HEALTH CARE GUIDE TO POLLUTION PREVENTION IMPLEMENTATION THROUGH ENVIRONMENTAL MANAGEMENT SYSTEMS

EPA Science Inventory

The Health Care Guide to Pollution Prevention Implementation through Environmental Management Systems provides example EMS procedures and forms used in four ISO 14001 EMS certified hospitals. The latest revisions include more EMS hospital case studies, more compliance resources, ...

76 FR 39263 - Antidumping and Countervailing Duty Proceedings: Electronic Filing Procedures; Administrative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-06

... resulting from the Department's implementation of an electronic filing and documents management program... regulations that is entitled ``IA ACCESS Handbook On Electronic Filing Procedures'' (``IA ACCESS Handbook... management program named Import Administration Antidumping and Countervailing Duty Centralized Electronic...

49 CFR 195.446 - Control room management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... written control room management procedures that implement the requirements of this section. The procedures... define the roles and responsibilities of a controller during normal, abnormal, and emergency operating... operator must define each of the following: (1) A controller's authority and responsibility to make...

Standard operating procedures improve acute neurologic care in a sub-Saharan African setting

PubMed Central

Jaiteh, Lamin E.S.; Helwig, Stefan A.; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman

2017-01-01

Objective: Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Methods: Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. Results: At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p < 0.05) and assessments of respiratory rate (98.0% vs 81.9%, p < 0.001), temperature (60.0% vs 36.2%; p < 0.001), and glucose levels (73.0% vs 58.1%; p < 0.05), in addition to written directives by physicians (96.0% vs 88.6%, p < 0.05), whereas assessments of other vital signs remained unchanged. In stroke patients, rates of stroke-related procedures increased: early CT scanning (24.3% vs 9.9%; p < 0.05), blood count (73.0% vs 49.3%; p < 0.01), renal and liver function tests (50.0% vs 5.6%, p < 0.001), aspirin prophylaxis (47.3% vs 9.9%; p < 0.001), and physiotherapy (41.9% vs 4.2%; p < 0.001). Most effects persisted until the second-year evaluation. SOP implementation was similarly feasible and beneficial at the Brikama hospital. However, outcomes did not significantly differ in the hospitals. Conclusions: Implementing SOPs is a realistic, low-cost option for improving process quality of neurologic emergency management in under-resourced settings. Classification of evidence: This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. PMID:28600460

Overcoming Barriers to Implementing Outdoor and Environmental Education (Continued): Safety/Legal Liability.

ERIC Educational Resources Information Center

Hanna, Glenda

1994-01-01

A risk management plan for outdoor education programs should include procedures for regular program implementation, as well as rescue, first aid, and accident follow-up procedures. Stresses understanding legal and ethical responsibilities and the importance of sufficient insurance protection. Includes suggestions for dealing with conflicts in…

Increasing nursing treatment for pediatric procedural pain.

PubMed

Bice, April A; Gunther, Mary; Wyatt, Tami

2014-03-01

Procedural pain management is an underused practice in children. Despite the availability of efficacious treatments, many nurses do not provide adequate analgesia for painful interventions. Complementary therapies and nonpharmacologic interventions are additionally essential to managing pain. Owing to the increasing awareness of inadequate nursing utilization of pharmacologic measures for procedural pain, this paper focuses only on analgesic treatments. The aim of this review was to examine how varying degrees of quality improvement affect nursing utilization of treatments for routine pediatric procedural pain. A comprehensive search of databases including Cinahl, Medline/Pubmed, Web of Science, Google Scholar, Psycinfo, and Cochrane Library was performed. Sixty-two peer-reviewed research articles were examined. Ten articles focusing on quality improvement in pediatric pain management published in English from 2001 to 2011 were included. Three themes emerged: 1) increasing nursing knowledge; 2) nursing empowerment; and 3) protocol implementation. Research critique was completed with the use of guidelines and recommendations from Creswell (2009) and Garrard (2011). The literature reveals that nurses still think that pediatric pain management is essential. Quality improvement increases nursing utilization of procedural pain treatments. Although increasing nursing knowledge improves pediatric pain management, it appears that nursing empowerment and protocol implementation increase nursing compliance more than just education alone. Nurses providing pain management can enhance their individual practice with quality improvement measures that may increase nursing adherence to institutional and nationally recommended pediatric procedural pain management guidelines. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A proposal for amending administrative law to facilitate adaptive management

NASA Astrophysics Data System (ADS)

Craig, Robin K.; Ruhl, J. B.; Brown, Eleanor D.; Williams, Byron K.

