enhancement and Water Quality Improvement Project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  6. Improvement in Herpes Zoster Vaccination in Patients with Rheumatoid Arthritis: A Quality Improvement Project.

    PubMed

    Sheth, Heena; Moreland, Larry; Peterson, Hilary; Aggarwal, Rohit

    2017-01-01

    To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy. This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase. The electronic best practice alert (BPA) for HZ vaccination was developed; it appeared on electronic medical records during registration and medication reconciliation of the eligible patient by the medical assistant. The BPA was designed to electronically identify patient eligibility and to enable the physician to order the vaccine or to document refusal or deferral reason. Education regarding vaccine guidelines, BPA, vaccination process, and feedback were crucial components of the project interventions. The vaccination rates were compared using the chi-square test. We evaluated 1823 and 1554 eligible patients with RA during the pre-intervention and post-intervention phases, respectively. The HZ vaccination rates, reported as patients vaccinated among all eligible patients, improved significantly from the pre-intervention period of 10.1% (184/1823) to 51.7% (804/1554) during the intervention phase (p < 0.0001). The documentation rates (vaccine received, vaccine ordered, patient refusal, and deferral reasons) increased from 28% (510/1823) to 72.9% (1133/1554; p < 0.0001). The HZ infection rates decreased significantly from 2% to 0.3% (p = 0.002). Electronic identification of vaccine eligibility and BPA significantly improved HZ vaccination rates. The process required minimal modification of clinic work flow and did not burden the physician's time, and has the potential for self-sustainability and generalizability.

  7. Projecting technology change to improve space technology planning and systems management

    NASA Astrophysics Data System (ADS)

    Walk, Steven Robert

    2011-04-01

    Projecting technology performance evolution has been improving over the years. Reliable quantitative forecasting methods have been developed that project the growth, diffusion, and performance of technology in time, including projecting technology substitutions, saturation levels, and performance improvements. These forecasts can be applied at the early stages of space technology planning to better predict available future technology performance, assure the successful selection of technology, and improve technology systems management strategy. Often what is published as a technology forecast is simply scenario planning, usually made by extrapolating current trends into the future, with perhaps some subjective insight added. Typically, the accuracy of such predictions falls rapidly with distance in time. Quantitative technology forecasting (QTF), on the other hand, includes the study of historic data to identify one of or a combination of several recognized universal technology diffusion or substitution patterns. In the same manner that quantitative models of physical phenomena provide excellent predictions of system behavior, so do QTF models provide reliable technological performance trajectories. In practice, a quantitative technology forecast is completed to ascertain with confidence when the projected performance of a technology or system of technologies will occur. Such projections provide reliable time-referenced information when considering cost and performance trade-offs in maintaining, replacing, or migrating a technology, component, or system. This paper introduces various quantitative technology forecasting techniques and illustrates their practical application in space technology and technology systems management.

  8. Development of a Multi-Domain Assessment Tool for Quality Improvement Projects.

    PubMed

    Rosenbluth, Glenn; Burman, Natalie J; Ranji, Sumant R; Boscardin, Christy K

    2017-08-01

    Improving the quality of health care and education has become a mandate at all levels within the medical profession. While several published quality improvement (QI) assessment tools exist, all have limitations in addressing the range of QI projects undertaken by learners in undergraduate medical education, graduate medical education, and continuing medical education. We developed and validated a tool to assess QI projects with learner engagement across the educational continuum. After reviewing existing tools, we interviewed local faculty who taught QI to understand how learners were engaged and what these faculty wanted in an ideal assessment tool. We then developed a list of competencies associated with QI, established items linked to these competencies, revised the items using an iterative process, and collected validity evidence for the tool. The resulting Multi-Domain Assessment of Quality Improvement Projects (MAQIP) rating tool contains 9 items, with criteria that may be completely fulfilled, partially fulfilled, or not fulfilled. Interrater reliability was 0.77. Untrained local faculty were able to use the tool with minimal guidance. The MAQIP is a 9-item, user-friendly tool that can be used to assess QI projects at various stages and to provide formative and summative feedback to learners at all levels.

  9. Computational and Experimental Characterization of the Mach 6 Facility Nozzle Flow for the Enhanced Injection and Mixing Project at NASA Langley Research Center

    NASA Technical Reports Server (NTRS)

    Drozda, Tomasz G.; Cabell, Karen F.; Passe, Bradley J.; Baurle, Robert A.

    2017-01-01

    Computational fluid dynamics analyses and experimental data are presented for the Mach 6 facility nozzle used in the Arc-Heated Scramjet Test Facility for the Enhanced Injection and Mixing Project (EIMP). This project, conducted at the NASA Langley Research Center, aims to investigate supersonic combustion ramjet (scramjet) fuel injection and mixing physics relevant to flight Mach numbers greater than 8. The EIMP experiments use a two-dimensional Mach 6 facility nozzle to provide the high-speed air simulating the combustor entrance flow of a scramjet engine. Of interest are the physical extent and the thermodynamic properties of the core flow at the nozzle exit plane. The detailed characterization of this flow is obtained from three-dimensional, viscous, Reynolds-averaged simulations. Thermodynamic nonequilibrium effects are also investigated. The simulations are compared with the available experimental data, which includes wall static pressures as well as in-stream static pressure, pitot pressure and total temperature obtained via in-stream probes positioned just downstream of the nozzle exit plane.

  10. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for

  11. Goddard Space Flight Center Spacecraft Magnetic Test Facility Restoration Project

    NASA Technical Reports Server (NTRS)

    Vernier, Robert; Bonalksy, Todd; Slavin, James

    2004-01-01

    The Goddard Space Flight Center Spacecraft Magnetic Test Facility (SMTF) was constructed in the 1960's for the purpose of simulating geomagnetic and interplanetary magnetic field environments. The facility includes a three axis Braunbek coil system consisting of 12 loops, 4 loops on each of the three orthogonal axes; a remote Earth field sensing magnetometer and servo controller; and a remote power control and instrumentation building. The inner coils of the Braunbek system are 42-foot in diameter with a 10-foot by 10-foot opening through the outer coils to accommodate spacecraft access into the test volume. The physical size and precision of the facility are matched by only two other such facilities in the world. The facility was used extensively from the late 1960's until the early 1990's when the requirement for spacecraft level testing diminished. New NASA missions planned under the Living with a Star, Solar Terrestrial Probes, Explorer, and New Millennium Programs include precision, high-resolution magnetometers to obtain magnetic field data that is critical to fulfilling their scientific mission. It is highly likely that future Lunar and Martian exploration missions will also use precision magnetometers to conduct geophysical magnetic surveys. To ensure the success of these missions, ground-testing using a magnetic test facility such as the GSFC SMTF will be required. This paper describes the history of the facility, the future mission requirements that have renewed the need for spacecraft level magnetic testing, and the plans for restoring the facility to be capable of performing to its original design specifications.

  12. Goddard Space Flight Center Spacecraft Magnetic Test Facility Restoration Project

    NASA Technical Reports Server (NTRS)

    Vernier, Robert; Bonalosky, Todd; Slavin, James

    2004-01-01

    The Goddard Space Flight Center Spacecraft Magnetic Test Facility (SMTF) was constructed in the 1960's for the purpose of simulating geomagnetic and interplanetary magnetic field environments. The facility includes a three axis Braunbek coil system consisting of 12 loops, 4 loops on each of the three orthogonal axes; a remote Earth field sensing magnetometer and servo controller; and a remote power control and instrumentation building. The inner coils of the Braunbek system are 42-foot in diameter with a 10-foot by 10-foot opening through the outer coils to accommodate spacecraft access into the test volume. The physical size and precision of the facility are matched by only two other such facilities in the world. The facility was used extensively from the late 1960's until the early 1990's when the requirement for spacecraft level testing diminished. New NASA missions planned under the Living with a Star, Solar Terrestrial Probes, Explorer, and New Millennium Programs include precision, high-resolution magnetometers to obtain magnetic field data that is critical to fulfilling their scientific mission. It is highly likely that future Lunar and Martian exploration missions will also use precision magnetometers to conduct geophysical magnetic surveys. To ensure the success of these missions, ground testing using a magnetic test facility such as the GSFC SMTF will be required. This paper describes the history of the facility, the future mission requirements that have renewed the need for spacecraft level magnetic testing, and the plans for restoring the facility to be capable of performing to its original design specifications.

  13. The AuScope Project and Trans-Tasman VLBI

    NASA Technical Reports Server (NTRS)

    Lovell, Jim; Dickey, John; Gulyaev, Sergei; Natusch, Tim; Titov, Oleg; Tingay, Steven

    2010-01-01

    Three 12-meter radio telescopes are being built in Australia (the AuScope project) and one in New Zealand. These facilities will be fully-equipped for undertaking S and X-band geodetic VLBI observations and correlation will take place on a software correlator (part of the AuScope project). All sites are equipped with permanent GPS receivers to provide co-location of several space geodetic techniques. The following scientific tasks of geodesy and astrometry are considered. 1. Improvement and densification of the International Celestial Reference Frame in the southern hemisphere; 2. Improvement of the International Terrestrial Reference Frame in the region; 3. Measurement of intraplate deformation of the Australian tectonic plate.

  14. Applicability of the 5S management method for quality improvement in health-care facilities: a review.

    PubMed

    Kanamori, Shogo; Shibanuma, Akira; Jimba, Masamine

    2016-01-01

    The 5S management method (where 5S stands for sort, set in order, shine, standardize, and sustain) was originally implemented by manufacturing enterprises in Japan. It was then introduced to the manufacturing sector in the West and eventually applied to the health sector for organizing and standardizing the workplace. 5S has recently received attention as a potential solution for improving government health-care services in low- and middle-income countries. We conducted a narrative literature review to explore its applicability to health-care facilities globally, with a focus on three aspects: (a) the context of its application, (b) its impacts, and (c) its adoption as part of government initiatives. To identify relevant research articles, we researched public health databases in English, including CINAHL, PubMed, ScienceDirect, and Web of Science. We found 15 of the 114 articles obtained from the search results to be relevant for full-text analysis of the context and impacts of the 5S application. To identify additional information particularly on its adoption as part of government initiatives, we also examined other types of resources including reference books, reports, didactic materials, government documents, and websites. The 15 empirical studies highlighted its application in primary health-care facilities and a wide range of hospital areas in Brazil, India, Jordan, Senegal, Sri Lanka, Tanzania, the UK, and the USA. The review also found that 5S was considered to be the starting point for health-care quality improvement. Ten studies presented its impacts on quality improvements; the changes resulting from the 5S application were classified into the three dimensions of safety, efficiency, and patient-centeredness. Furthermore, 5S was adopted as part of government quality improvement strategies in India, Senegal, Sri Lanka, and Tanzania. 5S could be applied to health-care facilities regardless of locations. It could be not only a tool for health workers and

  15. Kootenai River Wildlife Habitat Enhancement Project : Long-term Bighorn Sheep/Mule Deer Winter and Spring Habitat Improvement Project : Wildlife Mitigation Project, Libby Dam, Montana : Management Plan.

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

    Yde, Chis

    1990-06-01

    The Libby hydroelectric project, located on the Kootenai River in northwestern Montana, resulted in several impacts to the wildlife communities which occupied the habitats inundated by Lake Koocanusa. Montana Department of Fish, Wildlife and Parks, in cooperation with the other management agencies, developed an impact assessment and a wildlife and wildlife habitat mitigation plan for the Libby hydroelectric facility. In response to the mitigation plan, Bonneville Power Administration funded a cooperative project between the Kootenai National Forest and Montana Department of Fish, Wildlife and Parks to develop a long-term habitat enhancement plan for the bighorn sheep and mule deer wintermore » and spring ranges adjacent to Lake Koocanusa. The project goal is to rehabilitate 3372 acres of bighorn sheep and 16,321 acres of mule deer winter and spring ranges on Kootenai National Forest lands adjacent to Lake Koocanusa and to monitor and evaluate the effects of implementing this habitat enhancement work. 2 refs.« less

  16. Oak Grove Fork Habitat Improvement Project, 1988 Annual Report.

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

    Bettin, Scott

    The Lower Oak Grove Fork of the Clackamas River is a fifth-order tributary of the Clackamas River drainage supporting depressed runs of coho and chinook salmon, and summer and winter steelhead. Habitat condition rating for the Lower Oak Grove is good, but smelt production estimates are below the average for Clackamas River tributaries. Limiting factors in the 3.8 miles of the Lower Oak Grove supporting anadromous fish include an overall lack of quality spawning and rearing habitat. Beginning in 1986. measures to improve fish habitat in the Lower Oak Grove were developed in coordination with the Oregon Department of Fishmore » and Wildlife (ODF&W) and Portland General Electric (PGE) fisheries biologists. Prior to 1986, no measures had been applied to the stream to mitigate for PGE's storage and regulation of flows in the Oak Grove Fork (Timothy Lake, Harriet Lake). Catchable rainbow trout are stocked by ODF&W two or three times a year during the trout fishing season in the lowermost portion of the Oak Grove Fork near two Forest Service campgrounds (Ripplebrook and Rainbow). The 1987 field season marked the third year of efforts to improve fish habitat of the Lower Oak Grove Fork and restore anadromous fish production. The efforts included the development of an implementation plan for habitat improvement activities in the Lower Oak Grove Fork. post-project monitoring. and maintenance of the 1986 improvement structures. No new structures were constructed or placed in 1987. Fiscal year 1988 brought a multitude of changes which delayed implementation of plans developed in 1987. The most prominent change was the withdrawal of the proposed Spotted Owl Habitat Area (SOHA) which overlapped the Oak Grove project implementation area. Another was the change in the Forest Service biologist responsible for implementation and design of this project.« less

  17. RH-LLW Disposal Facility Project CD-2/3 to Design/Build Proposal Reconciliation Report

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

    Annette L. Schafer

    2012-06-01

    A reconciliation plan was developed and implemented to address potential gaps and responses to gaps between the design/build vendor proposals and the Critical Decision-2/3 approval request package for the Remote-Handled Low Level Waste Disposal Facility Project. The plan and results of the plan implementation included development of a reconciliation team comprised of subject matter experts from Battelle Energy Alliance and the Department of Energy Idaho Operations Office, identification of reconciliation questions, reconciliation by the team, identification of unresolved/remaining issues, and identification of follow-up actions and subsequent approvals of responses. The plan addressed the potential for gaps to exist in themore » following areas: • Department of Energy Order 435.1, “Radioactive Waste Management,” requirements, including the performance assessment, composite analysis, monitoring plan, performance assessment/composite analysis maintenance plan, and closure plan • Environmental assessment supporting the National Environmental Policy Act • Nuclear safety • Safeguards and security • Emplacement operations • Requirements for commissioning • General project implementation. The reconciliation plan and results of the plan implementation are provided in a business-sensitive project file. This report provides the reconciliation plan and non-business sensitive summary responses to identified gaps.« less

  18. Selecting Health Care Improvement Projects: A Methodology Integrating Cause-and-Effect Diagram and Analytical Hierarchy Process.

    PubMed

    Testik, Özlem Müge; Shaygan, Amir; Dasdemir, Erdi; Soydan, Guray

    It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making. The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided. The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs. The methodology is useful in cases where an aggregate decision based on experts' opinions is expected. Some suggestions for practical implementations are provided.

  19. Improving pedestrian facilities in congested urban areas: a case study of Chennai city

    NASA Astrophysics Data System (ADS)

    Subramanyam, B.; Prasanna Kumar, R.

    2017-07-01

    Traffic congestion and lack of public pedestrian space are some problems faced by most urban metropolises. Conventionally walking has been a mode of transportation in Indian cities. The percentage of pedestrians may vary from 16 to 57 depending upon the city. Encounters between vehicular traffic and pedestrian traffic are at its rise currently. Rapid industrialization and urbanization in India has resulted in neglecting of pedestrian facilities. Consequently pedestrian are at greater risk for their safety more especially in the commercial zones of large cities. A change in perspective spotlight will create a sense of awareness that the pedestrian traffic is also vital as the vehicular traffic. Soothing the traffic would moderately cut the driving expediency but the pedestrians will get a much safer and peaceful route to their terminuses. Safety and comfort are the two pans of a balance while considering the pedestrian traffic. Considering these aspects, this study deals a study in improving pedestrian facilities by analysing the existing skeleton of the selected locations. The adequacy of facility is checked based on IRC latest guidelines and counteractive measures are postulated.

  20. Preventing Stalled Quality Improvement Teams: A Written Test of Project Selectionability.

    ERIC Educational Resources Information Center

    Bacdayan, Paul

    2002-01-01

    Discusses organizations' use of quality improvement teams in total quality management and how they can benefit from training team personnel in how to select projects with a low risk of stalling. Describes an efficient written assessment test of project selection ability designed for those who conduct evaluations of training sessions. (Author/LRW)

  1. Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

    NASA Technical Reports Server (NTRS)

    Grinstead, Jay H.; Wilder, Michael C.; Porter, Barry J.; Brown, Jeffrey D.; Yeung, Dickson; Battazzo, Stephen J.; Brubaker, Timothy R.

    2016-01-01

    The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (LIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper will document the latest improvements of the LIF system design and demonstrations of the redeveloped AHF and IHF LIF systems.

  2. Projected Salt Waste Production from a Commercial Pyroprocessing Facility

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

    Simpson, Michael F.

    Pyroprocessing of used nuclear fuel inevitably produces salt waste from electrorefining and/or oxide reduction unit operations. Various process design characteristics can affect the actual mass of such waste produced. This paper examines both oxide and metal fuel treatment, estimates the amount of salt waste generated, and assesses potential benefit of process options to mitigate the generation of salt waste. For reference purposes, a facility is considered in which 100 MT/year of fuel is processed. Salt waste estimates range from 8 to 20 MT/year from considering numerous scenarios. It appears that some benefit may be derived from advanced processes for separatingmore » fission products from molten salt waste, but the degree of improvement is limited. Waste form production is also considered but appears to be economically unfavorable. Direct disposal of salt into a salt basin type repository is found to be the most promising with respect to minimizing the impact of waste generation on the economic feasibility and sustainability of pyroprocessing.« less

  3. Energy poverty in healthcare facilities: a "silent barrier" to improved healthcare in sub-Saharan Africa.

    PubMed

    Ouedraogo, Nadia S; Schimanski, Caroline

    2018-06-27

    This paper addresses an important topic, energy poverty in healthcare facilities. We try to provide an interesting perspective on bringing together two SDGs. The SDG 7, which seeks to ensure access to affordable, sustainable, and modern energy for all, is interlinked with Goal 3 on Health. The literature studies as well as data on the subject are sparse. Nevertheless, a systematic documentation of the levels and variation in access to energy at the health-facility level is important for designing effective policies to improve the quality of healthcare and the ultimate health of the population. Using the 2012-2013 Senegal Service Provision Assessment (SCSPA), we assessed energy access in health facilities and health systems' performance. Data were also geocoded using ArcGIS 10.3 to give a snapshot of the situation.

  4. Guidelines for Management Information Systems in Canadian Health Care Facilities

    PubMed Central

    Thompson, Larry E.

    1987-01-01

    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

  5. [Project to enhance bone bank tissue storage and distribution procedures].

    PubMed

    Huang, Jui-Chen; Wu, Chiung-Lan; Chen, Chun-Chuan; Chen, Shu-Hua

    2011-10-01

    Organ and tissue transplantation are now commonly preformed procedures. Improper organ bank handling procedures may increase infection risks. Execution accuracy in terms of tissue storage and distribution at our bone bank was 80%. We thus proposed an execution improvement project to enhance procedures in order to fulfill the intent of donors and ensure recipient safety. This project was designed to raise nurse professionalism, and ensure patient safety through enhanced tissue storage and distribution procedures. Education programs developed for this project focus on teaching standard operating procedures for bone and ligament storage and distribution, bone bank facility maintenance, trouble shooting and solutions, and periodic inspection systems. Cognition of proper storage and distribution procedures rose from 81% to 100%; Execution accuracy also rose from 80% to 100%. The project successfully conveyed concepts essential to the correct execution of organ storage and distribution procedures and proper organ bank facility management. Achieving and maintaining procedural and management standards is crucial to continued organ donations and the recipient safety.

  6. Special Project Grants Awarded for Improvement in Nurse Training. A Listing.

    ERIC Educational Resources Information Center

    National Institutes of Health (DHEW), Bethesda, MD. Div. of Nursing.

    This current directory lists alphabetically by state, special projects funded by the Title II Nurse Training Act of the Health Manpower Act of 1968, which are awarded for improvement programs in nurse training. Projects funded through June 1971 are listed and briefly annotated, including planning grants awarded for the first time during the fiscal…

  7. The Low Temperature Microgravity Physics Facility Project

    NASA Technical Reports Server (NTRS)

    Chui, T.; Holmes, W.; Lai, A.; Croonquist, A.; Eraker, J.; Abbott, R.; Mills, G.; Mohl, J.; Craig, J.; Balachandra, B.; hide

    2000-01-01

    We describe the design and development of the Low Temperature Microgravity Physics Facility, which is intended to provide a unique environment of low temperature and microgravity for the scientists to perform breakthrough investigations on board the International Space Station.

  8. Improvement of Project Portfolio Management in an Information Technology Consulting Company

    NASA Astrophysics Data System (ADS)

    Kaewta, S.; Chutima, P.

    2014-06-01

    The scope of this research is to improve the efficiency of multiple project management in an information technology consulting company through the adaptation of the project portfolio management technique. The project management information system (PMIS) is implemented to establish effective communication channels so that internal and external teams as well as all relevant stakeholders can be employed to negotiate their work schedules. In addition, all activities created by multiple teams can be systematically reviewed and combined into a single checklist to be used as an agreed working plan for all team members. A general guideline for project portfolio management in information technology consulting companies is also proposed, which could results in a higher level of project on-time delivery.

  9. Military Personnel: Enhanced Collaboration and Process Improvements Needed for Determining Military Treatment Facility Medical Personnel Requirements

    DTIC Science & Technology

    2010-07-01

    Department of Defense (DOD) are in great demand due to projected nationwide medical personnel shortages over the next decade and are essential to...for the first year, in order to assist the services in addressing near- term personnel shortages . It also provides a consistent staffing standard...dentists, medical service corps, and veterinarians , to name a few, at the work center level across Army fixed military treatment facilities. The model uses

  10. Projecting effects of improvements in passive safety of the New Zealand light vehicle fleet.

    PubMed

    Keall, Michael; Newstead, Stuart; Jones, Wayne

    2007-09-01

    In the year 2000, as part of the process for setting New Zealand road safety targets, a projection was made for a reduction in social cost of 15.5 percent associated with improvements in crashworthiness, which is a measure of the occupant protection of the light passenger vehicle fleet. Since that document was produced, new estimates of crashworthiness have become available, allowing for a more accurate projection. The objective of this paper is to describe a methodology for projecting changes in casualty rates associated with passive safety features and to apply this methodology to produce a new prediction. The shape of the age distribution of the New Zealand light passenger vehicle fleet was projected to 2010. Projected improvements in crashworthiness and associated reductions in social cost were also modeled based on historical trends. These projections of changes in the vehicle fleet age distribution and of improvements in crashworthiness together provided a basis for estimating the future performance of the fleet in terms of secondary safety. A large social cost reduction of about 22 percent for 2010 compared to the year 2000 was predicted due to the expected huge impact of improvements in passive vehicle features on road trauma in New Zealand. Countries experiencing improvements in their vehicle fleets can also expect significant reductions in road injury compared to a less crashworthy passenger fleet. Such road safety gains can be analyzed using some of the methodology described here.

  11. Statewide Publc Facilities section, Alaska Department of Transportation &

    Science.gov Websites

    &PF> Statewide Public Facilities Welcome to the Statewide Public Facilities Jack Hernandez Sport Fish Hatchery Anchorage Sport Fish Hatchery Statewide Public Facilities provides project management

  12. Constellation Training Facility Support

    NASA Technical Reports Server (NTRS)

    Flores, Jose M.

    2008-01-01

    The National Aeronautics and Space Administration is developing the next set of vehicles that will take men back to the moon under the Constellation Program. The Constellation Training Facility (CxTF) is a project in development that will be used to train astronauts, instructors, and flight controllers on the operation of Constellation Program vehicles. It will also be used for procedure verification and validation of flight software and console tools. The CxTF will have simulations for the Crew Exploration Vehicle (CEV), Crew Module (CM), CEV Service Module (SM), Launch Abort System (LAS), Spacecraft Adapter (SA), Crew Launch Vehicle (CLV), Pressurized Cargo Variant CM, Pressurized Cargo Variant SM, Cargo Launch Vehicle, Earth Departure Stage (EDS), and the Lunar Surface Access Module (LSAM). The Facility will consist of part-task and full-task trainers, each with a specific set of mission training capabilities. Part task trainers will be used for focused training on a single vehicle system or set of related systems. Full task trainers will be used for training on complete vehicles and all of its subsystems. Support was provided in both software development and project planning areas of the CxTF project. Simulation software was developed for the hydraulic system of the Thrust Vector Control (TVC) of the ARES I launch vehicle. The TVC system is in charge of the actuation of the nozzle gimbals for navigation control of the upper stage of the ARES I rocket. Also, software was developed using C standards to send and receive data to and from hand controllers to be used in CxTF cockpit simulations. The hand controllers provided movement in all six rotational and translational axes. Under Project Planning & Control, support was provided to the development and maintenance of integrated schedules for both the Constellation Training Facility and Missions Operations Facilities Division. These schedules maintain communication between projects in different levels. The Cx

  13. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2002-2003.

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

    Sears, Sheryl

    2004-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near themore » present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville

  14. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2001-2002.

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

    Sears, Sheryl

    2003-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near themore » present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville

  15. Evaluating projects for improving fish and wildlife habitat on National Forests.

    Treesearch

    Fred H. Everest; Daniel R. Talhelm

    1982-01-01

    Recent legislation (PL. 93-452; P.L. 94-588) has emphasized improvement of fish and wildlife habitat on lands of the National Forest System. A sequential procedure has been developed for screening potential projects to identify those producing the greatest fishery benefits. The procedure—which includes program planning, project planning, and intensive benefit/cost...

  16. Minnesota's Nursing Facility Performance-Based Incentive Payment Program: An Innovative Model for Promoting Care Quality

    ERIC Educational Resources Information Center

    Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa

    2010-01-01

    Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…

  17. Wii-Fit for Improving Gait and Balance in an Assisted Living Facility: A Pilot Study

    PubMed Central

    Padala, Kalpana P.; Padala, Prasad R.; Malloy, Timothy R.; Geske, Jenenne A.; Dubbert, Patricia M.; Dennis, Richard A.; Garner, Kimberly K.; Bopp, Melinda M.; Burke, William J.; Sullivan, Dennis H.

    2012-01-01

    Objectives. To determine the effects on balance and gait of a Wii-Fit program compared to a walking program in subjects with mild Alzheimer's dementia (AD). Methods. A prospective randomized (1 : 1) pilot study with two intervention arms was conducted in an assisted living facility with twenty-two mild AD subjects. In both groups the intervention occurred under supervision for 30 minutes daily, five times a week for eight weeks. Repeated measures ANOVA and paired t-tests were used to analyze changes. Results. Both groups showed improvement in Berg Balance Scale (BBS), Tinetti Test (TT) and Timed Up and Go (TUG) over 8 weeks. However, there was no statistically significant difference between the groups over time. Intragroup analysis in the Wii-Fit group showed significant improvement on BBS (P = 0.003), and TT (P = 0.013). The walking group showed a trend towards improvement on BBS (P = 0.06) and TUG (P = 0.07) and significant improvement in TT (P = 0.06). Conclusion. This pilot study demonstrates the safety and efficacy of Wii-Fit in an assisted living facility in subjects with mild AD. Use of Wii-Fit resulted in significant improvements in balance and gait comparable to those in the robust monitored walking program. These results need to be confirmed in a larger, methodologically sound study. PMID:22745909

  18. Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

    PubMed

    Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

    2008-12-01

    Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency

  19. Improvements Needed in Managing Scope Changes and Oversight of Construction Projects at Camp Lemonnier, Djibouti

    DTIC Science & Technology

    2016-09-30

    Improvements Needed in Managing Scope Changes and Oversight of Construction Projects at Camp Lemonnier, Djibouti S E P T E M B E R 3 0 , 2 0 1 6 Report...Improvements Needed in Managing Scope Changes and Oversight of Construction Projects at Camp Lemonnier, Djibouti Visit us at www.dodig.mil Objective We...Findings (cont’d) ii │ DODIG-2016-141 (Project No. D2014-D000RE-0157.000) Results in Brief Improvements Needed in Managing Scope Changes and Oversight

  20. Identify involved agencies addressing safety when freight centers are planned and developed : project summary.

    DOT National Transportation Integrated Search

    2017-01-01

    This project aimed to improve coordination and : cooperation among various entities in the : planning process for developing safer and more : efficient connections between intermodal : facilities and the highway network. Coordination : and cooperatio...

  1. Austin Energy: Pumping System Improvement Project Saves Energy and Improves Performance at a Power Plant

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

    Not Available

    2005-06-01

    This two-page performance spotlight describes how, in 2004, Austin Energy (the electric utility for the city of Austin, Texas) began saving about $1.2 million in energy and maintenance costs annually as a direct result of a pumping system efficiency project. The project was designed to improve the efficiency of the circulating water pumping system serving the utility's 405-MW steam turbine. A U.S. Department of Energy Qualified Pumping System Assessment Tool Specialist at Flowserve Corporation assisted in the initial assessment of the system.

  2. Concentrating Solar Power Projects - Parabolic Trough Projects |

    Science.gov Websites

    Project Godawari Solar Project Gujarat Solar One Gulang 100MW Thermal Oil Parabolic Trough project Guzmán Kuraymat (ISCC Kuraymat) Kathu Solar Park KaXu Solar One KVK Energy Solar Project La Africana La Dehesa La Power Facility Nevada Solar One (NSO) NOOR I NOOR II Olivenza 1 Orellana Palma del Río I Palma del Río

  3. Spent nuclear fuel project cold vacuum drying facility operations manual

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

    IRWIN, J.J.

    This document provides the Operations Manual for the Cold Vacuum Drying Facility (CVDF). The Manual was developed in conjunction with HNF-SD-SNF-SAR-002, Safety Analysis Report for the Cold Vacuum Drying Facility, Phase 2, Supporting Installation of Processing Systems (Garvin 1998) and, the HNF-SD-SNF-DRD-002, 1997, Cold Vacuum Drying Facility Design Requirements, Rev. 3a. The Operations Manual contains general descriptions of all the process, safety and facility systems in the CVDF, a general CVD operations sequence, and has been developed for the SNFP Operations Organization and shall be updated, expanded, and revised in accordance with future design, construction and startup phases of themore » CVDF until the CVDF final ORR is approved.« less

  4. Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

    PubMed

    Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

    2015-11-25

    The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase

  5. Current significant challenges in the decommissioning and environmental remediation of radioactive facilities: A perspective from outside the nuclear industry.

    PubMed

    Gil-Cerezo, V; Domínguez-Vilches, E; González-Barrios, A J

    2017-05-01

    This paper presents the results of implementing an extrajudicial environmental mediation procedure in the socioenvironmental conflict associated with routine operation of the El Cabril Disposal Facility for low- and medium- activity radioactive waste (Spain). We analyse the socio-ethical perspective of this facility's operation with regard to its nearby residents, detailing the structure and development of the environmental mediation procedure through the participation of society and interested parties who are or may become involved in such a conflict. The research, action, and participation method was used to apply the environmental mediation procedure. This experience provides lessons that could help improve decision-making processes in nuclear or radioactive facility decommissioning projects or in environmental remediation projects dealing with ageing facilities or with those in which nuclear or radioactive accidents/incidents may have occurred. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. A tool to aid the comparison of improvement projects for the Virginia Department of Transportation.

    DOT National Transportation Integrated Search

    1998-01-01

    The goal of this effort is to assist the Virginia Department of Transportation (VDOT) in improving the comparison in planning of potential primary and secondary roadway improvement projects. Historical projects that have been implemented or considere...

  7. African goat improvement project: A feed the future initiative harnessing geneticdiversity for conservation, disease resistance, and improved productivity

    USDA-ARS?s Scientific Manuscript database

    AFRICAN GOAT IMPROVEMENT PROJECT: A FEED THE FUTURE INITIATIVE HARNESSING GENETIC DIVERSITY FOR CONSERVATION, DISEASE RESISTANCE, AND IMPROVED PRODUCTIVITY Food production systems in Africa depend heavily on the use of locally adapted animals. These animals are of agricultural, cultural, and econom...

  8. 25 CFR 170.808 - Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can BIA Road Maintenance Program funds be used to improve... THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.808 Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities? No. BIA Road...

  9. Improving Initiation and Tracking of Research Projects at an Academic Health Center: A Case Study.

    PubMed

    Schmidt, Susanne; Goros, Martin; Parsons, Helen M; Saygin, Can; Wan, Hung-Da; Shireman, Paula K; Gelfond, Jonathan A L

    2017-09-01

    Research service cores at academic health centers are important in driving translational advancements. Specifically, biostatistics and research design units provide services and training in data analytics, biostatistics, and study design. However, the increasing demand and complexity of assigning appropriate personnel to time-sensitive projects strains existing resources, potentially decreasing productivity and increasing costs. Improving processes for project initiation, assigning appropriate personnel, and tracking time-sensitive projects can eliminate bottlenecks and utilize resources more efficiently. In this case study, we describe our application of lean six sigma principles to our biostatistics unit to establish a systematic continual process improvement cycle for intake, allocation, and tracking of research design and data analysis projects. The define, measure, analyze, improve, and control methodology was used to guide the process improvement. Our goal was to assess and improve the efficiency and effectiveness of operations by objectively measuring outcomes, automating processes, and reducing bottlenecks. As a result, we developed a web-based dashboard application to capture, track, categorize, streamline, and automate project flow. Our workflow system resulted in improved transparency, efficiency, and workload allocation. Using the dashboard application, we reduced the average study intake time from 18 to 6 days, a 66.7% reduction over 12 months (January to December 2015).

  10. Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

    PubMed

    Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

    2017-01-01

    Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries

  11. Surviving the storms: Emergency preparedness in Texas nursing facilities and assisted living facilities.

    PubMed

    Castro, Carmen; Persson, Diane; Bergstrom, Nancy; Cron, Stanley

    2008-08-01

    This study assesses the preparedness of long-term care facilities in Texas responding to Hurricanes Katrina and Rita. A 41-item questionnaire was mailed to facilities; the response rate was 42%. Among responding facilities, 4513 residents were evacuated, and 6% of respondents reported resident death. Financial losses were reported by 8% of nursing facilities and 45% of assisted living facilities due to transportation and staff overtime. Respondents indicated the need for improved disaster preparednesstraining, better coordination, and transportation. Changes in policy and practice will lead to better trained staff who will provide the care residents need for improved health outcomes during future public health disasters.

  12. Improving human papilloma virus vaccination rates throughout military treatment facilities.

    PubMed

    Dawson, Rachel; Lemmon, Keith; Trivedi, Nidhi J; Hansen, Shana

    2018-03-07

    The four objectives of this study were to (1) educate military healthcare providers on HPV disease and vaccine, (2) assess short term recall of information presented at educational sessions, (3) assess provider comfort level with the vaccine, and (4) assess improvement in HPV vaccination rates. Standardized interactive educational sessions were conducted at military primary care clinics with pre- and post-educational quizzes administered before and immediately following the sessions. Provider attitudes were assessed using Likert scale questionnaires. Vaccination rates in children and young adolescents ages 11-18 at one of the participating regions that had a champion and started a Quality Improvement (QI) project were assessed at baseline, at 3-months and at 6-months post sessions. 200 providers were reached at 48 primary care clinics during May 2014 through October 2015 with 200 quizzes and Likert scale questionnaires returned. There was increase in knowledge following the educational sessions as revealed in the pre- and post- test scores [t(57) = -5.04, p < 0.001]. There was a significant overall increase in comfort in answering patients' and parents' questions about HPV vaccine [p = 0.003]. There was a significant increase in the number of vaccines given at all the clinics 3-months after the educational sessions at the region who had a champion dedicated to monitoring vaccine rates and ensuring implementation efforts [p = 0.01] and started a QI project. This increase was not sustained at 6-months [p = 0.324]. Improvement in provider short term knowledge recall and comfort level in answering parents' questions was seen. We found that educational sessions can improve HPV vaccination rates in military clinics that have a vaccine champion for up to 3-months. Further research into the effects of having clinic vaccine champions is critical. Copyright © 2018. Published by Elsevier Ltd.

  13. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000-2011.

    PubMed

    Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

    2016-01-01

    Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9-2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8-60.0). More efforts are required to increase household access to

  14. Fund for the Improvement of Postsecondary Education Project Descriptions.

    ERIC Educational Resources Information Center

    Fund for the Improvement of Postsecondary Education (ED), Washington, DC.

    Descriptions of 155 programs supported by the Fund for the Improvement of Postsecondary Education are provided. In addition to a brief statement of the scope of each program, the project director, address, and phone number are identified. Topics addressed by the programs include: ensuring adequate math preparation for college work through…

  15. Project A+: School Based Improvement in AISD, 1991-92.

    ERIC Educational Resources Information Center

    Austin Independent School District, TX. Office of Research and Evaluation.

    Outcomes of Project A+, a school-based improvement (SBI) partnership developed between International Business Machines (IBM) and the Austin Independent School District, are described in this document. SBI is a vehicle for restructuring schools to meet the goal that all students will function successfully at or beyond their appropriate grade…

  16. Environmental Assessment (EA): Proposed Software Facilities, Hill Air Force Base, Utah

    DTIC Science & Technology

    2011-04-19

    retention facilities ; • connections to adjacent buried utilities consisting of water, electricity, natural gas, telephone/ data , sanitary sewer, and storm...engineering, development, and testing workloads for F-22 and F-35 aircraft. Military construction (MILCON) project data explain existing facilities ...Existing Facilities MILCON project data state there are no facilities on Hill AFB with adequate security to house the specialized laboratory space or

  17. FY11 Facility Assessment Study for Aeronautics Test Program

    NASA Technical Reports Server (NTRS)

    Loboda, John A.; Sydnor, George H.

    2013-01-01

    This paper presents the approach and results for the Aeronautics Test Program (ATP) FY11 Facility Assessment Project. ATP commissioned assessments in FY07 and FY11 to aid in the understanding of the current condition and reliability of its facilities and their ability to meet current and future (five year horizon) test requirements. The principle output of the assessment was a database of facility unique, prioritized investments projects with budgetary cost estimates. This database was also used to identify trends for the condition of facility systems.

  18. OIL AND GAS FACILITY EMERGENCY AWARENESS PARTNERSHIP

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

    Tod Bryant

    2002-08-31

    as part of the program. (3) Once the publication and the training program are developed, a video that will be used as an introduction to the actual training class, as a refresher for the class, or in a ''train-the-trainer'' program will be produced. In addition to the above-noted three steps, optional projects were considered by the pilot program states. Two optional projects were considered by the states: (1) Working with the local, regional or state firefighters, a training facility would be created using oil and gas equipment. This part of the project will require cooperation between firefighters and industry, and will assist especially the emergency responders in learning more about oil and gas equipment. (2) Also under consideration was a related web site that would include the location of all oil and gas wells and accessible only by password. The overall ''Oil and Gas Facility Emergency Awareness Program'' has many benefits, some of which are: The process will provide opportunity for key industry leaders to develop relationships with local emergency management agencies. Industry personnel will be able to better understand emergency planning, and emergency personnel will better understand industry operations. Health, safety and environment will be better protected because of training. Better risk management will improve the operating climate for independent oil and gas producers. The ''Oil and Gas Facility Emergency Awareness Program'' benefits the emergency response teams, oil and gas facility owners and operators, state and federal regulators, the environment, and most especially the citizens. All groups must work together for the health, safety and protection of the community and the environment.« less

  19. A critical care network pressure ulcer prevention quality improvement project.

    PubMed

    McBride, Joanna; Richardson, Annette

    2015-03-30

    Pressure ulcer prevention is an important safety issue, often underrated and an extremely painful event harming patients. Critically ill patients are one of the highest risk groups in hospital. The impact of pressure ulcers are wide ranging, and they can result in increased critical care and the hospital length of stay, significant interference with functional recovery and rehabilitation and increase cost. This quality improvement project had four aims: (1) to establish a critical care network pressure ulcer prevention group; (2) to establish baseline pressure ulcer prevention practices; (3) to measure, compare and monitor pressure ulcers prevalence; (4) to develop network pressure ulcer prevention standards. The approach used to improve quality included strong critical care nursing leadership to develop a cross-organisational pressure ulcer prevention group and a benchmarking exercise of current practices across a well-established critical care Network in the North of England. The National Safety Thermometer tool was used to measure pressure ulcer prevalence in 23 critical care units, and best available evidence, local consensus and another Critical Care Networks' bundle of interventions were used to develop a local pressure ulcer prevention standards document. The aims of the quality improvement project were achieved. This project was driven by successful leadership and had an agreed common goal. The National Safety Thermometer tool was an innovative approach to measure and compare pressure ulcer prevalence rates at a regional level. A limitation was the exclusion of moisture lesions. The project showed excellent engagement and collaborate working in the quest to prevent pressure ulcers from many critical care nurses with the North of England Critical Care Network. A concise set of Network standards was developed for use in conjunction with local guidelines to enhance pressure ulcer prevention. © 2015 British Association of Critical Care Nurses.