2017-07-01

In this article we examine how federal agencies use adaptive management. In order for federal agencies to implement adaptive management more successfully, administrative law must adapt to adaptive management, and we propose changes in administrative law that will help to steer the current process out of a dead end. Adaptive management is a form of structured decision making that is widely used in natural resources management. It involves specific steps integrated in an iterative process for adjusting management actions as new information becomes available. Theoretical requirements for adaptive management notwithstanding, federal agency decision making is subject to the requirements of the federal Administrative Procedure Act, and state agencies are subject to the states’ parallel statutes. We argue that conventional administrative law has unnecessarily shackled effective use of adaptive management. We show that through a specialized ‘adaptive management track’ of administrative procedures, the core values of administrative law—especially public participation, judicial review, and finality— can be implemented in ways that allow for more effective adaptive management. We present and explain draft model legislation (the Model Adaptive Management Procedure Act) that would create such a track for the specific types of agency decision making that could benefit from adaptive management.

A proposal for amending administrative law to facilitate adaptive management

USGS Publications Warehouse

Craig, Robin K.; Ruhl, J.B.; Brown, Eleanor D.; Williams, Byron K.

2017-01-01

In this article we examine how federal agencies use adaptive management. In order for federal agencies to implement adaptive management more successfully, administrative law must adapt to adaptive management, and we propose changes in administrative law that will help to steer the current process out of a dead end. Adaptive management is a form of structured decision making that is widely used in natural resources management. It involves specific steps integrated in an iterative process for adjusting management actions as new information becomes available. Theoretical requirements for adaptive management notwithstanding, federal agency decision making is subject to the requirements of the federal Administrative Procedure Act, and state agencies are subject to the states' parallel statutes. We argue that conventional administrative law has unnecessarily shackled effective use of adaptive management. We show that through a specialized 'adaptive management track' of administrative procedures, the core values of administrative law—especially public participation, judicial review, and finality— can be implemented in ways that allow for more effective adaptive management. We present and explain draft model legislation (the Model Adaptive Management Procedure Act) that would create such a track for the specific types of agency decision making that could benefit from adaptive management.

12 CFR 234.5 - Changes to rules, procedures, or operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... risk-management techniques. (4) A designated financial market utility shall not implement a change to...) Participant eligibility or access criteria; (ii) Product eligibility; (iii) Risk management; (iv) Settlement..., procedures, or operations that could materially affect the nature or level of risks presented by the...

12 CFR 234.5 - Changes to rules, procedures, or operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... risk-management techniques. (4) A designated financial market utility shall not implement a change to...) Participant eligibility or access criteria; (ii) Product eligibility; (iii) Risk management; (iv) Settlement..., procedures, or operations that could materially affect the nature or level of risks presented by the...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

23 CFR 630.1008 - State-level processes and procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., data and information resources, training, and periodic evaluation enable a systematic approach for... management procedures. States should develop and implement systematic procedures to assess work zone impacts... practices and State processes and procedures. (e) Process review. In order to assess the effectiveness of...

Information sharing for traffic incident management.

DOT National Transportation Integrated Search

2009-01-01

Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

7 CFR 7.36 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... part, the Deputy Administrator, State and County Operations, or the Deputy Administrator, Management, ASCS, is authorized to issue the instructions and procedures referred to herein which implement the...

Dentist-Implemented Contingent Escape for Management of Disruptive Child Behavior.

ERIC Educational Resources Information Center

Allen, Keith D.; And Others

1992-01-01

This paper describes a dentist-implemented intervention in which brief escape from dental treatment (contingent on brief periods of cooperative behavior) was provided to manage disruptive child behavior during restorative dental treatment with four children, aged three to seven years. The procedure required no more time than traditional management…

Application of the Flood-IMPAT procedure in the Valle d'Aosta Region, Italy

NASA Astrophysics Data System (ADS)

Minucci, Guido; Mendoza, Marina Tamara; Molinari, Daniela; Atun, Funda; Menoni, Scira; Ballio, Francesco