  20. Innovative tools and techniques in identifying highway safety improvement projects : technical report.

    DOT National Transportation Integrated Search

    2017-08-01

    The Highway Safety Improvement Program (HSIP) aims to achieve a reduction in the number and severity of fatalities and serious injury crashes on all public roads by implementing highway safety improvement projects. Although the structure and main com...

  1. An Evaluation: Improvement of Teaching English as a Second Language.

    ERIC Educational Resources Information Center

    New York Univ., NY. Center for Field Research and School Services.

    The primary objective of the project for Improving the Teaching of English as a Second Language in the High Schools was to improve the facility of English-language-handicapped students in the four language skills (listening, speaking, reading, and writing) so that they can make a proper adjustment to high school. Most of the students are from…

  2. Novel and Improved Nanomaterials, Chemistries and Apparatus for Nanobiotechnology: the NACBO project.

    PubMed

    Bruce, Ian James

    2011-02-01

    This article outlines the nature and activities of the recently completed EU Framework Programme 6 Integrated Project, Novel and Improved Nanomaterials, Chemistries and Apparatus for Nanobiotechnology (NACBO). This project was designed to yield new nanomaterials, surface activation and synthetic nucleic acid chemistries, procedures and hardware for applications in forensics and diagnostics. It provides details on the project's structure and partnership along with its principal objectives and successes in terms of publications and commercial exploitation.

  3. 76 FR 18581 - Correction; Central Valley Project Improvement Act, Standard Criteria for Agricultural and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Correction; Central Valley Project Improvement Act, Standard Criteria for Agricultural and Urban Water Management Plans AGENCY: Bureau of Reclamation... notice in the Federal Register at 76 FR 16818 on the Central Valley Project Improvement Act Standard...

  4. 75 FR 23843 - Discretionary Bus and Bus Facilities Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... transit facilities and equipment. d. For facilities, evidence of proposed project compliance with ``Green Building'' certification. 3. For transit asset management system projects: If asset management system...-New York, Administrator, Region 7-Kansas One Bowling Green, Room 429, New City, MO, 901 Locust Street...

  5. Improved Cryogenic Optical Test Capability at Marshall Space Flight Center's X-ray Cryogenic Test Facility

    NASA Technical Reports Server (NTRS)

    Kegley, Jeffrey; Haight, Harlan; Hogue, William; Carpenter, Jay; Siler, Richard; Wright, Ernie; Eng, Ron; Baker, Mark; McCracken, Jeff

    2005-01-01

    Marshall Space Flight Center's X-ray & Cryogenic Test Facility (XRCF) has been performing optical wavefront testing and thermal structural deformation testing at subliquid nitrogen cryogenic temperatures since 1999. Recent modifications have been made to the facility in support of the James Webb Space Telescope (JWST) program. The test article envelope and the chamber's refrigeration capacity have both been increased. A new larger helium-cooled enclosure has been added to the existing enclosure increasing both the cross-sectional area and the length. This new enclosure is capable of supporting six JWST Primary Mirror Segment Assemblies. A second helium refrigeration system has been installed essentially doubling the cooling capacity available at the facility. Modifications have also been made to the optical instrumentation area. Improved access is now available for both the installation and operation of optical instrumentation outside the vacuum chamber. Chamber configuration, specifications, and performance data will be presented.

  6. Multiple R&D projects scheduling optimization with improved particle swarm algorithm.

    PubMed

    Liu, Mengqi; Shan, Miyuan; Wu, Juan

    2014-01-01

    For most enterprises, in order to win the initiative in the fierce competition of market, a key step is to improve their R&D ability to meet the various demands of customers more timely and less costly. This paper discusses the features of multiple R&D environments in large make-to-order enterprises under constrained human resource and budget, and puts forward a multi-project scheduling model during a certain period. Furthermore, we make some improvements to existed particle swarm algorithm and apply the one developed here to the resource-constrained multi-project scheduling model for a simulation experiment. Simultaneously, the feasibility of model and the validity of algorithm are proved in the experiment.

  7. Redesigning the care of fragility fracture patients to improve osteoporosis management: a health care improvement project.

    PubMed

    Harrington, J Timothy; Barash, Harvey L; Day, Sherry; Lease, Joellen

    2005-04-15

    To develop new processes that assure more reliable, population-based care of fragility fracture patients. A 4-year clinical improvement project was performed in a multispecialty, community practice health system using evidence-based guidelines and rapid cycle process improvement methods (plan-do-study-act cycles). Prior to this project, appropriate osteoporosis care was provided to only 5% of our 1999 hip fracture patients. In 2001, primary physicians were provided prompts about appropriate care (cycle 1), which resulted in improved care for only 20% of patients. A process improvement pilot in 2002 (cycle 2) and full program implementation in 2003 (cycle 3) have assured osteoporosis care for all willing and able patients with any fragility fracture. Altogether, 58% of 2003 fragility fracture patients, including 46% of those with hip fracture, have had a bone measurement, have been assigned to osteoporosis care with their primary physician or a consultant, and are being monitored regularly. Only 19% refused osteoporosis care. Key process improvements have included using orthopedic billings to identify patients, referring patients directly from orthopedics to an osteoporosis care program, organizing care with a nurse manager and process management computer software, assigning patients to primary or consultative physician care based on disease severity, and monitoring adherence to therapy by telephone. Reliable osteoporosis care is achievable by redesigning clinical processes. Performance data motivate physicians to reconsider traditional approaches. Improving the care of osteoporosis and other chronic diseases requires coordinated care across specialty boundaries and health system support.

  8. EERC pilot-scale CFBC evaluation facility Project CFB test results. Topical report, Task 7.30

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

    Mann, M.D.; Hajicek, D.R.; Henderson, A.K.

    Project CFB was initiated at the University of North Dakota Energy and Environmental Research Center (EERC) in May 1988. Specific goals of the project were to (1) construct a circulating fluidized-bed combustor (CFBC) facility representative of the major boiler vendors` designs with the capability of producing scalable data, (2) develop a database for use in making future evaluations of CFBC technology, and (3) provide a facility for evaluating fuels, free of vendor bias for use in the - energy industry. Five coals were test-burned in the 1-MWth unit: North Dakota and Asian lignites, a Wyoming subbituminous, and Colorado and Pennsylvaniamore » bituminous coats. A total of 54 steady-state test periods were conducted, with the key test parameters being the average combustor temperature, excess air, superficial gas velocity, calcium-to-sulfur molar ratio, and the primary air-to-secondary air split. The capture for a coal fired in a CFBC is primarily dependent upon the total alkali-to-sulfur ratio. The required alkali-to ratio for 90% sulfur retention ranged from 1.4 to 4.9, depending upon coal type. While an alkali-to-ratio of 4.9 was required to meet 90% sulfur retention for the Salt Creek coal versus 1.4 for the Asian lignite, the total amount of sorbent addition required is much less for the Salt Creek coal, 4.2 pound sorbent per million Btu coal input, versus 62 pound/million Btu for the Asian lignite. The bituminous coals tested show optimal capture at combustor temperatures of approximately 1550{degree}F, with low-rank coals having optimal sulfur capture approximately 100{degree}F lower.« less

  9. 'Take Ten' improving the surgical post-take ward round: a quality improvement project.

    PubMed

    Banfield, Danielle Alice; Adamson, Carly; Tomsett, Amy; Povey, James; Fordham, Tony; Richards, Sarah Kathryn

    2018-01-01

    The surgical post-take ward round is a complex multidisciplinary interaction in which new surgical patients are reviewed and management plans formulated. Its fast-paced nature can lead to poor communication and inaccurate or incomplete documentation with potential detriment to patient safety. Junior team members often do not fully understand the diagnosis and management plan. The aims of this project were to improve both communication and documentation on the surgical post-take ward round, influencing patient safety. The ward round was deconstructed to identify individual roles and determine where intervention would have the most impact. Ten important points were identified that should be documented in the management of an acute surgical patient; observations, examination, impression, investigations, antibiotics, intravenous fluids, VTE assessment, nutrition status, estimated length of stay and ceiling of treatment. A 'Take Ten' checklist was devised with these items to be used as a 'time out' after each patient with the whole team for discussion, clarification and clear documentation. Four plan do study act cycles were completed over a period of a year. A retrospective review of post-take documentation preintervention and postintervention was performed, and the percentage of points that were accurately documented was calculated. For further clarification, 2 weekends were compared-one where the checklist was used and one where it was not. Results showed documentation postintervention varied between categories but there was improvement in documentation of VTE assessment, fluids, observations and investigations. On direct comparison of weekends the checklist showed improved documentation in all categories except length of stay. Junior team members found the checklist improved understanding of diagnosis and management plan, and encouraged a more effective ward round. The 'Take Ten' checklist has been well received. Three years on from its inception, the checklist

  10. Risk Management Technique for design and operation of facilities and equipment

    NASA Technical Reports Server (NTRS)

    Fedor, O. H.; Parsons, W. N.; Coutinho, J. De S.

    1975-01-01

    The Risk Management System collects information from engineering, operating, and management personnel to identify potentially hazardous conditions. This information is used in risk analysis, problem resolution, and contingency planning. The resulting hazard accountability system enables management to monitor all identified hazards. Data from this system are examined in project reviews so that management can decide to eliminate or accept these risks. This technique is particularly effective in improving the management of risks in large, complex, high-energy facilities. These improvements are needed for increased cooperation among industry, regulatory agencies, and the public.

  11. Discharge documentation of patients discharged to subacute facilities: a three-year quality improvement process across an integrated health care system.

    PubMed

    Gandara, Esteban; Ungar, Jonathan; Lee, Jason; Chan-Macrae, Myrna; O'Malley, Terrence; Schnipper, Jeffrey L

    2010-06-01

    Effective communication among physicians during hospital discharge is critical to patient care. Partners Healthcare (Boston) has been engaged in a multi-year process to measure and improve the quality of documentation of all patients discharged from its five acute care hospitals to subacute facilities. Partners first engaged stakeholders to develop a consensus set of 12 required data elements for all discharges to subacute facilities. A measurement process was established and later refined. Quality improvement interventions were then initiated to address measured deficiencies and included education of physicians and nurses, improvements in information technology, creation of or improvements in discharge documentation templates, training of hospitalists to serve as role models, feedback to physicians and their service chiefs regarding reviewed cases, and case manager review of documentation before discharge. To measure improvement in quality as a result of these efforts, rates of simultaneous inclusion of all 12 applicable data elements ("defect-free rate") were analyzed over time. Some 3,101 discharge documentation packets of patients discharged to subacute facilities from January 1, 2006, through September 2008 were retrospectively studied. During the 11 monitored quarters, the defect-free rate increased from 65% to 96% (p < .001 for trend). The largest improvements were seen in documentation of preadmission medication lists, allergies, follow-up, and warfarin information. Institution of rigorous measurement, feedback, and multidisciplinary, multimodal quality improvement processes improved the inclusion of data elements in discharge documentation required for safe hospital discharge across a large integrated health care system.

  12. The National Ignition Facility and Industry

    NASA Astrophysics Data System (ADS)

    Harri, J. G.; Paisner, J. A.; Lowdermilk, W. H.; Boyes, J. D.; Kumpan, S. A.; Sorem, M. S.

    1994-09-01

    The mission of the National Ignition Facility is to achieve ignition and gain in inertial confinement fusion targets in the laboratory. The facility will be used for defense applications such as weapons physics and weapons effects testing, and for civilian applications such as fusion energy development and fundamental studies of matter at high temperatures and densities. The National Ignition Facility construction project will require the best of our construction industries and its success will depend on the best products offered by hundreds of the nation's high technology companies. Three-fourths of the construction costs will be invested in industry. This article reviews the design, cost and schedule, and required industrial involvement associated with the construction project.

  13. Project definition study for the National Biomedical Tracer Facility

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

    Roozen, K.

    The University of Alabama at Birmingham (UAB) has conducted a study of the proposed National Biomedical Tracer Facility (NBTF). In collaboration with General Atomics, RUST International, Coleman Research Corporation (CRC), IsoMed, Ernst and Young and the advisory committees, they have examined the issues relevant to the NBTF in terms of facility design, operating philosophy, and a business plan. They have utilized resources within UAB, CRC and Chem-Nuclear to develop recommendations on environmental, safety and health issues. The Institute of Medicine Panel`s Report on Isotopes for Medicine and the Life Sciences took the results of prior workshops further in developing recommendationsmore » for the mission of the NBTF. The IOM panel recommends that the NBTF accelerator have the capacity to accelerate protons to 80 MeV and a minimum of 750 microamperes of current. The panel declined to recommend a cyclotron or a linac. They emphasized a clear focus on research and development for isotope production including target design, separation chemistry and generator development. The facility needs to emphasize education and training in its mission. The facility must focus on radionuclide production for the research and clinical communities. The formation of a public-private partnership resembling the TRIUMF-Nordion model was encouraged. An advisory panel should assist with the NBTF operations and prioritization.« less

  14. Improved pupil dilation with medication-soaked pledget sponges.

    PubMed

    Weddle, Celeste; Thomas, Nikki; Dienemann, Jacqueline

    2013-08-01

    Use of multiple preoperative drops for pupil dilation has been shown to be inexact, to delay surgery, and to cause dissatisfaction among perioperative personnel. This article reports on an evidence-based, quality improvement project to locate and appraise research on improved effectiveness and efficiency of mydriasis (ie, pupillary dilation), and the subsequent implementation of a pledget-sponge procedure for pupil dilation at one ambulatory surgery center. Project leaders used an evidence-based practice model to assess the problem, research options for improvement, define goals, and implement a pilot project to test the new dilation technique. Outcomes from the pilot project showed a reduced number of delays caused by poor pupil dilation and a decrease in procedure turnover time. The project team solicited informal feedback from preoperative nurses, which reflected increased satisfaction in preparing patients for cataract procedures. After facility administrators and surgeons accepted the procedure change, it was adopted for preoperative use for all patients undergoing cataract surgery at the ambulatory surgery center. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  15. Alaska road weather project : technical performance assessment report Fairbanks field demonstration 2013-2014.

    DOT National Transportation Integrated Search

    2014-02-01

    The Alaska Department of Transportation and Public Facilities began implementation of a Maintenance Decision Support System in an : effort to improve snow and ice control in the Fairbanks area. As part of the project the reliability of the weather fo...

  16. Quality Assurance Project Plan for Closure of the Central Facilities Area Sewage Treatment Plant Lagoon 3 and Land Application Area

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

    Lewis, Michael G.

    This quality assurance project plan describes the technical requirements and quality assurance activities of the environmental data collection/analyses operations to close Central Facilities Area Sewage treatment Plant Lagoon 3 and the land application area. It describes the organization and persons involved, the data quality objectives, the analytical procedures, and the specific quality control measures to be employed. All quality assurance project plan activities are implemented to determine whether the results of the sampling and monitoring performed are of the right type, quantity, and quality to satisfy the requirements for closing Lagoon 3 and the land application area.

  17. Summary Report for the C50 Cryomodule Project

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

    Drury, Michael; Davis, G; Fischer, John

    2011-03-01

    The Thomas Jefferson National Accelerator Facility has recently completed the C50 cryomodule refurbishment project. The goal of this project was to enable robust 6 GeV, 5 pass operation of the Continuous Electron Beam Accelerator Facility (CEBAF). The scope of the project included removal, refurbishment and reinstallation of ten CEBAF cryomodules at a rate of three per year. The refurbishment process included reprocessing of SRF cavities to eliminate field emission and to increase the nominal gradient from the original 5 MV/m to 12.5 MV/m. New 'dogleg' couplers were installed between the cavity and helium vessel flanges to intercept secondary electrons thatmore » produce arcing in the fundamental Power Coupler (FPC). Other changes included new ceramic RF windows for the air to vacuum interface of the FPC and improvements to the mechanical tuner. Damaged or worn components were replaced as well. All ten of the refurbished cryomodules are now installed in CEBAF and are currently operational. This paper will summarize the performance of the cryomodules.« less

  18. Construction Cost Growth for New Department of Energy Nuclear Facilities

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

    Kubic, Jr., William L.

    Cost growth and construction delays are problems that plague many large construction projects including the construction of new Department of Energy (DOE) nuclear facilities. A study was conducted to evaluate cost growth of large DOE construction projects. The purpose of the study was to compile relevant data, consider the possible causes of cost growth, and recommend measures that could be used to avoid extreme cost growth in the future. Both large DOE and non-DOE construction projects were considered in this study. With the exception of Chemical and Metallurgical Research Building Replacement Project (CMRR) and the Mixed Oxide Fuel Fabrication Facilitymore » (MFFF), cost growth for DOE Nuclear facilities is comparable to the growth experienced in other mega construction projects. The largest increase in estimated cost was found to occur between early cost estimates and establishing the project baseline during detailed design. Once the project baseline was established, cost growth for DOE nuclear facilities was modest compared to non-DOE mega projects.« less

  19. [Healthcare manager and project management of quality improvement : analysis of managerial action using a professional hands-on training in project management].

    PubMed

    Dujardin, Pierre-Philippe; Reverdy, Thomas; Valette, Annick; François, Patrice

    2016-06-01

    Introduction : project management is on the expected proficiencies for head nurses. Context : The work on the organizations’ improvement carried out by head nurses, is rarely covered in the literature. Objectives : to follow the implementation of actions from projects led by head nurses and to analyze the parameters of success. Method : for a year, an intervention study has followed 17 projects initiating improvement measures. Semistructured interviews were conducted with health-care teams and managers. All of them reported the results of the implementation of each measure as an operational improvement. A mixed analysis containing a logistic regression investigated associations between the result of the action and the various contextual characteristics. Results : this study involved 111 actions. 71 % of them concluded an operational improvement. The organizational and supporting actions had a high success rate, which decreased when hazards were not managed by healthcare managers. Discussion : this study highlights the place of strategies through the implementing methods and the chosen actions. Recommendations are made in order to promote a collective assessment. Conclusion : scientific approaches are proposed to discuss the organizational work.

  20. Project management; considerations for success.

    PubMed

    Maas, Jos

    2013-01-01

    During the past two years the author was a project leader for three Information Communication Technology (ICT) security related systems projects for a newly built healthcare facility. These projects were: a CCTV system, an Access Control system and an Identity & Access Management system. During those two years he gained experiences on how to coop with ICT projects related to security and healthcare as well as some pitfalls to be contended with along the way. With this article, he shares his experiences so that colleagues can benefit from them when they are a project leaders for their health facility and need to better decide how or how not to address their project and project issues.

  1. Identification of Management and Personnel Responsibility to Provide and Accept Opportunities for Improvement Thru Vocational and Educational Programs. Evaluation of PROJECT IMPROVE.

    ERIC Educational Resources Information Center

    Coast Guard, Washington, DC. Office of Personnel.

    Project Improve, the new title for the Coast Guard Aircraft Repair and Supply Center (AR&SC) Testing and Counseling Program in Elizabeth City, N.C., expresses the idea of this study: to assist all employees in gaining better understanding of their full potential and their training needs. The results of Project Improve are listed in tables…

  2. Solar project cost report for Ingham County, Medical Care Facility, Okemos, Michigan

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

    Not Available

    The solar energy system supplies service hot water for a 204 bed medical and geriatric care facility with laundry and kitchen. The system was designed at the time the building was designed. The 9,374 ft/sup 2/ of collectors were manufactured by Revere Copper and Brass, Inc., and are mounted at grade level behind the building. Solar heated water for use in heating service water is stored in a 5000 gallon hot water storage tank. The heaviest use of hot water occurs during the day so the requirement for thermal storage is modest. The construction costs of this solar project aremore » presented. Category costs are listed by materials, direct labor, ad subcontract costs. The subcontract costs include both materials, labor, overhead and profit for electrical, control and other minor subcontractors. The installed cost of the system was $312,825 not including prime contractor overhead and profit and general and administrative costs. (MHR)« less

  3. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

    PubMed Central

    Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

    2016-01-01

    Background Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. Results There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9–2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8–60.0). Conclusions More

  4. Methodologies for Improving Flight Project Information Capture, Storage, and Dissemination

    NASA Technical Reports Server (NTRS)

    Equils, Douglas J.