2016-04-01

Flood Risk Management Plans (FRMPs) established by European "Floods" Directive (Directive 2007/60/EU) to Member States in order to address all aspects of flood risk management, taking into account costs and benefits of proposed mitigation tools must be reviewed by the same law every six years. This is aimed at continuously increasing the effectiveness of risk management, on the bases of the most advanced knowledge of flood risk and most (economically) feasible solutions, also taking into consideration achievements of the previous management cycle. Within this context, the Flood-IMPAT (i.e. Integrated Meso-scale Procedure to Assess Territorial flood risk) procedure has been developed aiming at overcoming limits of risk maps produced by the Po River Basin Authority and adopted for the first version of the Po River FRMP. The procedure allows the estimation of flood risk at the meso-scale and it is characterized by three main peculiarities. First is its feasibility for the entire Italian territory. Second is the possibility to express risk in monetary terms (i.e. expected damage), at least for those categories of damage for which suitable models are available. Finally, independent modules compose the procedure: each module allows the estimation of a certain type of damage (i.e. direct, indirect, intangibles) on a certain sector (e.g. residential, industrial, agriculture, environment, etc.) separately, guaranteeing flexibility in the implementation. This paper shows the application of the Flood-IMPAT procedure and the recent advancements in the procedure, aiming at increasing its reliability and usability. Through a further implementation of the procedure in the Dora Baltea River Basin (North of Italy), it was possible to test the sensitivity of risk estimates supplied by Flood-IMPAT with respect to different damage models and different approaches for the estimation of assets at risk. Risk estimates were also compared with observed damage data in the investigated areas to identify the most suitable damage model/exposure assessment approach to be implemented in the procedure. In the end, the procedure was adapted to be applied at the micro-scale, in such a way to supply risk estimates, which are coherent with those at the meso-scale. This way the procedure can be first implemented in the whole catchment to identify hotspots; the micro-scale approach can be implemented in a second run to investigate in depth (i) the most risk prone areas and (ii) the possible risk mitigation strategies.

10 CFR 712.12 - HRP implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false HRP implementation. 712.12 Section 712.12 Energy... Program Procedures § 712.12 HRP implementation. (a) The implementation of the HRP is the responsibility of... by April 22, 2004. (b) The HRP Management Official must: (1) Prepare an initial HRP implementation...

10 CFR 712.12 - HRP implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false HRP implementation. 712.12 Section 712.12 Energy... Program Procedures § 712.12 HRP implementation. (a) The implementation of the HRP is the responsibility of... by April 22, 2004. (b) The HRP Management Official must: (1) Prepare an initial HRP implementation...

21 CFR 820.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intended to have uniform characteristics and quality within specified limits. (n) Management with executive... management with executive responsibility. (v) Quality system means the organizational structure, responsibilities, procedures, processes, and resources for implementing quality management. (w) Remanufacturer...

Experience Of Implementing The Integrated Management System In Manufacturing Companies In Slovakia

NASA Astrophysics Data System (ADS)

Lestyánszka Škůrková, Katarína; Kučerová, Marta; Fidlerová, Helena

2015-06-01

In corporate practice, the term of Integrated Management System means a system the aim of which is to manage an organization regarding the quality, environment, health and safety at work. In the first phase of the VEGA project No. 1/0448/13 "Transformation of ergonomics program into the company management structure through interaction and utilization QMS, EMS, HSMS", we focused on obtaining information about the way or procedure of implementing the integrated management systems in manufacturing companies in Slovakia. The paper considers characteristics of integrated management system, specifies the possibilities for successive integration of the management systems and also describes the essential aspects of the practical implementation of integrated management systems in companies in Slovakia.

44 CFR 59.30 - A pilot inspection procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false A pilot inspection procedure... PROVISIONS Pilot Inspection Program § 59.30 A pilot inspection procedure. (a) Purpose. This section sets forth the criteria for implementing a pilot inspection procedure in Monroe County and the Village of...

44 CFR 59.30 - A pilot inspection procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false A pilot inspection procedure... PROVISIONS Pilot Inspection Program § 59.30 A pilot inspection procedure. (a) Purpose. This section sets forth the criteria for implementing a pilot inspection procedure in Monroe County and the Village of...

Gravel roads management : volume 2, gravel roads management : implementation guide.

DOT National Transportation Integrated Search

2011-10-01

This report establishes procedures for managing dirt and gravel roads, with a primary focus on smaller agencies, such as Wyoming counties, that must manage their roads with very limited resources. The report strives, first, to guide and assist smalle...

Standard operating procedures improve acute neurologic care in a sub-Saharan African setting.

PubMed

Jaiteh, Lamin E S; Helwig, Stefan A; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman; Fassbender, Klaus

2017-07-11

Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p < 0.05) and assessments of respiratory rate (98.0% vs 81.9%, p < 0.001), temperature (60.0% vs 36.2%; p < 0.001), and glucose levels (73.0% vs 58.1%; p < 0.05), in addition to written directives by physicians (96.0% vs 88.6%, p < 0.05), whereas assessments of other vital signs remained unchanged. In stroke patients, rates of stroke-related procedures increased: early CT scanning (24.3% vs 9.9%; p < 0.05), blood count (73.0% vs 49.3%; p < 0.01), renal and liver function tests (50.0% vs 5.6%, p < 0.001), aspirin prophylaxis (47.3% vs 9.9%; p < 0.001), and physiotherapy (41.9% vs 4.2%; p < 0.001). Most effects persisted until the second-year evaluation. SOP implementation was similarly feasible and beneficial at the Brikama hospital. However, outcomes did not significantly differ in the hospitals. Implementing SOPs is a realistic, low-cost option for improving process quality of neurologic emergency management in under-resourced settings. This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