    2011-01-01

    This paper will discuss the drawbacks and risks of the current documentation paradigm, how Document QuickStart improves on that process and ultimately how this stream-lined approach will reduce risk and costs to the next generation of Flight Projects at JPL

  5. Improving Exclusive Breastfeeding in an Urban Academic Hospital.

    PubMed

    Ward, Laura P; Williamson, Susan; Burke, Stephanie; Crawford-Hemphill, Ruby; Thompson, Amy M

    2017-02-01

    Breastfeeding has many well-established health benefits for infants and mothers. There is greater risk reduction in health outcomes with exclusive breastfeeding (EBF). Our urban academic facility has had long-standing low EBF rates, serving a population with breastfeeding disparities. We sought to improve EBF rates through a Learning Collaborative model by participating in the Best Fed Beginnings project. Formal improvement science methods were used, including the development of a key driver diagram and plan-do-study-act cycles. Improvement activities followed the Ten Steps to Successful Breastfeeding. We demonstrated significant improvement in the median adherence to 2 process measures, rooming in and skin-to-skin after delivery. Subsequently, the proportion of infants exclusively breastfed at hospital discharge in our facility increased from 37% to 59%. We demonstrated an increase in sustained breastfeeding in a subset of patients at a postpartum follow-up visit. These improvements led to Baby-Friendly designation at our facility. This quality improvement initiative resulted in a higher number of infants exclusively breastfed in our patient population at "high risk not to breastfeed." Other hospitals can use these described methods and techniques to improve their EBF rates. Copyright © 2017 by the American Academy of Pediatrics.

  6. EMPRESS: A European Project to Enhance Process Control Through Improved Temperature Measurement

    NASA Astrophysics Data System (ADS)

    Pearce, J. V.; Edler, F.; Elliott, C. J.; Rosso, L.; Sutton, G.; Andreu, A.; Machin, G.

    2017-08-01

    A new European project called EMPRESS, funded by the EURAMET program `European Metrology Program for Innovation and Research,' is described. The 3 year project, which started in the summer of 2015, is intended to substantially augment the efficiency of high-value manufacturing processes by improving temperature measurement techniques at the point of use. The project consortium has 18 partners and 5 external collaborators, from the metrology sector, high-value manufacturing, sensor manufacturing, and academia. Accurate control of temperature is key to ensuring process efficiency and product consistency and is often not achieved to the level required for modern processes. Enhanced efficiency of processes may take several forms including reduced product rejection/waste; improved energy efficiency; increased intervals between sensor recalibration/maintenance; and increased sensor reliability, i.e., reduced amount of operator intervention. Traceability of temperature measurements to the International Temperature Scale of 1990 (ITS-90) is a critical factor in establishing low measurement uncertainty and reproducible, consistent process control. Introducing such traceability in situ (i.e., within the industrial process) is a theme running through this project.

  7. Reconstruction of 3d Objects of Assets and Facilities by Using Benchmark Points

    NASA Astrophysics Data System (ADS)

    Baig, S. U.; Rahman, A. A.

    2013-08-01

    Acquiring and modeling 3D geo-data of building assets and facility objects is one of the challenges. A number of methods and technologies are being utilized for this purpose. Total station, GPS, photogrammetric and terrestrial laser scanning are few of these technologies. In this paper, points commonly shared by potential facades of assets and facilities modeled from point clouds are identified. These points are useful for modeling process to reconstruct 3D models of assets and facilities stored to be used for management purposes. These models are segmented through different planes to produce accurate 2D plans. This novel method improves the efficiency and quality of construction of models of assets and facilities with the aim utilize in 3D management projects such as maintenance of buildings or group of items that need to be replaced, or renovated for new services.

  8. How to implement security controls for an information security program at CBRN facilities

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

    Lenaeus, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.

    This document was prepared by PNNL within the framework of Project 19 of the European Union Chemical Biological Radiological and Nuclear Risk Mitigation Centres of Excellence Initiative entitled, ''Development of procedures and guidelines to create and improve secure information management systems and data exchange mechanisms for CBRN materials under regulatory control.'' It provides management and workers at CBRN facilities, parent organization managers responsible for those facilities, and regulatory agencies (governmental and nongovernmental) with guidance on the best practices for protecting information security. The security mitigation approaches presented in this document were chosen because they present generally accepted guidance in anmore » easy-to-understand manner, making it easier for facility personnel to grasp key concepts and envision how security controls could be implemented by the facility. This guidance is presented from a risk management perspective.« less

  9. The Revolutionary Vertical Lift Technology (RVLT) Project

    NASA Technical Reports Server (NTRS)

    Yamauchi, Gloria K.

    2018-01-01

    The Revolutionary Vertical Lift Technology (RVLT) Project is one of six projects in the Advanced Air Vehicles Program (AAVP) of the NASA Aeronautics Research Mission Directorate. The overarching goal of the RVLT Project is to develop and validate tools, technologies, and concepts to overcome key barriers for vertical lift vehicles. The project vision is to enable the next generation of vertical lift vehicles with aggressive goals for efficiency, noise, and emissions, to expand current capabilities and develop new commercial markets. The RVLT Project invests in technologies that support conventional, non-conventional, and emerging vertical-lift aircraft in the very light to heavy vehicle classes. Research areas include acoustic, aeromechanics, drive systems, engines, icing, hybrid-electric systems, impact dynamics, experimental techniques, computational methods, and conceptual design. The project research is executed at NASA Ames, Glenn, and Langley Research Centers; the research extensively leverages partnerships with the US Army, the Federal Aviation Administration, industry, and academia. The primary facilities used by the project for testing of vertical-lift technologies include the 14- by 22-Ft Wind Tunnel, Icing Research Tunnel, National Full-Scale Aerodynamics Complex, 7- by 10-Ft Wind Tunnel, Rotor Test Cell, Landing and Impact Research facility, Compressor Test Facility, Drive System Test Facilities, Transonic Turbine Blade Cascade Facility, Vertical Motion Simulator, Mobile Acoustic Facility, Exterior Effects Synthesis and Simulation Lab, and the NASA Advanced Supercomputing Complex. To learn more about the RVLT Project, please stop by booth #1004 or visit their website at https://www.nasa.gov/aeroresearch/programs/aavp/rvlt.

  10. Reducing Falls After Electroconvulsive Therapy: A Quality Improvement Project.

    PubMed

    Brown, Allana Marie

    2017-07-01

    Falls after electroconvulsive therapy (ECT) in patients 60 and older have been long recognized as a major clinical care issue across many mental health care settings. The evidence base for fall prevention strategies after receiving ECT is sparse. The risk factors for falls after ECT are vast and complex in nature, especially considering existing comorbid medical conditions. The dearth of research in guiding practitioners on fall reduction interventions for this patient population illuminates a gap in mental health care quality and safety. The purpose of the current nurse-led quality improvement project was to reduce falls in patients undergoing ECT by enhancing safety measures through education and a post-ECT treatment protocol. The project did not prove to be as efficacious as anticipated as measured by fall rate outcomes. Several factors that may account for the project's findings are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 20-29.]. Copyright 2017, SLACK Incorporated.

  11. Improvements and Lingering Challenges with Modeling Low-Level Winds Over Complex Terrain during the Wind Forecast Improvement Project 2

    NASA Astrophysics Data System (ADS)

    Olson, J.; Kenyon, J.; Brown, J. M.; Angevine, W. M.; Marquis, M.; Pichugina, Y. L.; Choukulkar, A.; Bonin, T.; Banta, R. M.; Bianco, L.; Djalalova, I.; McCaffrey, K.; Wilczak, J. M.; Lantz, K. O.; Long, C. N.; Redfern, S.; McCaa, J. R.; Stoelinga, M.; Grimit, E.; Cline, J.; Shaw, W. J.; Lundquist, J. K.; Lundquist, K. A.; Kosovic, B.; Berg, L. K.; Kotamarthi, V. R.; Sharp, J.; Jiménez, P.

    2017-12-01

    The Rapid Refresh (RAP) and High-Resolution Rapid Refresh (HRRR) are NOAA real-time operational hourly updating forecast systems run at 13- and 3-km grid spacing, respectively. Both systems use the Advanced Research version of the Weather Research and Forecasting (WRF-ARW) as the model component of the forecast system. During the second installment of the Wind Forecast Improvement Project (WFIP 2), the RAP/HRRR have been targeted for the improvement of low-level wind forecasts in the complex terrain within the Columbia River Basin (CRB), which requires much finer grid spacing to resolve important terrain peaks in the Cascade Mountains as well as the Columbia River Gorge. Therefore, this project provides a unique opportunity to test and develop the RAP/HRRR physics suite within a very high-resolution nest (Δx = 750 m) over the northwestern US. Special effort is made to incorporate scale-aware aspects into the model physical parameterizations to improve RAP/HRRR wind forecasts for any application at any grid spacing. Many wind profiling and scanning instruments have been deployed in the CRB in support the WFIP 2 field project, which spanned 01 October 2015 to 31 March 2017. During the project, several forecast error modes were identified, such as: (1) too-shallow cold pools during the cool season, which can mix-out more frequently than observed and (2) the low wind speed bias in thermal trough-induced gap flows during the warm season. Development has been focused on the column-based turbulent mixing scheme to improve upon these biases, but investigating the effects of horizontal (and 3D) mixing has also helped improve some of the common forecast failure modes. This presentation will highlight the testing and development of various model components, showing the improvements over original versions for temperature and wind profiles. Examples of case studies and retrospective periods will be presented to illustrate the improvements. We will demonstrate that the

  12. Using Q Methodology in Quality Improvement Projects.

    PubMed

    Tiernon, Paige; Hensel, Desiree; Roy-Ehri, Leah

    Q methodology consists of a philosophical framework and procedures to identify subjective viewpoints that may not be well understood, but its use in nursing is still quite limited. We describe how Q methodology can be used in quality improvement projects to better understand local viewpoints that act as facilitators or barriers to the implementation of evidence-based practice. We describe the use of Q methodology to identify nurses' attitudes about the provision of skin-to-skin care after cesarean birth. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  13. User Facilities

    Science.gov Websites

    Los Alamos National Laboratory Search Site submit About Mission Business Newsroom Publications Los Innovation in New Mexico Los Alamos Collaboration for Explosives Detection (LACED) SensorNexus Exascale Computing Project (ECP) User Facilities Center for Integrated Nanotechnologies (CINT) Los Alamos Neutron

  14. Improvement in Outflow Facility by Two Novel Microinvasive Glaucoma Surgery Implants

    PubMed Central

    Hays, Cassandra L.; Gulati, Vikas; Fan, Shan; Samuelson, Thomas W.; Ahmed, Iqbal Ike K.; Toris, Carol B.

    2014-01-01

    Purpose. To determine improvement in outflow facility (C) in human anterior segments implanted with a novel Schlemm's canal scaffold or two trabecular micro-bypasses. Methods. Human anterior segments were isolated from 12 pairs of eyes from donors with no history of ocular disease and then perfused at 50, 40, 30, 20, and 10 mm Hg pressures for 10 minutes each. Baseline C was calculated from perfusion pressures and flow rates. The scaffold was implanted into Schlemm's canal of one anterior segment, and two micro-bypasses were implanted three clock-hours apart in the contralateral anterior segment. Outflow facility and resistance were compared at various standardized perfusion pressures and between each device. Results. Compared to baseline, C increased by 0.16 ± 0.12 μL/min/mm Hg (74%) with the scaffold, and 0.08 ± 0.12 μL/min/mm Hg (34%) with two micro-bypasses. The scaffold increased C at perfusion pressures of 50, 40, 30, and 20 mm Hg (P < 0.005). Two micro-bypasses increased C at a perfusion pressure of 40 mm Hg (P < 0.05). Conclusions. Both implants effectively increased C in human eyes ex vivo. The scaffold increased C by a greater percentage (73% vs. 34%) and at a greater range of perfusion pressures (20 to 50 mm Hg vs. 40 mm Hg) than the two micro-bypasses, suggesting that the 8-mm dilation of Schlemm's canal by the scaffold may have additional benefits in lowering the outflow resistance. The Hydrus Microstent scaffold may be an effective therapy for increasing outflow facility and thus reducing the IOP in patients with glaucoma. PMID:24550367

  15. Biotechnology Protein Expression and Purification Facility

    NASA Technical Reports Server (NTRS)

    2003-01-01

    The purpose of the Project Scientist Core Facility is to provide purified proteins, both recombinant and natural, to the Biotechnology Science Team Project Scientists and the NRA-Structural Biology Test Investigators. Having a core facility for this purpose obviates the need for each scientist to develop the necessary expertise and equipment for molecular biology, protein expression, and protein purification. Because of this, they are able to focus their energies as well as their funding on the crystallization and structure determination of their target proteins.

  16. The Improvement of Higher Education in Indonesia: A Project Approach.

    ERIC Educational Resources Information Center

    Ruitjer, Kees; Utomo, Tjipto

    1983-01-01

    An international project for improvement of an Indonesian university's chemical engineering curriculum and later extended to other institutions and departments, included these changes: greater emphasis on discussion and problem-solving techniques, use of learning modules, introduction of criterion-referenced grading, and extended and improved…

  17. Leadership, Medication Administration, and Knowledge Retention: A Quality Improvement Project

    ERIC Educational Resources Information Center

    Treister, Pamela

    2017-01-01

    A leadership and quality improvement project was undertaken in order to assist undergraduate baccalaureate nursing students in knowledge retention for medication administration during their senior semester in nursing school. Specific changes in curriculum were implemented to assist these undergraduate baccalaureate nursing students at a suburban…

  18. 30 CFR 285.651 - When may I construct complex or significant OCS facilities on my limited lease or any facilities...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... facilities on my limited lease or any facilities on my project easement proposed under my GAP? 285.651 Section 285.651 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER...

  19. Breaking the Backlog Reduction Mold with FacMan: A Facilities Management Application for Maintenance Backlogs and Capital Renewal.

    ERIC Educational Resources Information Center

    Managan, William H.

    1999-01-01

    Describes a facilities-management software program that helps managers better document and understand maintenance backlogs, improvements, and future cyclic renewal needs. Major software components are examined including a software tool that filters, groups, and ranks projects to help determine funding requests. (GR)

  20. Sanford Underground Research Facility - The United State's Deep Underground Research Facility

    NASA Astrophysics Data System (ADS)

    Vardiman, D.

    2012-12-01

    The 2.5 km deep Sanford Underground Research Facility (SURF) is managed by the South Dakota Science and Technology Authority (SDSTA) at the former Homestake Mine site in Lead, South Dakota. The US Department of Energy currently supports the development of the facility using a phased approach for underground deployment of experiments as they obtain an advanced design stage. The geology of the Sanford Laboratory site has been studied during the 125 years of operations at the Homestake Mine and more recently as part of the preliminary geotechnical site investigations for the NSF's Deep Underground Science and Engineering Laboratory project. The overall geology at DUSEL is a well-defined stratigraphic sequence of schist and phyllites. The three major Proterozoic units encountered in the underground consist of interbedded schist, metasediments, and amphibolite schist which are crosscut by Tertiary rhyolite dikes. Preliminary geotechnical site investigations included drift mapping, borehole drilling, borehole televiewing, in-situ stress analysis, laboratory analysis of core, mapping and laser scanning of new excavations, modeling and analysis of all geotechnical information. The investigation was focused upon the determination if the proposed site rock mass could support the world's largest (66 meter diameter) deep underground excavation. While the DUSEL project has subsequently been significantly modified, these data are still available to provide a baseline of the ground conditions which may be judiciously extrapolated throughout the entire Proterozoic rock assemblage for future excavations. Recommendations for facility instrumentation and monitoring were included in the preliminary design of the DUSEL project design and include; single and multiple point extensometers, tape extensometers and convergence measurements (pins), load cells and pressure cells, smart cables, inclinometers/Tiltmeters, Piezometers, thermistors, seismographs and accelerometers, scanners (laser

  1. Life Sciences Centrifuge Facility assessment

    NASA Technical Reports Server (NTRS)

    Benson, Robert H.

    1994-01-01

    This report provides an assessment of the status of the Centrifuge Facility being developed by ARC for flight on the International Space Station Alpha. The assessment includes technical status, schedules, budgets, project management, performance of facility relative to science requirements, and identifies risks and issues that need to be considered in future development activities.

  2. Planning and Financing School Improvement and Construction Projects. NOLPE Monograph Series, No. 57.

    ERIC Educational Resources Information Center

    Bittle, Edgar H., Ed.

    Suggestions and guidelines to help school administrators, business officials, board members, and others interested in improving school facilities are presented in this book. Chapter 1, "School Building Programs, Equipment Acquisition: The Anatomy of School Debt Financing" (Edgar H. Bittle), provides an overview of the legal and planning issues…

  3. Decreasing IV Infiltrates in the Pediatric Patient--System-Based Improvement Project.

    PubMed

    Major, Tracie Wilt; Huey, Tricia K

    2016-01-01

    Intravenous infiltrates pose tremendous risk for the hospitalized pediatric patient. Infiltrate events increase hospital-acquired harm, the number of painful procedures, use of supplies, length of stay, and nursing time; it threatens relationships essential in patient- and family-centered care. The goal of this quality improvement project was to achieve a 10% decrease in the baseline infiltrate rate on two inpatient units and in the overall infiltrate rate across all of the pediatric units. A Lean Six Sigma methodology was used to guide project activities. Improvement strategies focused on evidence-based education, intravenous (IV) catheter securement, and family engagement. A comparative purposive sample was used to evaluate the pre- and post-implementation period to determine if desired project success measures were achieved. Data analysis revealed positive results across all units, with the number of events (n = 51 pre; n = 19 post) and the infiltration rates (13.5 pre; 7.1 post) decreasing over a three-month period. A decrease was also noted in the overall percent of IVs that infiltrated in the first 24 hours (45% pre; 42% post). A statistically significant increase (t = 15.16; p < 0.001) was noted in nurses' education pre- and post-assessment survey scores. The family engagement strategy revealed overall parental responses to be 88% positive. By decreasing infiltrates, quality of care improved, resulting in the delivery of safe, effective, and patient-centered IV therapy.

  4. Use of 4MAT Learning Theory to Promote Better Skin Care During Radiation Therapy: An Evidence-Based Quality Improvement Project.

    PubMed

    Bauer, Carole; Magnan, Morris; Laszewski, Pamela

    Radiation therapy is a key treatment modality for cancer patients, but it is associated with adverse side effects such as radiation dermatitis. To mitigate the adverse effects of radiation on the skin, patients must participate in skin-related self-care. However, even with self-care instruction, adherence can be poor. This quality improvement project used best available evidence for skin care in patients undergoing radiation therapy and a theoretical framework, 4MATing, to provide a structured approach to patient education designed to enhance adherence to skin care recommendations. Implementation of this approach resulted in increased adherence to a topical skin care protocol in our facility. Patients were highly satisfied with their education. While there was a 4-day delay in the onset of radiation dermatitis, this difference was not statistically significant.

  5. DOE passive solar commercial buildings program: project summaries

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

    Not Available

    1982-01-01

    The 23 projects participating in this program comprise a wide range of building types including offices, retail establishments, educational facilities, public service facilities, community and visitor centers, and private specialized-use facilities, located throughout the United States. Summary data and drawings are presented for each project. (MHR)

  6. Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

    PubMed

    Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

    2015-07-01

    Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

  7. Gamma greenhouse: A chronic facility for crops improvement and agrobiotechnology

    NASA Astrophysics Data System (ADS)

    Azhar, M.; Ahsanulkhaliqin, A. W.

    2014-02-01

    Gamma irradiation is one of the most common procedures in plant mutagenesis and agrobiotechnology activities. The procedures consist of chronic and acute gamma radiation. Generally, 60Co and 137Cs are gamma radiation sources for radiation processing with relatively high energy (half-life 5.27 years for 60Co and 30.1 years for 137Cs). The energy associated with gamma radiation is high enough to break the molecular bonds and ionize atoms without affecting structure of the atomic nucleus (avoiding induction of radioactivity). The Gamma Green House (GGH) is the only chronic irradiation facility in Malaysia, located at Malaysian Nuclear Agency (Nuclear Malaysia). GGH is used for induction of mutation in plants and other biological samples at low dose radiation over period of time depending on the nature and sensitivity of the plant species. The GGH consist of circular green house with 30 meters radius, control room and irradiator with interlock system. The irradiator produces low dose gamma radiation derived from Caesium-137 radioactive source. The biological samples can be exposed to low dose radiation in days, weeks, months or years. The current irradiation rate for GGH is 2.67 Gy/hr at 1 meter from the source. Chronic gamma irradiation produces a wider mutation spectrum and useful for minimizing radiation damages towards obtaining new improved traits for research and commercial values. The prospect of the gamma greenhouse is its uses in research, educations and services on induced mutation techniques for the improvement of plant varieties and microbes. In generating awareness and attract users to the facility, Nuclear Malaysia provides wide range of irradiation services for plant species and mutagenesis consultancies to academicians, students scientists, and plant breeders, from local universities, other research institutes, and growers. Charges for irradiation and consultancy services are at nominal rates. The utilization activities of the gamma greenhouse mainly

  8. Cervical Spine Collar Removal by Emergency Room Nurses: A Quality Improvement Project.

    PubMed

    Fontaine, Guillaume; Forgione, Massimo; Lusignan, Francis; Lanoue, Marc-André; Drouin, Simon

    2018-05-01

    The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians. The project began with the creation of an interdisciplinary team. Clinical guidelines were established by the interdisciplinary project team. Nine charge nurses of the emergency room were then trained to use the CCR (3 on each 8-hour shift). The use of the CCR was monitored throughout the project period, from June 1 to October 5, 2016. The 3 aims of this practice improvement project were attained successfully. Over a 5-month period, 114 patients were assessed with the CCR. Charge nurses removed the cervical collars for 54 of 114 patients (47%). A perfect agreement rate (114 of 114 patients, 100%) was attained between the assessments of the nurses and those of physicians. This project shows that the charge nurses of a secondary trauma center can use the CCR safely on alert, orientated, and low-risk adult trauma patients as demonstrated by the agreement in the assessments of emergency room nurses and physicians. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  9. Mortality monitoring design for utility-scale solar power facilities

    USGS Publications Warehouse

    Huso, Manuela; Dietsch, Thomas; Nicolai, Chris

    2016-05-27

    IntroductionSolar power represents an important and rapidly expanding component of the renewable energy portfolio of the United States (Lovich and Ennen, 2011; Hernandez and others, 2014). Understanding the impacts of renewable energy development on wildlife is a priority for the U.S. Fish and Wildlife Service (FWS) in compliance with Department of Interior Order No. 3285 (U.S. Department of the Interior, 2009) to “develop best management practices for renewable energy and transmission projects on the public lands to ensure the most environmentally responsible development and delivery of renewable energy.” Recent studies examining effects of renewable energy development on mortality of migratory birds have primarily focused on wind energy (California Energy Commission and California Department of Fish and Game, 2007), and in 2012 the FWS published guidance for addressing wildlife conservation concerns at all stages of land-based wind energy development (U.S. Fish and Wildlife Service, 2012). As yet, no similar guidelines exist for solar development, and no published studies have directly addressed the methodology needed to accurately estimate mortality of birds and bats at solar facilities. In the absence of such guidelines, ad hoc methodologies applied to solar energy projects may lead to estimates of wildlife mortality rates that are insufficiently accurate and precise to meaningfully inform conversations regarding unintended consequences of this energy source and management decisions to mitigate impacts. Although significant advances in monitoring protocols for wind facilities have been made in recent years, there remains a need to provide consistent guidance and study design to quantify mortality of bats, and resident and migrating birds at solar power facilities (Walston and others, 2015).In this document, we suggest methods for mortality monitoring at solar facilities that are based on current methods used at wind power facilities but adapted for the

  10. Northeast Oregon Hatchery Project, Final Siting Report.

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

    Watson, Montgomery

    1995-03-01

    This report presents the results of site analysis for the Bonneville Power Administration Northeast Oregon Hatchery Project. The purpose of this project is to provide engineering services for the siting and conceptual design of hatchery facilities for the Bonneville Power Administration. The hatchery project consists of artificial production facilities for salmon and steelhead to enhance production in three adjacent tributaries to the Columbia River in northeast Oregon: the Grande Ronde, Walla Walla, and Imnaha River drainage basins. Facilities identified in the master plan include adult capture and holding facilities; spawning incubation, and early rearing facilities; full-term rearing facilities; and directmore » release or acclimation facilities. The evaluation includes consideration of a main production facility for one or more of the basins or several smaller satellite production facilities to be located within major subbasins. The historic and current distribution of spring and fall chinook salmon and steelhead was summarized for the Columbia River tributaries. Current and future production and release objectives were reviewed. Among the three tributaries, forty seven sites were evaluated and compared to facility requirements for water and space. Site screening was conducted to identify the sites with the most potential for facility development. Alternative sites were selected for conceptual design of each facility type. A proposed program for adult holding facilities, final rearing/acclimation, and direct release facilities was developed.« less

  11. Facility Accounting: Hammering Out a Capital Replacement Budget.

    ERIC Educational Resources Information Center

    Readinger, Jay

    1996-01-01

    Most facility and finance managers cannot adequately handle school infrastructure issues because they lack the tools to describe the problem appropriately. Facility accounting gives managers accurate deferral and projected replacement costs, using nationally recognized life-cycle and cost data. Facility accounting enables proper management of…

  12. Collaborative Project: Improving the Representation of Coastal and Estuarine Processes in Earth System Models

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

    Bryan, Frank; Dennis, John; MacCready, Parker

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation.

  13. 30 CFR 585.651 - When may I construct complex or significant OCS facilities on my limited lease or any facilities...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... facilities on my limited lease or any facilities on my project easement proposed under my GAP? 585.651 Section 585.651 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY AND ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and...

  14. 30 CFR 585.651 - When may I construct complex or significant OCS facilities on my limited lease or any facilities...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... facilities on my limited lease or any facilities on my project easement proposed under my GAP? 585.651 Section 585.651 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY AND ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and...

  15. 30 CFR 585.651 - When may I construct complex or significant OCS facilities on my limited lease or any facilities...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... facilities on my limited lease or any facilities on my project easement proposed under my GAP? 585.651 Section 585.651 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY AND ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and...

  16. FAST FLUX TEST FACILITY CONCEPTUAL FACILTY DESIGN DESCRIPTION FOR THE INERT GAS CELL EXAMINATION FACILITY NO. 71

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

    None

    1968-12-12

    The purpose of this Conceptual Facility Design Description (CFDD) is to provide a technical description of the Inert Gas Cell Examination Facility such that agreement with RDT on a Conceptual Design can be reached . The CFDD also serves to establish a common understanding of the facility concept among all responsible FFTF Project parties including the Architect Engineer and Reactor Designer. Included are functions and design requirements, a physical description of the facility, safety considerations, principles of operation, and maintenance principles.

  17. Quality improvement training for core medical and general practice trainees: a pilot study of project participation, completion and journal publication.

    PubMed

    McNab, Duncan; McKay, John; Bowie, Paul

    2015-11-01

    Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal. A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success. Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%). This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be

  18. Management of the Atmosphere Resource Recovery and Environmental Monitoring Project

    NASA Technical Reports Server (NTRS)

    Roman, Monsi; Perry, Jay; Howard, David

    2013-01-01

    The Advanced Exploration Systems Program's Atmosphere Resource Recovery and Environmental Monitoring (ARREM) project is working to further optimize atmosphere revitalization and environmental monitoring system architectures. This paper discusses project management strategies that tap into skill sets across multiple engineering disciplines, projects, field centers, and industry to achieve the project success. It is the project's objective to contribute to system advances that will enable sustained exploration missions beyond Lower Earth Orbit (LEO) and improve affordability by focusing on the primary goals of achieving high reliability, improving efficiency, and reducing dependence on ground-based logistics resupply. Technology demonstrations are achieved by infusing new technologies and concepts with existing developmental hardware and operating in a controlled environment simulating various crewed habitat scenarios. The ARREM project's strengths include access to a vast array of existing developmental hardware that perform all the vital atmosphere revitalization functions, exceptional test facilities to fully evaluate system performance, and a well-coordinated partnering effort among the NASA field centers and industry partners to provide the innovative expertise necessary to succeed.

  19. Nurse-led multidisciplinary initiatives to improve outcomes and reduce hospital admissions for older adults: The Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration project.

    PubMed

    Marsden, Elizabeth; Craswell, Alison; Taylor, Andrea; Coates, Kaye; Crilly, Julia; Broadbent, Marc; Glenwright, Amanda; Johnston, Colleen; Wallis, Marianne

    2018-04-03

    This article describes the Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration (CEDRiC) project. CEDRiC is designed to improve the health outcomes for older people with an acute illness. It attempts this via enhanced primary care in residential aged care facilities, focused and streamlined care in the emergency department and enhanced intersectoral communication and referral. Implementing this approach has the potential to decrease inappropriate hospital admissions while improving care for older people in residential aged care and community settings. This article discusses an innovative way of caring for older adults in an ageing population utilising the existing evidence. A formal evaluation is currently underway. © 2018 AJA Inc.

  20. Improved Weather and Power Forecasts for Energy Operations - the German Research Project EWeLiNE

    NASA Astrophysics Data System (ADS)

    Lundgren, Kristina; Siefert, Malte; Hagedorn, Renate; Majewski, Detlev

    2014-05-01

    The German energy system is going through a fundamental change. Based on the energy plans of the German federal government, the share of electrical power production from renewables should increase to 35% by 2020. This means that, in the near future at certain times renewable energies will provide a major part of Germany's power production. Operating a power supply system with a large share of weather-dependent power sources in a secure way requires improved power forecasts. One of the most promising strategies to improve the existing wind power and PV power forecasts is to optimize the underlying weather forecasts and to enhance the collaboration between the meteorology and energy sectors. Deutscher Wetterdienst addresses these challenges in collaboration with Fraunhofer IWES within the research project EWeLiNE. The overarching goal of the project is to improve the wind and PV power forecasts by combining improved power forecast models and optimized weather forecasts. During the project, the numerical weather prediction models COSMO-DE and COSMO-DE-EPS (Ensemble Prediction System) by Deutscher Wetterdienst will be generally optimized towards improved wind power and PV forecasts. For instance, it will be investigated whether the assimilation of new types of data, e.g. power production data, can lead to improved weather forecasts. With regard to the probabilistic forecasts, the focus is on the generation of ensembles and ensemble calibration. One important aspect of the project is to integrate the probabilistic information into decision making processes by developing user-specified products. In this paper we give an overview of the project and present first results.

  1. Nuclotron-Based Ion Collider Facility (nica)

    NASA Astrophysics Data System (ADS)

    Meshkov, I.; Sissakian, A.; Sorin, A.

    2008-09-01

    The project of an ion collider accelerator complex NICA that is under development at JINR is presented. The article is based on the Conceptual Design Report (CDR)1 of the NICA project delivered in January 2008. The article contains NICA facility scheme, the facility operation scenario, its elements parameters, the proposed methods of intense ion beam acceleration and achievement of the required luminosity of the collider. The symmetric mode of the collider operation is considered here and most attention is concentrated on the luminosity provision in collisions of uranium ions (nuclei).

  2. Rubbertown NGEM Demonstration Project Planning meetings ...

    EPA Pesticide Factsheets

    From the shared perspective of industrial facilities, workers, regulators, and communities, cost-effective detection and assessment of significant onset fugitive leaks or process issues, is a mutually beneficial concept. If emissions that require mitigation can be detected and fixed quickly, benefits such as safer working environments, cost saving through reduced product loss, lower air shed pollutant impacts, and improved transparency and community relations can be realized. Under its next generation emission measurement program (NGEM), EPA’s Office of Research and Development (ORD), National Risk Management Research Laboratory (NRMRL) is working collaboratively with industry, instrument /information companies, state and local agencies, communities, and academic groups to explore new technical approaches for non-point source detection and migration. Techniques such as mobile and fixed point sensors and passive samplers employed on various spatial scales are being explored. With collaboration of the project team including EPA R4, the Louisville Metro Air Pollution Control District (LMAPCD), industrial facilities, and contractors to the EPA, a select subset of these NGEM approaches will be demonstrated in this project as per the quality assurance project plan. From April 17-20, 2017, E. Thoma will travel to Louisville KY to work with the Louisville Metro Air Pollution Control District (LMAPCD) and other parties for planning activities related to the

  3. [The efficacy of health improvement measures for sickly children in a children's health promotion facility].

    PubMed

    Khan, M A; Kuiantseva, L V; Rassulova, M A; Bykova, H I

    2011-01-01

    The results of the present study confirm the efficacy of combined health improvement measures applied in the children's health promotion facility for the treatment of frequently ill children. These measures included climatic therapy, rational day regimen, full-rate balanced diet, therapeutic physical exercises, and aromatherapy with the use of natural essential oils, e.g. clary sage oil. Children presenting with the symptoms of an acute respiratory infection were additionally treated with polarized light having the anti-inflammatory, immunocorrective, and antioxidative properties and thereby improved adaptive capacity of the organism.

  4. [Residential facilities for the elderly in five Italian regions. The Progres-Anziani Project].

    PubMed

    de Girolamo, Giovanni; Tempestini, Antonella; Cavrini, Giulia; Argentino, Paola; Federici, Stefano; Putzu, Paolo; Scocco, Paolo; Zappia, Mario; Morosini, Pierluigi; Cascavilla, Isabella; Sgadari, Antonio; Azzarito, Caterina; Brancati, Giacomo; Spalletta, Gianfranco; Pasini, Augusto

    2005-01-01

    To survey all Residential Facilities (RFs) for the elderly in five Italian Regions (Calabria, Sardinia, Sicily. Umbria and Veneto), and to evaluate their logistic and organizational characteristics, staff and residents' features. Structured interviews were conducted with RF managers. All RFs operating in the five Italian Regions. In the five Regions there are 853 RFs with an average of 198.0 beds per 10000 elderly inhabitants; this rate shows a marked variability between different Regions. The mean number of beds in the RFs is 59.8 (median: 34). The large majority (96%) have a 24-hour staff cover. In terms of management, the RFs are handled by local municipalities (29%), religious non-profit associations (24%), and other non-profit organizations (21%). In the 754 RFs surveyed (91.1% of the sample) there were 24.456 workers employed, even the number of staff in each facility shows a great variability. The mean number of workers directly involved in residents' care is 27.8, and the ratio residents/staff is 2.1, which becomes lower (1.8) if we consider the ratio non-independent residents/staff. In the 754 RFs there were 42,687 residents, with an average of 53.5 elderly residents for each facility and 3.2 residents below the age of 65; the mean age of the resident sample was 79.3 years, and there is an high proportion of residents with neurological (including dementia), psychiatric or medical disorders. There is marked variability in the provision of residential places between different Regions; many other characteristics of RFs for the elderly, including staff/residents ratios, show a similar variability Most RFs host elderly with a variety of neurological, psychiatric and medical disorders. The future waves of the project will shed light on many features of these institutions, which care for 2.1% of the elderly population in Italy and may serve larger proportions of the elderly in the future.

  5. Partnerships for Improving Literacy in Urban Schools: Advanced Reading Development Demonstration Project

    ERIC Educational Resources Information Center

    Reading Teacher, 2008

    2008-01-01

    How many times have researchers and professional developers approached you or your school with "the answer" to improving literacy achievement? How did it work out? If changes occurred during the engagement with these outside partners, what remained after the project ended? Did such efforts lead to lasting change and improvement in…

  6. Impact of rural water projects on hygienic behaviour in Swaziland

    NASA Astrophysics Data System (ADS)

    Peter, Graciana

    In Swaziland, access to safe water supply and sanitation has improved significantly and was expected to result in improved health and, in particular, reduced infant mortality rates. On the contrary, mortality rates in the under 5 years age group are high and have doubled from 60 in 1996, to 120 deaths per 1000 in 2006. The main objective of the study was to assess whether the water projects permit, and are accompanied by, changes in hygienic behaviour to prevent transmission of diseases. The study area was Phonjwane, located in the dry Lowveld of Swaziland, where water projects play a significant role in meeting domestic water demands. Hygienic behaviour and sanitation facilities were analysed and compared before and after project. The results of the study show that domestic water supply projects have significantly reduced distances travelled and time taken to collect water, and that increased quantities of water are collected and used. While the majority of respondents (95.6%) used the domestic water project source, the quantities allowed per household (125 l which translates to an average of 20.8 l per person) were insufficient and therefore were supplemented with harvested rainwater (57.8%), water from a polluted river (17.8%), and water from a dam (2.2%). Increased water quantities have permitted more baths and washing of clothes and hands, but significant proportions of the population still skip hygienic practices such as keeping water for washing hands inside or near toilet facilities (40%) and washing hands (20%). The study concludes that the water supply project has permitted and improved hygienic practices but not sufficiently. The health benefits of safe domestic water supplies are hampered by insufficient quantities of water availed through the projects, possible contamination of the water in the house, poor hygienic behaviours and lack of appropriate sanitation measures by some households. There is a need to provide sufficient quantities of safe water

  7. Improved Marine Waters Monitoring

    NASA Astrophysics Data System (ADS)

    Palazov, Atanas; Yakushev, Evgeniy; Milkova, Tanya; Slabakova, Violeta; Hristova, Ognyana

    2017-04-01

    IMAMO - Improved Marine Waters Monitoring is a project under the Programme BG02: Improved monitoring of marine waters, managed by Bulgarian Ministry of environment and waters and co-financed by the Financial Mechanism of the European Economic Area (EEA FM) 2009 - 2014. Project Beneficiary is the Institute of oceanology - Bulgarian Academy of Sciences with two partners: Norwegian Institute for Water Research and Bulgarian Black Sea Basin Directorate. The Project aims to improve the monitoring capacity and expertise of the organizations responsible for marine waters monitoring in Bulgaria to meet the requirements of EU and national legislation. The main outcomes are to fill the gaps in information from the Initial assessment of the marine environment and to collect data to assess the current ecological status of marine waters including information as a base for revision of ecological targets established by the monitoring programme prepared in 2014 under Art. 11 of MSFD. Project activities are targeted to ensure data for Descriptors 5, 8 and 9. IMAMO aims to increase the institutional capacity of the Bulgarian partners related to the monitoring and assessment of the Black Sea environment. The main outputs are: establishment of real time monitoring and set up of accredited laboratory facilities for marine waters and sediments chemical analysis to ensure the ability of Bulgarian partners to monitor progress of subsequent measures undertaken.

  8. CMC-Based Projects and L2 Learning: Confirming the Importance of Nativisation

    ERIC Educational Resources Information Center

    Grosbois, Muriel

    2011-01-01

    Despite the spread of reliable desktop audio and videoconferencing facilities, some CMC-based projects still rely on asynchronous written environments, if only because of the temporal constraints of synchronicity (Guichon, 2009; Develotte, Guichon & Vincent, 2010). Yet speaking is usually the skill students most need to improve when learning a…

  9. Determination of the Microbial Diversity of Spacecraft Assembly Facilities: First Results of the Project MiDiv

    NASA Astrophysics Data System (ADS)

    Rettberg, P.; Horneck, G.; Fritze, D.; Stackebrandt, E.; Kminek, G.

    The first step in the implementation of planetary protection guidelines encompasses a qualitative and quantitative inventory of the bioburden of spacecraft assembly facilities. In such an artificial environment mainly microorganisms are to be expected that are brought in by the humans themselves and that are able to withstand the controlled air circulation, the low relative humidity, the moderately high temperature and the low-nutrient conditions in the clean rooms of the assembly facilities. With informations about the composition of these microbial communities the development and/or optimization of adequate cleaning and sterilization procedures for spacecraft preparation before launch will be possible. The bioburden assessment in spacecraft assembly facilities requires a standardized procedure for sampling the air and surfaces in the facilities as well as of the spacecraft, a transfer of the biological samples under controlled conditions to the analyzing laboratory and a scientifically approved set of methods for analysis. In the ESA project MiDiv we started to investigate the bioburden of spacecrafts using the satellites SMART-1 and ROSETTA as test objects. The analysis of the samples included so far cultivation on different media at different pH and temperatures with and without oxygen with and without pasteurization, establishment of a culture collection of bacteria and partial 16S rRNA gene analysis. The results of these preliminary measurements, the total number of microorganisms, the numbers of colony forming units, differentiated according to the subgroups of aerobes, facultative anaerobes and anaerobes, and the phylogenetic classification, will be assessed with respect to the physiological potential of the identified microorganisms to withstand the different cleaning and sterilizing procedures used up to now for planetary protection measures. In the next step the ability of selected microorganisms to survive has to tested under environmental conditions as

  10. Life Sciences Centrifuge Facility review

    NASA Technical Reports Server (NTRS)

    Young, Laurence R.

    1994-01-01

    The Centrifuge Facility Project at ARC was reviewed by a code U team to determine appropriateness adequacy for the ISSA. This report represents the findings of one consultant to this team and concentrates on scientific and technical risks. This report supports continuation of the project to the next phase of development.

  11. CHP Project Development

    EPA Pesticide Factsheets

    Access information and tools to support the CHP project development process, including identifying if your facility is a good fit for CHP, the steps involved with CHP project development, and policies and incentives supportive of CHP.

  12. Testing the Impact of The Worksite Heart Health Improvement Project on Cardiovascular Disease Risk factors Overtime.

    PubMed

    Doran, Kelly; Resnick, Barbara; Zhu, Shijun; Alghzawi, Hamzah

    2018-02-13

    We aimed to test the impact of the Worksite Heart Health Improvement Project (WHHIP) on cardiovascular risk factors among long-term care staff. The WHHIP was an 18-month cluster randomized control trial conducted in four long-term care facilities (n = 98). A significant positive delayed intervention effect for diastolic blood pressure was seen in intervention group (80.34 mm/Hg [SD = 6.10] at baseline to 73.08 mm/Hg [SD = 4.99] at 18-months; p = <.001). Whereas, a significant negative intervention effect was seen for steps with a mean increase from 5,807.18 (SD = 3,934.30) steps at baseline to 7,839.19 (SD = 3,126.09) steps at 18-months (p = .022) as well as body mass index with a mean change from 29.86 (SD = 7.38) at baseline to 26.67 (SD = 5.29) at 18-months (p = .045). (p = .045). The WHHIP demonstrated the ability to impact participants' blood pressure over time.

  13. Quality improvement for patient safety: project-level versus program-level learning.

    PubMed

    Rivard, Peter E; Parker, Victoria A; Rosen, Amy K

    2013-01-01

    Improving quality and patient safety is of increasing strategic importance to health care organizations. However, simply increasing the volume of quality improvement (QI) activity does not necessarily improve patient outcomes. There is a need for greater understanding of QI success factors. This study looked for differences in QI implementation across hospitals with a range of performance on Patient Safety Indicators. We conducted an exploratory comparative case study of 4 Veterans Health Administration hospitals including site visits and interviews with leaders and staff. Two themes emerged. Project-level QI learning is assessing and modifying specific QI projects relative to expectations. Program-level QI learning is assessing and modifying the overall QI endeavor. The nature of project-level QI learning was similar across sites, whereas we identified qualitative differences across organizations in program-level QI learning. The highest performing organization was evaluating and refining its overall approach to QI, whereas the others were learning how to build and control QI programs. Program-level QI learning may be key if a QI program is to succeed in improving patient outcomes. This type of organizational learning entails a big-picture, organization-wide view of QI. It also entails second-order organizational learning based on assessment not only of whether QI is being done correctly but also whether the right QI activities are being done, for the right reasons. The organization is "learning to learn." In addition to gaining mastery and control of QI, leaders regularly engage with staff in rethinking QI and experimenting with new approaches. Leaders also assess how QI activity fits in the organization's developmental journey and how it supports realization of strategy.

  14. The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

    PubMed

    Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

    2013-01-01

    This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P < .01) but not at discharge (baseline, 14.9%; postintervention, 21.8%; P = .41). Residents cited the importance of PCP communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

  15. The Surgical Care Improvement Project Antibiotic Guidelines: Should We Expect More Than Good Intentions?

    PubMed

    Schonberger, Robert B; Barash, Paul G; Lagasse, Robert S

    2015-08-01

    Since 2006, the Surgical Care Improvement Project (SCIP) has promoted 3 perioperative antibiotic recommendations designed to reduce the incidence of surgical site infections. Despite good evidence for the efficacy of these recommendations, the efforts of SCIP have not measurably improved the rates of surgical site infections. We offer 3 arguments as to why SCIP has fallen short of expectations. We then suggest a reorientation of quality improvement efforts to focus less on reporting, and incentivizing adherence to imperfect metrics, and more on creating local and regional quality collaboratives to educate clinicians about how to improve practice. Ultimately, successful quality improvement projects are behavioral interventions that will only succeed to the degree that they motivate individual clinicians, practicing within a particular context, to do the difficult work of identifying failures and iteratively working toward excellence.

  16. The Surgical Care Improvement Project Antibiotic Guidelines: Should We Expect More than Good Intentions?

    PubMed Central

    Schonberger, Robert B.; Barash, Paul G.; Lagasse, Robert S.

    2015-01-01

    Since 2006, the Surgical Care Improvement Project (SCIP) has promoted three perioperative antibiotic recommendations designed to reduce the incidence of surgical-site infections. Despite good evidence for the efficacy of these recommendations, SCIP's efforts have not measurably improved rates of surgical site-infections. We offer three arguments as to why SCIP has fallen-short of expectations. We then suggest a reorientation of quality improvement efforts to focus less on reporting, and incentivizing adherence to imperfect metrics, and more on creating local and regional quality collaboratives to educate clinicians about how to improve practice. Ultimately, successful quality improvement projects are behavioral interventions that will only succeed to the degree that they motivate individual clinicians, practicing within a particular context, to do the difficult work of identifying failures and iteratively working toward excellence. PMID:26197373

  17. Program/Project Management Resources: A collection of 50 bibliographies focusing on continual improvement, reinventing government, and successful project management

    NASA Technical Reports Server (NTRS)

    Michaels, Jeffrey

    1994-01-01

    These Program/Project Management Resource Lists were originally written for the NASA project management community. Their purpose was to promote the use of the NASA Headquarters Library Program/Project Management Collection funded by NASA Headquarters Code FT, Training & Development Division, by offering introductions to the management topics studied by today's managers. Lists were also written at the request of NASA Headquarters Code T, Office of Continual improvements, and at the request of NASA members of the National Performance Review. This is the second edition of the compilation of these bibliographies; the first edition was printed in March 1994.

  18. Environmentally Preferable Coatings for Structural Steel Project

    NASA Technical Reports Server (NTRS)

    Lewis, Pattie L. (Editor)

    2014-01-01

    The Ground Systems Development and Operations (GSDO) Program at NASA John F. Kennedy Space Center (KSC) has the primary objective of modernizing and transforming the launch and range complex at KSC to benefit current and future NASA programs along with other emerging users. Described a the "launch support and infrastructure modernization program" in the NASA Authorization Act of 2010, the GSDO Program will develop and implement shared infrastructure and process improvements to provide more flexible, affordable, and responsive capabilities to a multi-user community. In support of the GSDO Program, the objective of this project is to determine the feasibility of environmentally friendly corrosion resistant coatings for launch facilities and ground support equipment. The focus of the project is corrosion resistance and survivability with the goal to reduce the amount of maintenance required to preserve the performance of launch facilities while reducing mission risk. Number of facilities/structures with metallic structural and non-structural components in a highly corrosive environment. Metals require periodic maintenance activity to guard against the insidious effects of corrosion and thus ensure that structures meet or exceed design or performance life. The standard practice for protecting metallic substrates in atmospheric environments is the application of corrosion protective coating system.

  19. Improving the quality of life of aged care residents through the joy of food: The Lantern Project.

    PubMed

    Hugo, Cherie; Dwonczyk, Marcia; Skinner, Jan; Isenring, Liz

    2018-03-23

    Mealtimes directly impact the quality of life of residents in aged care. The objective of The Lantern Project is to improve the dining experience of aged care residents to reduce malnutrition risk through improving dietary intake, meal. A transdisciplinary team of aged care professionals and resident advocates was formed as a collaboration collectively known as The Lantern Project. This paper outlines the journey and timeline of The Lantern Project collaboration since its inception and the interplay between the monthly stakeholder meetings and inter-related research projects demonstrating improved outcomes. Transdisciplinary collaboration offers well-grounded benefits and realistic strategies sensitive to the complexity of the aged care setting. © 2018 AJA Inc.

  20. West Virginia peer exchange : streamlining highway safety improvement program project delivery.

    DOT National Transportation Integrated Search

    2015-01-01

    The West Virginia Division of Highways (WV DOH) hosted a Peer Exchange to share information and experiences : for streamlining Highway Safety Improvement Program (HSIP) project delivery. The event was held September : 22 to 23, 2014 in Charleston, We...

  1. Recent Developments at the NASA Langley Research Center National Transonic Facility

    NASA Technical Reports Server (NTRS)

    Paryz, Roman W.

    2011-01-01

    Several upgrade projects have been completed or are just getting started at the NASA Langley Research Center National Transonic Facility. These projects include a new high capacity semi-span balance, model dynamics damping system, semi-span model check load stand, data acquisition system upgrade, facility automation system upgrade and a facility reliability assessment. This presentation will give a brief synopsis of each of these efforts.

  2. Evaluating the Impact of Sea Level Rise and Coastal Flooding on NASA Centers and Facilities by Implementing Terrestrial Laser Scanning Surveys to Improve Coastal Digital Elevation and Inundation Models

    NASA Astrophysics Data System (ADS)

    Bell, L. J.; Nerem, R. S.; Williams, K.; Meertens, C.; Lestak, L.; Masters, D.

    2014-12-01

    Sea level is rising in response to climate change. Currently the global mean rate is a little over 3 mm/year, but it is expected to accelerate significantly over this century. This will have a profound impact on coastal populations and infrastructure, including NASA centers and facilities. A detailed study proposed by the University of Colorado's Center for Astrodynamics Research on the impact of sea level rise on several of NASA's most vulnerable facilities was recently funded by NASA. Individual surveys at several high-risk NASA centers were conducted and used as case studies for a broader investigation that needs to be done for coastal infrastructure around the country. The first two years of this study included implementing and conducting a terrestrial laser scanning (TLS) and GPS survey at Kennedy Space Center, Cape Canaveral, Florida, Wallops Flight Facility, Wallops Island, Virginia, Langley Research Center, Hampton, Virginia, and Ames Research Center, Moffett Field, California. We are currently using airborne LiDAR (Light Detection and Ranging) data and TLS (Terrestrial Laser Scanning) data to construct detailed digital elevation models (DEMs) of the facilities that we have assessed. The TLS data acquired at each center provides a very dense point cloud that is being used to improve the detail and accuracy of the digital elevation models currently available. We are also using GPS data we acquired at each center to assess the rate of vertical land movement at the facilities and to tie the DEM to tide gauges and other reference points. With completed, detailed DEMs of the topography and facilities at each center, a series of simple inundation models will then be applied to each area. We will use satellite altimeter data from TOPEX, Jason-1, and Jason-2 to assess the sea level changes observed near these NASA facilities over the last 20 years along with sea level projections from global climate models (GCMs) and semi-empirical projections to make detailed maps

  3. Layout Improvement Study to Reduce Staff Walking Distance in a Large Health Care Facility: How to Not Walk an Extra 4740 Miles.

    PubMed

    Ley-Chavez, Adriana; Hmar-Lagroun, Tatiana; Douglas-Ntagha, Pamela; Cumbo, Charlotte L

    2016-01-01

    Inefficient facility layouts have been found to be a challenge in health care, with excessive walking adding to the demands of staff and creating delays, which can impact the quality of care. Minimizing unnecessary transportation during care delivery improves efficiency, reduces delays, and frees up resources for use on value-added activities. This article presents a methodology and application of facility design to improve responsiveness and efficiency at a large hospital. The approach described provides the opportunity to improve existing layouts in facilities in which the floor plan is already defined, but there is some flexibility to relocate key areas. The existing physical constraints and work flows are studied and taken into consideration, and the volume of traffic flow throughout the facility guides the decision of where to relocate areas for maximum efficiency. Details on the steps followed and general recommendations to perform the necessary process and data analyses are provided. We achieved a 34.8% reduction in distance walked (4740 miles saved per year) and a 30% reduction in floors traveled in elevators (344 931 floors, which translate to 842 hours spent using elevators) by relocating 4 areas in which frequently used resources are housed.

  4. Psychology in an Interdisciplinary Setting: A Large-Scale Project to Improve University Teaching

    ERIC Educational Resources Information Center

    Koch, Franziska D.; Vogt, Joachim

    2015-01-01

    At a German university of technology, a large-scale project was funded as a part of the "Quality Pact for Teaching", a programme launched by the German Federal Ministry of Education and Research to improve the quality of university teaching and study conditions. The project aims at intensifying interdisciplinary networking in teaching,…

  5. Preliminary Plans Presented for Construction of John F. Kennedy School and Community Center- 1966 Bond Fund Project No. PS42-62-785-7 and Neighborhood Facilities Grant Project No. GA. N-7.

    ERIC Educational Resources Information Center

    Atlanta Board of Education, GA.

    A proposed project which is a result of the cooperative efforts of many agencies is described. The planned facility will offer to residents of the community, a multitude of needed services which have never been brought together under one roof. The center will include a middle school of grades six to eight for approximately 1,050 students. The…

  6. Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

    PubMed

    Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

    2013-01-01

    With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.

  7. Ground-water monitoring compliance projects for Hanford Site facilities: Volume 1, The report and Appendix A, Progress report for the period October 1 to December 31, 1986

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

    Not Available

    This report documents recent progress on ground-water monitoring projects for four Hanford Site facilities: the 300 Area Process Trenches, the 183-H Solar Evaporation Basins, the 200 Area Low-Level Burial Grounds, and the Nonradioactive Dangerous Waste (NRDW) Landfill. The existing ground-water monitoring projects for the first two facilities named in the paragraph above are currently being expanded by adding new wells to the networks. During the reporting period, sampling of the existing wells continued on a monthly basis, and the analytical results for samples collected from September through November 1986 are included and discussed in this document. 8 refs., 41 figs.,more » 7 tabs.« less

  8. Study on beam geometry and image reconstruction algorithm in fast neutron computerized tomography at NECTAR facility

    NASA Astrophysics Data System (ADS)

    Guo, J.; Bücherl, T.; Zou, Y.; Guo, Z.

    2011-09-01

    Investigations on the fast neutron beam geometry for the NECTAR facility are presented. The results of MCNP simulations and experimental measurements of the beam distributions at NECTAR are compared. Boltzmann functions are used to describe the beam profile in the detection plane assuming the area source to be set up of large number of single neutron point sources. An iterative algebraic reconstruction algorithm is developed, realized and verified by both simulated and measured projection data. The feasibility for improved reconstruction in fast neutron computerized tomography at the NECTAR facility is demonstrated.

  9. Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

    PubMed

    Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

    2016-10-01

    In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

  10. Accreditation of ambulatory facilities.

    PubMed

    Urman, Richard D; Philip, Beverly K

    2014-06-01

    With the continued growth of ambulatory surgical centers (ASC), the regulation of facilities has evolved to include new standards and requirements on both state and federal levels. Accreditation allows for the assessment of clinical practice, improves accountability, and better ensures quality of care. In some states, ASC may choose to voluntarily apply for accreditation from a recognized organization, but in others it is mandated. Accreditation provides external validation of safe practices, benchmarking performance against other accredited facilities, and demonstrates to patients and payers the facility's commitment to continuous quality improvement. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project.

    PubMed

    Buck, Harleah G; Kolanowski, Ann; Fick, Donna; Baronner, Lawrence

    2016-07-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project," found on pages 306-313, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the unique nursing challenges that occur in caring for older adults in rural areas. Discuss the

  12. CAPITAL IMPROVEMENTS PROGRAM FOR THE OKLAHOMA STATE SYSTEM OF HIGHER EDUCATION, 1965-75. PHASE TWO.

    ERIC Educational Resources Information Center

    CLEEK, JOHN E.; COFFELT, JOHN J.

    THIS STUDY UPDATES THE 1963 TEN-YEAR PROJECTION OF CAPITAL IMPROVEMENTS FOR THE INSTITUTIONS OF THE OKLAHOMA STATE SYSTEM OF HIGHER EDUCATION. SPACE NEEDS OF THE STATE SYSTEM WERE DETERMINED BY A COMPARISON OF FACILITY INVENTORIES FOR CURRENT SPACE NEEDS AND PROJECTED SPACE NEEDS. THE SPACE NEEDS WERE TABULATED FOR CLASSROOMS, FACULTY OFFICES,…

  13. University of Alaska 1997 Facilities Inventory.

    ERIC Educational Resources Information Center

    Alaska Univ., Fairbanks. Statewide Office of Institutional Research.

    This facilities inventory report presents a comprehensive listing of physical assets owned and operated by the University of Alaska and includes, for each asset, data on average age, weighted average age, gross square footage, original total project funding, and the asset's plant investment value adjusted to the current year. Facilities are listed…

  14. ATR National Scientific User Facility 2009 Annual Report

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

    Todd R. Allen; Mitchell K. Meyer; Frances Marshall

    2010-11-01

    This report describes activities of the ATR NSUF from FY-2008 through FY-2009 and includes information on partner facilities, calls for proposals, users week and education programs. The report also contains project information on university research projects that were awarded by ATR NSUF in the fiscal years 2008 & 2009. This research is university-proposed researcher under a user facility agreement. All intellectual property from these experiments belongs to the university per the user agreement.

  15. Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India.

    PubMed

    Iyengar, Kirti; Jain, Motilal; Thomas, Sunil; Dashora, Kalpana; Liu, William; Saini, Paramsukh; Dattatreya, Rajesh; Parker, Indrani; Iyengar, Sharad

    2014-08-13

    After the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled "Parijaat" was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund. The intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period. Use of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing. An intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.

  16. Association of U.S. Dialysis Facility Neighborhood Characteristics with Facility-Level Kidney Transplantation

    PubMed Central

    Plantinga, Laura; Pastan, Stephen; Kramer, Michael; McClellan, Ann; Krisher, Jenna; Patzer, Rachel E.

    2014-01-01

    Background Improving access to optimal healthcare may depend on attributes of neighborhoods where patients receive healthcare services. We investigated whether characteristics of dialysis facility neighborhoods—where most patients with end-stage renal disease are treated—were associated with facility-level kidney transplantation. Methods We examined the association between census tract (neighborhood)-level sociodemographic factors and facility-level kidney transplantation rate in 3,983 U.S. dialysis facilities with reported kidney transplantation rates. Number of kidney transplants and total person-years contributed at the facility level in 2007-2010 were obtained from the Dialysis Facility Report and linked to census tract data on sociodemographic characteristics from the American Community Survey 2006-2010 by dialysis facility location. We used multivariable Poisson models with generalized estimating equations to estimate associations between neighborhood characteristics and transplant incidence. Results U.S. dialysis facilities were located in neighborhoods with substantially greater proportions of black and poor residents, relative to the national average. Most facility neighborhood characteristics were associated with transplant, with incidence rate ratios (95% CI) for standardized increments (in percentage) of neighborhood exposures of: living in poverty, 0.88 (0.84-0.92), black race, 0.83 (0.78-0.89); high school graduates, 1.22 (1.17-1.26); and unemployed, 0.90 (0.85-0.95). Conclusion Dialysis facility neighborhood characteristics may be modestly associated with facility rates of kidney transplantation. The success of dialysis facility interventions to improve access to kidney transplantation may partially depend on reducing neighborhood-level barriers. PMID:25196018

  17. Explosion symmetry improvement of polyimide-coated tungsten wire in vacuum on negative discharge facility

    NASA Astrophysics Data System (ADS)

    Li, Mo; Wu, Jian; Lu, Yihan; Li, Xingwen; Li, Yang; Qiu, Mengtong

    2018-01-01

    Tungsten wire explosion is very asymmetric when fast current rate and insulated coatings are both applied on negative discharge facility using a 24-mm-diameter cathode geometry, which is commonly used on mega-ampere facilities. It is inferred, based on an analytical treatment of the guiding center drift and COMSOL simulations, that the large negative radial electric field causes early voltage breakdown and terminates energy deposition into the wire core on the anode side of the wire. After the anode side is short circuited, the radial electric field along the wire surface on the cathode side will change its polarity and thus leading to additional energy deposition into the wire core. This change causes ˜10 times larger energy deposition and ˜14 times faster explosion velocity in the cathode side than the anode side. In order to reduce this asymmetry, a hollow cylindrical cathode geometry was used to reverse the polarity of radial electric field and was optimized to use on multi-MA facilities. In this case, fully vaporized polyimide-coated tungsten wire with great symmetry improvement was achieved with energy deposition of ˜8.8 eV/atom. The atomic and electronic density distributions for the two different load geometries were obtained by the double-wavelength measurement.

  18. Pre-Project Planning of Capital Facilities at NASA

    DTIC Science & Technology

    1999-12-01

    recognize the unfailing love and support of my extended family; Jim and Nancy Marasco , Dan and Monica Mustard, Jimmy and Jodi Marasco , Irene Brekelmans...completion Attachment B 116 Bibliography/References Dumont, Peter R. (1995). Project Definition Rating Index (PDRI) for Industrial Projects. Austin

  19. M.U.S.T. 2007 Summer Research Project at NASA's KSC MILA Facility

    NASA Technical Reports Server (NTRS)

    PintoRey, Christian R.

    2007-01-01

    The summer research activity at Kennedy Space Center (KSC) aims to introduce the student to the basic principles in their field of study. While at KSC, a specific research project awaits the student to complete. As an Aeronautical Engineering student, my assigned project is to assist the cognizant engineer, Mr. Troy Hamilton, in the six engineering phases for replacing the Ponce De Leon (PDL)4.3M Antenna Control Unit (ACU). Although the project mainly requires the attention of two engineers and two students, it also involves the participation of many colleagues at various points during the course of the engineering change (EC). Since the PDL 4.3M ACU engineering change makes both hardware and software changes, it calls upon the expertise of a Hardware Engineer as well as a Software Engineer. As students, Mr. Jeremy Bresette and I have worked side by side with the engineers, gaining invaluable experience. We work in two teams, the hardware team and the software team, On certain tasks, we assist the engineers, while on others we assume their roles. By diligently working in this fashion, we are learning how to communicate effectively as professionals, despite the fact that we are studying different engineering fields. This project has been a great fit for my field of study, as it has highly improved my awareness of the many critical tasks involved in carrying out an engineering project.

  20. Facile mechanical shaking method is an improved isolation approach for islet preparation and transplantation.

    PubMed

    Yin, Nina; Chen, Tao; Yu, Yuling; Han, Yongming; Yan, Fei; Zheng, Zhou; Chen, Zebin

    2016-12-01

    Successful islet isolation is crucial for islet transplantation and cell treatment for type 1 diabetes. Current isolation methods are able to obtain 500-1,000 islets per rat, which results in a waste of ≥50% of total islets. In the present study, a facile mechanical shaking method for improving islet yield (up to 1,500 per rat) was developed and summarized, which was demonstrated to be more effective than the existing well-established stationary method. The present results showed that isolated islets have a maximum yield of 1,326±152 when shaking for 15 min for the fully-cannulated pancreas. For both fully-cannulated and half-cannulated pancreas in the presence of rat DNAse inhibitor, the optimal shaking time was amended to 20 min with a further increased yield of 1,344±134 and 1,286±124 islets, respectively. Furthermore, the majority of the isolated islets were morphologically intact with a well-defined surface and almost no central necrotic zone, which suggested that the condition of islets obtained via the mechanical shaking method was consistent with the stationary method. Islet size distribution was also calculated and it was demonstrated that islets from the stationary method exhibited the same size distribution as the non-cannulated group, which had more larger islets than the fully-cannulated and half-cannulated groups isolated via the shaking method. In addition, the results of glucose challenge showed that the refraction index of each group was >2.5, which indicated the well-preserved function of isolated islets. Furthermore, the transplanted islets exhibited a therapeutic effect after 1 day of transplantation; however, they failed to control blood glucose levels after ~7 days of transplantation. In conclusion, these results demonstrated that the facile mechanical shaking method may markedly improve the yield of rat islet isolation, and in vitro and in vivo investigation demonstrated the well-preserved function of isolated islets in the control of

  1. National facilities study. Volume 4: Space operations facilities task group

    NASA Technical Reports Server (NTRS)

    1994-01-01

    The principal objectives of the National Facilities Study (NFS) were to: (1) determine where U.S. facilities do not meet national aerospace needs; (2) define new facilities required to make U.S. capabilities 'world class' where such improvements are in the national interest; (3) define where consolidation and phase-out of existing facilities is appropriate; and (4) develop a long-term national plan for world-class facility acquisition and shared usage. The Space Operations Facilities Task Group defined discrete tasks to accomplish the above objectives within the scope of the study. An assessment of national space operations facilities was conducted to determine the nation's capability to meet the requirements of space operations during the next 30 years. The mission model used in the study to define facility requirements is described in Volume 3. Based on this model, the major focus of the Task Group was to identify any substantive overlap or underutilization of space operations facilities and to identify any facility shortfalls that would necessitate facility upgrades or new facilities. The focus of this initial study was directed toward facility recommendations related to consolidations, closures, enhancements, and upgrades considered necessary to efficiently and effectively support the baseline requirements model. Activities related to identifying facility needs or recommendations for enhancing U.S. international competitiveness and achieving world-class capability, where appropriate, were deferred to a subsequent study phase.

  2. Water Quality Indicators Data Usability Improvement Project ...

    EPA Pesticide Factsheets

    ECHO, Enforcement and Compliance History Online, provides compliance and enforcement information for approximately 800,000 EPA-regulated facilities nationwide. ECHO includes permit, inspection, violation, enforcement action, and penalty information about facilities regulated under the Clean Air Act (CAA) Stationary Source Program, Clean Water Act (CWA) National Pollutant Elimination Discharge System (NPDES), and/or Resource Conservation and Recovery Act (RCRA). Information also is provided on surrounding demographics when available.

  3. ISTC Projects from RFNC-VNIIEF Devoted to Improving Laser Beam Quality

    NASA Astrophysics Data System (ADS)

    Starikov, F.; Kochemasov, G.

    Information is given about the Projects # 1929 and # 2631 supported by ISTC and concerned with improving laser beam quality and interesting for adaptive optics community. One of them, Project # 1929 has been recently finished. It has been devoted to development of an SBS phase conjugation mirror of superhigh conjugation quality employing the kinoform optics for high-power lasers with nanosecond scale pulse duration. With the purpose of reaching ideal PC fidelity, the SBS mirror includes the raster of small lenses that has been traditionally used as the lenslet in Shack-Hartmann wavefront sensor in adaptive optics. The second of them, Project # 2631, is concerned with the development of an adaptive optical system for phase correction of laser beams with wavefront vortex. The principles of operation of modern adaptive systems are based on the assumption that the phase is a smooth continuous function in space. Therefore the solution of the Project tasks will assume a new step in adaptive optics.

  4. Experimental and theoretical analysis for improved microscope design of optical projection tomographic microscopy.

    PubMed

    Coe, Ryan L; Seibel, Eric J

    2013-09-01

    We present theoretical and experimental results of axial displacement of objects relative to a fixed condenser focal plane (FP) in optical projection tomographic microscopy (OPTM). OPTM produces three-dimensional, reconstructed images of single cells from two-dimensional projections. The cell rotates in a microcapillary to acquire projections from different perspectives where the objective FP is scanned through the cell while the condenser FP remains fixed at the center of the microcapillary. This work uses a combination of experimental and theoretical methods to improve the OPTM instrument design.

  5. Implications of system usability on intermodal facility design.

    DOT National Transportation Integrated Search

    2010-08-01

    Ensuring good design of intermodal transportation facilities is critical for effective and : satisfactory operation. Passenger use of the facilities is often hindered by inadequate space, a poor : layout, or lack of signage. This project aims to impr...

  6. Introducing quality improvement methods into local public health departments: structured evaluation of a statewide pilot project.

    PubMed

    Riley, William; Parsons, Helen; McCoy, Kim; Burns, Debra; Anderson, Donna; Lee, Suhna; Sainfort, François

    2009-10-01

    To test the feasibility and assess the preliminary impact of a unique statewide quality improvement (QI) training program designed for public health departments. One hundred and ninety-five public health employees/managers from 38 local health departments throughout Minnesota were selected to participate in a newly developed QI training program and 65 of those engaged in and completed eight expert-supported QI projects over a period of 10 months from June 2007 through March 2008. As part of the Minnesota Quality Improvement Initiative, a structured distance education QI training program was designed and deployed in a first large-scale pilot. To evaluate the preliminary impact of the program, a mixed-method evaluation design was used based on four dimensions: learner reaction, knowledge, intention to apply, and preliminary outcomes. Subjective ratings of three dimensions of training quality were collected from participants after each of the scheduled learning sessions. Pre- and post-QI project surveys were administered to collect participant reactions, knowledge, future intention to apply learning, and perceived outcomes. Monthly and final QI project reports were collected to further inform success and preliminary outcomes of the projects. The participants reported (1) high levels of satisfaction with the training sessions, (2) increased perception of the relevance of the QI techniques, (3) increased perceived knowledge of all specific QI methods and techniques, (4) increased confidence in applying QI techniques on future projects, (5) increased intention to apply techniques on future QI projects, and (6) high perceived success of, and satisfaction with, the projects. Finally, preliminary outcomes data show moderate to large improvements in quality and/or efficiency for six out of eight projects. QI methods and techniques can be successfully implemented in local public health agencies on a statewide basis using the collaborative model through distance training and

  7. 340 Facility secondary containment and leak detection

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

    Bendixsen, R.B.

    1995-01-31

    This document presents a preliminary safety evaluation for the 340 Facility Secondary Containment and Leak Containment system, Project W-302. Project W-302 will construct Building 340-C which has been designed to replace the current 340 Building and vault tank system for collection of liquid wastes from the Pacific Northwest Laboratory buildings in the 300 Area. This new nuclear facility is Hazard Category 3. The vault tank and related monitoring and control equipment are Safety Class 2 with the remainder of the structure, systems and components as Safety Class 3 or 4.

  8. Innovative health systems projects.

    PubMed

    Green, Michael; Amad, Mansoor; Woodland, Mark

    2015-02-01

    Residency programmes struggle with the systems-based practice and improvement competency promoted by the Accreditation Council for Graduate Medical Education. The development of Innovative Health Systems Projects (IHelP) was driven by the need for better systems-based initiatives at an institutional level. Our objective was to develop a novel approach that successfully incorporates systems-based practice in our Graduate Medical Education (GME) programmes, while tracking our impact on health care delivery as an academic medical centre. We started the IHelP programme as a 'volunteer initiative' in 2010. A detailed description of the definition, development and implementation of the IHelP programme, along with our experience of the first year, is described. Residents, fellows and faculty mentors all played an important role in establishing the foundation of this initiative. Following the positive response, we have now incorporated IHelP into all curricula as a graduating requirement. IHelP has promoted scholarly activity and faculty mentorship, [and] has improved aspects of patient care and safety A total of 123 residents and fellows, representing 26 specialties, participated. We reviewed 145 projects that addressed topics ranging from administrative and departmental improvements to clinical care algorithms. The projects by area of focus were: patient care - clinical care, 38 per cent; patient care - quality, 27 per cent; resident education, 21 per cent; and a cumulative 16 per cent among pharmacy, department activities, patient education, medical records and clinical facility. We are pleased with the results of our first year of incorporating a systems-based improvement programme into the GME programmes. This initiative has promoted scholarly activity and faculty mentorship, has improved aspects of patient care and safety, and has led to the development of many practical innovations. © 2015 John Wiley & Sons Ltd.

  9. Code JEF Facilities Engineering Home Page for the Internet

    NASA Technical Reports Server (NTRS)

    Mahaffey, Valerie A.; Harrison, Marla J. (Technical Monitor)

    1995-01-01

    There are always many activities going on in JEF. We work on and manage the Construction of Facilities (C of F) projects at NASA-Ames. We are constantly designing or analyzing a new facility or project, or a modification to an existing facility. Every day we answer numerous questions about engineering policy, codes and standards, we attend design reviews, we count dollars and we make sure that everything at the Center is designed and built according to good engineering judgment. In addition, we study literature and attend conferences to make sure that we keep current on new legislation and standards.

  10. Facilities Standards and Planning Manual for New Jersey County Community Colleges.

    ERIC Educational Resources Information Center

    New Jersey State Dept. of Higher Education, Trenton. Office of Community Coll. Programs.

    After some general comments concerning all guidelines, planning standards are described for--(1) various types of new facilities, (2) expansion of present facilities, (3) minimum space requirements for a college, (4) net-to-gross space ratios, and (5) total project costs. Information regarding capital construction project submissions procedure is…

  11. An Orthopedic Performance Improvement Initiative at a Small Military Treatment Facility.

    PubMed

    McGee, John Christopher; Bise, Christopher G; Stevens, Joel M

    2017-03-01

    The scientific literature demonstrates a cost-benefit associated with early access to physical therapy. The purpose of this case study is to report the results of an orthopedic performance improvement initiative (OPII) at a small military treatment facility (approximately 4.5K active duty beneficiaries). The OPII was introduced to (1) limit variation by ensuring that all active duty orthopedic consults were audited ensuring proper timing of appropriate services and (2) establish contractual agreement for shared resources with the U.S. Naval Jacksonville Orthopedic Department. OPII was accomplished through consensus development and strong leadership support. All orthopedic referrals (n = 260) were audited for 6 months. Appropriate recommendations were provided to either continue with orthopedic care or to redirect to a physical therapy first approach. Orthopedic referrals decreased 27% with concomitant 32% increase in physical therapy referrals producing overall savings of $462K (33%). Meanwhile, surgical throughput improved 45%. Seventy percent of the savings were attributed to improved utilization translating to a relative value unit savings per beneficiary of $17.64 (23.7%). Our results support the value of a conservative physical therapy first approach for musculoskeletal conditions and shared mil-to-mil resourcing agreements. Success requires an iterative audit/feedback process balanced with stakeholder consensus. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  12. [Evaluation of 12 pilot projects to improve outpatient palliative care].

    PubMed

    Schmidt-Wolf, G; Elsner, F; Lindena, G; Hilgers, R-D; Heussen, N; Rolke, R; Ostgathe, C; Radbruch, L

    2013-12-01

    With a priority programme the German Cancer Aid supported the development of quality-assured outpatient palliative care to cover the whole country. The 12 regional pilot projects funded with the aim to improve outpatient palliative care in different models and different frameworks were concurrently monitored and evaluated. The supported projects, starting and ending individually, documented all patients who were cared for using HOPE (Hospice and palliative care evaluation) and MIDOS (Minimal documentation system for palliative patients). Total data were analyzed for 3239 patients decriptively. In addition to the quantitative data the experiences of the projects were recorded in a number of workshops (2008, 2009, 2010, and 2012). In particular, the experiences reported in the final meeting in July 2012 were considered for this article as well as the final reports for the German Cancer Aid. In the quantitative evaluation 85.6% of 3239 palliative care patients had a cancer diagnosis. In all model projects the goal of a network with close cooperation of primary providers, social support, and outpatient and inpatient specialist services has been achieved. For all projects, the initial financing of the German Cancer Aid was extremely important, because contracts with health insurance funds were negotiated slowly, and could then be built on the experiences with the projects. The participants of the project-completion meeting emphasized the need to carry out a market analysis before starting palliative care organizations considering the different regional structures and target groups of patients. Education, training and continuing education programs contribute significantly to the network. A reliably funded coordination center/case management across all institutions is extremely important. © Georg Thieme Verlag KG Stuttgart · New York.

  13. 77 FR 55120 - Federal Housing Administration (FHA): Section 232 Healthcare Facility Insurance Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ...In 2010 through 2011, HUD commenced and completed the process of revising regulations applicable to, and closing documents used in, FHA insurance of multifamily rental projects, to reflect current policy and practices in the multifamily mortgage market. This final rule results from a similar process that was initiated in 2011 for revising and updating the regulations governing, and the transactional documents used in, the program for insurance of healthcare facilities under section 232 of the National Housing Act (Section 232 program). HUD's Section 232 program insures mortgage loans to facilitate the construction, substantial rehabilitation, purchase, and refinancing of nursing homes, intermediate care facilities, board and care homes, and assisted-living facilities. This rule revises the Section 232 program regulations to reflect current policy and practices, and improve accountability and strengthen risk management in the Section 232 program.

  14. Intermediate Care Facilities for Persons with Mental Retardation (ICFs-MR): Program Utilization and Resident Characterstics. Project Report #31.

    ERIC Educational Resources Information Center

    Minnesota Univ., Minneapolis. Center for Residential and Community Services.

    This report on the Intermediate Care Facility for the Mentally Retarded (ICF-MR) and related programs under Title XIX (Medicaid) of the Social Security Act aims to assist in consideration of improvements to Medicaid services. The report begins with a background description of the key Medicaid programs of interest, discussing: federal involvement…

  15. A Practice Improvement Education Program Using a Mentored Approach to Improve Nursing Facility Depression Care-Preliminary Data.

    PubMed

    Chodosh, Joshua; Price, Rachel M; Cadogan, Mary P; Damron-Rodriguez, JoAnn; Osterweil, Dan; Czerwinski, Alfredo; Tan, Zaldy S; Merkin, Sharon S; Gans, Daphna; Frank, Janet C

    2015-11-01

    Depression is common in nursing facility residents. Depression data obtained using the Minimum Data Set (MDS) 3.0 offer opportunities for improving diagnostic accuracy and care quality. How best to integrate MDS 3.0 and other data into quality improvement (QI) activity is untested. The objective was to increase nursing home (NH) capability in using QI processes and to improve depression assessment and management through focused mentorship and team building. This was a 6-month intervention with five components: facilitated collection of MDS 3.0 nine-item Patient Health Questionnaire (PHQ-9) and medication data for diagnostic interpretation; education and modeling on QI approaches, team building, and nonpharmacological depression care; mentored team meetings; educational webinars; and technical assistance. PHQ-9 and medication data were collected at baseline and 6 and 9 months. Progress was measured using team participation measures, attitude and care process self-appraisal, mentor assessments, and resident depression outcomes. Five NHs established interprofessional teams that included nursing (44.1%), social work (20.6%), physicians (8.8%), and other disciplines (26.5%). Members participated in 61% of eight offered educational meetings (three onsite mentored team meetings and five webinars). Competency self-ratings improved on four depression care measures (P = .05 to <.001). Mentors observed improvement in team process and enthusiasm during team meetings. For 336 residents with PHQ-9 and medication data, depression scores did not change while medication use declined, from 37.2% of residents at baseline to 31.0% at 9 months (P < .001). This structured mentoring program improved care processes, achieved medication reductions, and was well received. Application to other NH-prevalent syndromes is possible. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  16. Final Report of Project CHOICE: A Center for Helping Organizations Improve Choice in Education.

    ERIC Educational Resources Information Center

    Chapman, Davis W.; And Others

    The purpose of the Center for Helping Organizations Improve Choice in Education (CHOICE) project, the scope of its activities, and evaluations of the effectiveness of those activities are described. One major project goal was to encourage and facilitate institutional efforts to provide more complete and accurate information to prospective…

  17. Improving Immunization Rates Using Lean Six Sigma Processes: Alliance of Independent Academic Medical Centers National Initiative III Project

    PubMed Central

    Hina-Syeda, Hussaini; Kimbrough, Christina; Murdoch, William; Markova, Tsveti

    2013-01-01

    Background Quality improvement education and work in interdisciplinary teams is a healthcare priority. Healthcare systems are trying to meet core measures and provide excellent patient care, thus improving their Hospital Consumer Assessment of Healthcare Providers & Systems scores. Crittenton Hospital Medical Center in Rochester Hills, MI, aligned educational and clinical objectives, focusing on improving immunization rates against pneumonia and influenza prior to the rates being implemented as core measures. Improving immunization rates prevents infections, minimizes hospitalizations, and results in overall improved patient care. Teaching hospitals offer an effective way to work on clinical projects by bringing together the skill sets of residents, faculty, and hospital staff to achieve superior results. Methods We designed and implemented a structured curriculum in which interdisciplinary teams acquired knowledge on quality improvement and teamwork, while focusing on a specific clinical project: improving global immunization rates. We used the Lean Six Sigma process tools to quantify the initial process capability to immunize against pneumococcus and influenza. Results The hospital's process to vaccinate against pneumonia overall was operating at a Z score of 3.13, and the influenza vaccination Z score was 2.53. However, the process to vaccinate high-risk patients against pneumonia operated at a Z score of 1.96. Improvement in immunization rates of high-risk patients became the focus of the project. After the implementation of solutions, the process to vaccinate high-risk patients against pneumonia operated at a Z score of 3.9 with a defects/million opportunities rate of 9,346 and a yield of 93.5%. Revisions to the adult assessment form fixed 80% of the problems identified. Conclusions This process improvement project was not only beneficial in terms of improved quality of patient care but was also a positive learning experience for the interdisciplinary team

  18. Improving Immunization Rates Using Lean Six Sigma Processes: Alliance of Independent Academic Medical Centers National Initiative III Project.

    PubMed

    Hina-Syeda, Hussaini; Kimbrough, Christina; Murdoch, William; Markova, Tsveti

    2013-01-01

    Quality improvement education and work in interdisciplinary teams is a healthcare priority. Healthcare systems are trying to meet core measures and provide excellent patient care, thus improving their Hospital Consumer Assessment of Healthcare Providers & Systems scores. Crittenton Hospital Medical Center in Rochester Hills, MI, aligned educational and clinical objectives, focusing on improving immunization rates against pneumonia and influenza prior to the rates being implemented as core measures. Improving immunization rates prevents infections, minimizes hospitalizations, and results in overall improved patient care. Teaching hospitals offer an effective way to work on clinical projects by bringing together the skill sets of residents, faculty, and hospital staff to achieve superior results. WE DESIGNED AND IMPLEMENTED A STRUCTURED CURRICULUM IN WHICH INTERDISCIPLINARY TEAMS ACQUIRED KNOWLEDGE ON QUALITY IMPROVEMENT AND TEAMWORK, WHILE FOCUSING ON A SPECIFIC CLINICAL PROJECT: improving global immunization rates. We used the Lean Six Sigma process tools to quantify the initial process capability to immunize against pneumococcus and influenza. The hospital's process to vaccinate against pneumonia overall was operating at a Z score of 3.13, and the influenza vaccination Z score was 2.53. However, the process to vaccinate high-risk patients against pneumonia operated at a Z score of 1.96. Improvement in immunization rates of high-risk patients became the focus of the project. After the implementation of solutions, the process to vaccinate high-risk patients against pneumonia operated at a Z score of 3.9 with a defects/million opportunities rate of 9,346 and a yield of 93.5%. Revisions to the adult assessment form fixed 80% of the problems identified. This process improvement project was not only beneficial in terms of improved quality of patient care but was also a positive learning experience for the interdisciplinary team, particularly for the residents. The

  19. Guidebook to the School Facility Program.

    ERIC Educational Resources Information Center

    California State Dept. of General Services, Sacramento. Office of Public School Construction.

    This guidebook assists California school districts in applying for and obtaining "grant" funds for new construction and modernization projects of its public schools under the provisions of the Leroy F. Greene School Facilities Act of 1998. It provides direction on accessing the processes leading to project approvals, insight into the various…

  20. Design of the Long-term Waste Management Facility for Historic LLRW Port Hope Project - 13322

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

    Campbell, Don; Barton, David; Case, Glenn

    2013-07-01

    The Municipality of Port Hope is located on the northern shores of Lake Ontario approximately 100 km east of Toronto, Ontario, Canada. Starting in the 1930's, radium and later uranium processing by Eldorado Gold Mines Limited (subsequently Eldorado Nuclear Limited) (Eldorado) at their refinery in Port Hope resulted in the generation of process residues and wastes that were disposed of indiscriminately throughout the Municipality until about the mid-1950's. These process residues contained radium (Ra- 226), uranium, arsenic and other contaminants. Between 1944 and 1988, Eldorado was a Federal Crown Corporation, and as such, the Canadian Federal Government has assumed responsibilitymore » for the clean-up and long-term management of the historic waste produced by Eldorado during this period. The Port Hope Project involves the construction and development of a new long-term waste management facility (LTWMF), and the remediation and transfer of the historic wastes located within the Municipality of Port Hope to the new LTWMF. The new LTWMF will consist of an engineered above-ground containment mound designed to contain and isolate the wastes from the surrounding environment for the next several hundred years. The design of the engineered containment mound consists of a primary and secondary composite base liner system and composite final cover system, made up of both natural materials (e.g., compacted clay, granular materials) and synthetic materials (e.g., geo-synthetic clay liner, geo-membrane, geo-textiles). The engineered containment mound will cover an area of approximately 13 hectares and will contain the estimated 1.2 million cubic metres of waste that will be generated from the remedial activities within Port Hope. The LTWMF will also include infrastructure and support facilities such as access roads, administrative offices, laboratory, equipment and personnel decontamination facilities, waste water treatment plant and other ancillary facilities. Preliminary

  1. Sustainable data policy for a data production facility: a work in (continual) progress

    NASA Astrophysics Data System (ADS)

    Ketcham, R. A.

    2017-12-01

    The University of Texas High-Resolution X-Ray Computed Tomography Facility (UTCT) has been producing volumetric data and data products of geological and other scientific specimens and engineering materials for over 20 years. Data volumes, both in terms of the size of individual data sets and overall facility production, have progressively grown and fluctuated near the upper boundary of what can be managed by contemporary workstations and lab-scale servers and network infrastructure, making data policy a preoccupation for our entire history. Although all projects have been archived since our first day of operation, policies on which data to keep (raw, reconstructed after corrections, processed) have varied, and been periodically revisited in consideration of the cost of curation and the likelihood of revisiting and reprocessing data when better techniques become available, such as improved artifact corrections or iterative tomographic reconstruction. Advances in instrumentation regularly make old data obsolete and more advantageous to reacquire, but the simple act of getting a sample to a scanning facility is a practical barrier that cannot be overlooked. In our experience, the main times that raw data have been revisited using improved processing to improve image quality were predictable, high-impact charismatic projects (e.g., Archaeopteryx, A. Afarensis "Lucy"). These cases actually provided the impetus for development of the new techniques (ring and beam hardening artifact reduction), which were subsequently incorporated into our data processing pipeline going forward but were rarely if ever retroactively applied to earlier data sets. The only other times raw data have been reprocessed were when reconstruction parameters were inappropriate, due to unnoticed sample features or human error, which are usually recognized fairly quickly. The optimal data retention policy thus remains an open question, although erring on the side of caution remains the default

  2. Tracing Scientific Facilities through the Research Literature Using Persistent Identifiers

    NASA Astrophysics Data System (ADS)

    Mayernik, M. S.; Maull, K. E.

    2016-12-01

    Tracing persistent identifiers to their source publications is an easy task when authors use them, since it is a simple matter of matching the persistent identifier to the specific text string of the identifier. However, trying to understand if a publication uses the resource behind an identifier when such identifier is not referenced explicitly is a harder task. In this research, we explore the effectiveness of alternative strategies of associating publications with uses of the resource referenced by an identifier when it may not be explicit. This project is explored within the context of the NCAR supercomputer, where we are broadly interesting in the science that can be traced to the usage of the NCAR supercomputing facility, by way of the peer-reviewed research publications that utilize and reference it. In this project we explore several ways of drawing linkages between publications and the NCAR supercomputing resources. Identifying and compiling peer-reviewed publications related to NCAR supercomputer usage are explored via three sources: 1) User-supplied publications gathered through a community survey, 2) publications that were identified via manual searching of the Google scholar search index, and 3) publications associated with National Science Foundation (NSF) grants extracted from a public NSF database. These three sources represent three styles of collecting information about publications that likely imply usage of the NCAR supercomputing facilities. Each source has strengths and weaknesses, thus our discussion will explore how our publication identification and analysis methods vary in terms of accuracy, reliability, and effort. We will also discuss strategies for enabling more efficient tracing of research impacts of supercomputing facilities going forward through the assignment of a persistent web identifier to the NCAR supercomputer. While this solution has potential to greatly enhance our ability to trace the use of the facility through

  3. Examples of actions that improve partnering cooperation among the participants of construction projects

    NASA Astrophysics Data System (ADS)

    Radziszewska-Zielina, E.; Szewczyk, B.

    2017-10-01

    The aim of the article is to present examples of actions that can be undertaken in order to improve partnering cooperation in construction projects. These actions are a practical supplementation to the previously developed fuzzy system of controlling partnering relations in construction projects. The actions relate to 18 parameters of partnering relations that describe cooperation between a general contractor or a company that manages the project and four other participants: the contractors (subcontractors), the designer, the material and equipment suppliers and the real estate developer. The actions have been listed based on a review of subject literature, self-analysis, as well as interviews with participants of construction projects. They can provide examples of good practices that maintain partnering cooperation at a high level. Good cooperation, in turn, translates into a better performance of the project.

  4. Vibration control with adaptive structures: MAVO FASPAS project review

    NASA Astrophysics Data System (ADS)

    Hanselka, Holger; Melz, Tobias; Drossel, Welf-Guntram; Sporn, Dieter; Schönecker, Andreas; Poigné, Axel

    2006-03-01

    The mission of the Fraunhofer Gesellschaft, one of the biggest research facilities in Germany, is to identify technologies with a high impact potential for commercial applications and to take all necessary steps to successfully promote them by performing cooperative industrial research activities. One of these technologies is called smart structures, also known as adaptive structures. Most recently, Fraunhofer decided to strategically extend its portfolio to include this technology and summarize its R&D activities in the FIT (Fraunhofer Innovation Topics) ADAPTRONIK. To improve Fraunhofer's competencies in adaptronics, especially with respect to system design and implementation, the Fraunhofer internal project MAVO FASPAS was launched in 2003. Now, after 3 years of work, the project comes to a close. This article discusses some major project results.

  5. The Current Status of the Space Station Biological Research Project: a Core Facility Enabling Multi-Generational Studies under Slectable Gravity Levels

    NASA Astrophysics Data System (ADS)

    Santos, O.

    2002-01-01

    The Space Station Biological Research Project (SSBRP) has developed a new plan which greatly reduces the development costs required to complete the facility. This new plan retains core capabilities while allowing for future growth. The most important piece of equipment required for quality biological research, the 2.5 meter diameter centrifuge capable of accommodating research specimen habitats at simulated gravity levels ranging from microgravity to 2.0 g, is being developed by NASDA, the Japanese space agency, for the SSBRP. This is scheduled for flight to the ISS in 2007. The project is also developing a multi-purpose incubator, an automated cell culture unit, and two microgravity habitat holding racks, currently scheduled for launch in 2005. In addition the Canadian Space Agency is developing for the project an insect habitat, which houses Drosophila melanogaster, and provides an internal centrifuge for 1 g controls. NASDA is also developing for the project a glovebox for the contained manipulation and analysis of biological specimens, scheduled for launch in 2006. This core facility will allow for experimentation on small plants (Arabidopsis species), nematode worms (C. elegans), fruit flies (Drosophila melanogaster), and a variety of microorganisms, bacteria, yeast, and mammalian cells. We propose a plan for early utilization which focuses on surveys of changes in gene expression and protein structure due to the space flight environment. In the future, the project is looking to continue development of a rodent habitat and a plant habitat that can be accommodated on the 2.5 meter centrifuge. By utilizing the early phases of the ISS to broadly answer what changes occur at the genetic and protein level of cells and organisms exposed to the ISS low earth orbit environment, we can generate interest for future experiments when the ISS capabilities allow for direct manipulation and intervention of experiments. The ISS continues to hold promise for high quality, long

  6. X-ray Cryogenic Facility (XRCF) Handbook

    NASA Technical Reports Server (NTRS)

    Kegley, Jeffrey R.

    2016-01-01

    The X-ray & Cryogenic Facility (XRCF) Handbook is a guide for planning operations at the facility. A summary of the capabilities, policies, and procedures is provided to enhance project coordination between the facility user and XRCF personnel. This handbook includes basic information that will enable the XRCF to effectively plan and support test activities. In addition, this handbook describes the facilities and systems available at the XRCF for supporting test operations. 1.2 General Facility Description The XRCF was built in 1989 to meet the stringent requirements associated with calibration of X-ray optics, instruments, and telescopes and was subsequently modified in 1999 & 2005 to perform the challenging cryogenic verification of Ultraviolet, Optical, and Infrared mirrors. These unique and premier specialty capabilities, coupled with its ability to meet multiple generic thermal vacuum test requirements for large payloads, make the XRCF the most versatile and adaptable space environmental test facility in the Agency. XRCF is also recognized as the newest, most cost effective, most highly utilized facility in the portfolio and as one of only five NASA facilities having unique capabilities. The XRCF is capable of supporting and has supported missions during all phases from technology development to flight verification. Programs/projects that have benefited from XRCF include Chandra, Solar X-ray Imager, Hinode, and James Webb Space Telescope. All test programs have been completed on-schedule and within budget and have experienced no delays due to facility readiness or failures. XRCF is currently supporting Strategic Astrophysics Technology Development for Cosmic Origins. Throughout the years, XRCF has partnered with and continues to maintain positive working relationships with organizations such as ATK, Ball Aerospace, Northrop Grumman Aerospace, Excelis (formerly Kodak/ITT), Smithsonian Astrophysical Observatory, Goddard Space Flight Center, University of Alabama

  7. Treatment at high-volume facilities and academic centers is independently associated with improved survival in patients with locally advanced head and neck cancer.

    PubMed

    David, John M; Ho, Allen S; Luu, Michael; Yoshida, Emi J; Kim, Sungjin; Mita, Alain C; Scher, Kevin S; Shiao, Stephen L; Tighiouart, Mourad; Zumsteg, Zachary S

    2017-10-15

    The treatment of head and neck cancers is complex and associated with significant morbidity, requiring multidisciplinary care and physician expertise. Thus, facility characteristics, such as clinical volume and academic status, may influence outcomes. The current study included 46,567 patients taken from the National Cancer Data Base who were diagnosed with locally advanced invasive squamous cell carcinomas of the oropharynx, larynx, and hypopharynx and were undergoing definitive radiotherapy. High-volume facilities (HVFs) were defined as the top 1% of centers by the number of patients treated from 2004 through 2012. Multivariable Cox regression and propensity score matching were performed to account for imbalances in covariates. The median follow-up was 55.1 months. Treatment at a HVF (hazard ratio, 0.798; 95% confidence interval, 0.753-0.845 [P<.001]) and treatment at an academic facility (hazard ratio, 0.897; 95% confidence interval, 0.871-0.923 [P<.001]) were found to be independently associated with improved overall survival in multivariable analysis. In propensity score-matched cohorts, the 5-year overall survival rate was 61.6% versus 55.5% for patients treated at an HVF versus lower-volume facilities, respectively (P<.001). Similarly, the 5-year overall survival rate was 52.3% versus 49.7% for patients treated at academic versus nonacademic facilities (P<.001). Analysis of facility volume as a continuous variable demonstrated continual improvement in survival with an increased number of patients treated. The impact of facility volume and academic designation on survival was observed when using a variety of thresholds to define HVF, and across the vast majority of subgroups, including both oropharyngeal and nonoropharyngeal subsites. Patients with locally advanced head and neck squamous cell carcinoma who are undergoing curative radiotherapy at HVFs and academic centers appear to have improved survival. Cancer 2017;123:3933-42. © 2017 American Cancer

  8. Syracuse Labor/Management Consortium Workplace Literacy Skills Improvement Project. Evaluation Report.

    ERIC Educational Resources Information Center

    Mosenthal, Peter B.; Hinchman, Kathleen A.

    An evaluation of this Syracuse, New York workplace literacy skills improvement project had three purposes: to characterize changes in the baseline performance of adults' workplace literacy skills as a function of instructional treatment; to characterize changes in workers' and supervisors' perceptions of worker effectiveness as a function of…

  9. Heritage plaza parking lots improvement project- Solar PV installation

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

    Hooks, Todd

    The Agua Caliente Band of Cahuilla Indians (ACBCI or the “Tribe”) installed a 79.95 kW solar photovoltaic (PV) system to offset the energy usage costs of the Tribal Education and Family Services offices located at the Tribe's Heritage Plaza office building, 90I Tahquitz Way, Palm Springs, CA, 92262 (the "Project"). The installation of the Solar PV system was part of the larger Heritage Plaza Parking Lot Improvements Project and mounted on the two southern carport shade structures. The solar PV system will offset 99% of the approximately 115,000 kWh in electricity delivered annually by Southern California Edison (SCE) to themore » Tribal Education and Family Services offices at Heritage Plaza, reducing their annual energy costs from approximately $22,000 annually to approximately $200. The total cost of the proposed solar PV system is $240,000.« less

  10. Improving the coordination of patients' medication management: a regional Finnish development project.

    PubMed

    Kivekäs, Eija; Luukkonen, Irmeli; Mykkänen, Juha; Saranto, Kaija

    2014-01-01

    In this paper, we present an overview of activities and results from a regional development project in Finland. The aim in this project was to analyze how healthcare providers produce and receive information on a patient's medication, and to identify opportunities to improve the quality, effectiveness, availability and collaboration of social and healthcare services in relation to medication information. The project focused on the most important points in patients' medication management such as home care and care transitions. In a regional development project, data was gathered by interviews and a multi professional workshop. The study revealed that medication information reached only some professionals and lay caregivers despite electronic patient record (EPR) systems and tools. Differences in work processes related to medication reconciliation and information management were discussed in the group meeting and were regarded as a considerable risk for patient safety.

  11. 24 CFR 232.902 - Eligible project.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Eligible project. 232.902 Section... FACILITIES Insurance of Mortgages Covering Existing Projects § 232.902 Eligible project. Existing projects... for insurance under this subpart. The project must not require substantial rehabilitation and three...

  12. 24 CFR 232.902 - Eligible project.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Eligible project. 232.902 Section... FACILITIES Insurance of Mortgages Covering Existing Projects § 232.902 Eligible project. Existing projects... for insurance under this subpart. The project must not require substantial rehabilitation and three...

  13. 24 CFR 232.902 - Eligible project.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Eligible project. 232.902 Section... FACILITIES Insurance of Mortgages Covering Existing Projects § 232.902 Eligible project. Existing projects... for insurance under this subpart. The project must not require substantial rehabilitation and three...

  14. 24 CFR 232.902 - Eligible project.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Eligible project. 232.902 Section... FACILITIES Insurance of Mortgages Covering Existing Projects § 232.902 Eligible project. Existing projects... for insurance under this subpart. The project must not require substantial rehabilitation and three...

  15. Land Acquisition and Relocation Assistance for Airport Improvement Program (AIP) Assisted Projects

    DOT National Transportation Integrated Search

    2017-07-10

    This advisory circular (AC) provides guidance to sponsors of airport projects developed under the Airport Improvement Program (AIP) to meet the requirements of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Pl 9...

  16. Developing the Rehabilitation Facility Personnel Manual.

    ERIC Educational Resources Information Center

    Gilbertson, Alan D.

    This guide is intended to provide rehabilitation facilities with assistance in developing or improving their facility personnel manual, along with examples of what some rehabilitation facilities are including within their personnel manuals. The introduction to the guide discusses how a facility can begin the formulation of its personnel manual.…

  17. Projected techno-economic improvements for advanced solar thermal power plants

    NASA Technical Reports Server (NTRS)

    Fujita, T.; Manvi, R.; Roschke, E. J.

    1979-01-01

    The projected characteristics of solar thermal power plants (with outputs up to 10 MWe) employing promising advanced technology subsystems/components are compared to current (or pre-1985) steam-Rankine systems. Improvements accruing to advanced technology development options are delineated. The improvements derived from advanced systems result primarily from achieving high efficiencies via solar collector systems which (1) capture a large portion of the available insolation and (2) concentrate this captured solar flux to attain high temperatures required for high heat engine/energy conversion performance. The most efficient solar collector systems employ two-axis tracking. Attractive systems include the central receiver/heliostat and the parabolic dish.

  18. National Facilities study

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This study provides a set of recommendations for improving the effectiveness of our nation's aeronautics and space facilities. The study plan considers current and future government and commercial needs as well as DOD and NASA mission requirements through the year 2023. It addresses shortfalls in existing capabilities, new facility requirements, upgrades, consolidations, and phase-out of existing facilities. If the recommendations are implemented, they will provide world-class capability where it is vital to our country's needs and make us more efficient in meeting future needs.

  19. Multimillion Dollar Construction Project Completed in Glenn's Icing Research Tunnel

    NASA Technical Reports Server (NTRS)

    Kevdzija, Susan L.

    2001-01-01

    Over the last year, the Glenn Research Center's Icing Research Tunnel (IRT) underwent a major $5.2 million rehabilitation project as part of the Construction of Facilities program. The scope of the project included redesign and replacement of the 55-yr-old heat exchanger, the addition of fan outlet guide vanes for flow conditioning downstream of the 25-ft-diameter fan, and redesign and replacement of the C and D corner-turning vanes. The purpose of the rehabilitation was to replace old portions of the infrastructure and to improve the aerodynamic flow quality in the tunnel.

  20. Harnessing the power of enhanced data for healthcare quality improvement: lessons from a Minnesota Hospital Association Pilot Project.

    PubMed

    Pine, Michael; Sonneborn, Mark; Schindler, Joe; Stanek, Michael; Maeda, Jared Lane; Hanlon, Carrie

    2012-01-01

    The imperative to achieve quality improvement and cost-containment goals is driving healthcare organizations to make better use of existing health information. One strategy, the construction of hybrid data sets combining clinical and administrative data, has strong potential to improve the cost-effectiveness of hospital quality reporting processes, improve the accuracy of quality measures and rankings, and strengthen data systems. Through a two-year contract with the Agency for Healthcare Research and Quality, the Minnesota Hospital Association launched a pilot project in 2007 to link hospital clinical information to administrative data. Despite some initial challenges, this project was successful. Results showed that the use of hybrid data allowed for more accurate comparisons of risk-adjusted mortality and risk-adjusted complications across Minnesota hospitals. These increases in accuracy represent an important step toward targeting quality improvement efforts in Minnesota and provide important lessons that are being leveraged through ongoing projects to construct additional enhanced data sets. We explore the implementation challenges experienced during the Minnesota Pilot Project and their implications for hospitals pursuing similar data-enhancement projects. We also highlight the key lessons learned from the pilot project's success.