PubMed

Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

2014-05-01

Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P < .001). This improved to baseline levels by the late EHR period (46%, P = .28), although POTD in the cataract group remained worse than at baseline (64%, P < .001). There was a worsening in absolute mean documentation time in the early EHR period (16.7 minutes) vs paper baseline (7.5 minutes) (P < .001). This improved in the late EHR period (9.2 minutes) but remained worse than in the paper baseline (P < .001). While cataract procedures required more circulating nurses in the early EHR (mean, 1.9 nurses/procedure) and late EHR (mean, 1.5 nurses/procedure) periods than in the paper baseline (mean, 1.0 nurses/procedure) (P < .001), overall staffing requirements and surgical volume were not significantly different between the periods. Electronic health record OR management system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

41 CFR 102-76.45 - What procedures must Federal agencies follow to implement the requirements of NEPA?

Code of Federal Regulations, 2011 CFR

2011-01-01

... MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Design and Construction National Environmental... standards that they have promulgated to implement CEQ's regulations. Sustainable Development ...

41 CFR 102-76.45 - What procedures must Federal agencies follow to implement the requirements of NEPA?

Code of Federal Regulations, 2014 CFR

2014-01-01

... MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Design and Construction National Environmental... standards that they have promulgated to implement CEQ's regulations. Sustainable Development ...

41 CFR 102-76.45 - What procedures must Federal agencies follow to implement the requirements of NEPA?

Code of Federal Regulations, 2013 CFR

2013-07-01

... MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Design and Construction National Environmental... standards that they have promulgated to implement CEQ's regulations. Sustainable Development ...

41 CFR 102-76.45 - What procedures must Federal agencies follow to implement the requirements of NEPA?

Code of Federal Regulations, 2012 CFR

2012-01-01

... MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Design and Construction National Environmental... standards that they have promulgated to implement CEQ's regulations. Sustainable Development ...

76 FR 19750 - Gulf of Mexico Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... control rule, establish a generic framework procedure for implementing management changes, establish the... Mexico Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS.... SUMMARY: The Gulf of Mexico Fishery Management Council will convene a meeting of the Reef Fish Advisory...

IMPORTANCE OF INTEGRATED MANAGEMENT SYSTEM APPLIED IN HEALTH ESTABLISHMENTS IN ORDER TO RAISE TREATMENT QUALITY.

PubMed

Dodić, Biljana; Miljković, Tatjana; Bjelobrk, Marija; Cemerlic Ađić, Nada; Ađić, Filip; Dodić, Slobodan

2016-01-01

The term "management" is best characterized as "managing" economic or social processes to achieve objectives through a rational use of material and immaterial resources by applying the principles, functions, and management methods. This study has been aimed at evaluating the value of an integrated quality management system implemented at the Institute of Cardiovascular Diseases of Vojvodina to improve the quality of treatment. In the period from 2008 to 2010 about 40 employees from the Institute of Cardiovascular Diseases of Vojvodina attended various courses given by the lecturers of the Faculty of Technical Sciences, where the function and significance of the "International Standards Organization" were explained, after which standards of interest were implemented at the Institute of Cardiovascular Diseases of Vojvodina. The Department of Cardiology has introduced 11 cardiac procedures with 5 special instructions, 14 general procedures, and 7 specific procedures with 2 instructions. The Department of Cardiac Surgery has introduced 7 procedures to be implemented. The "Vojvodina score" model was put into practice for the perioperative evaluation of cardiac surgery risk. During 2014, the Institute of Cardiovascular Diseases ofVojvodina obtained accreditation for the period of 7 years. The integrated quality management system must be applied in order to achieve a high level of health care in the shortest possible time and with the least possible consumption of material and human resources. The application of this system in practice gives a realistic insight into the working processes and facilitates their functioning. It demands and requires constant monitoring of the system efficiency along with continuous changes and improvements of all elements of the working processes and functional units.

23 CFR 1200.26 - Non-compliance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TRANSPORTATION PROCEDURES FOR STATE HIGHWAY SAFETY PROGRAMS UNIFORM PROCEDURES FOR STATE HIGHWAY SAFETY PROGRAMS Implementation and Management of the Highway Safety Program § 1200.26 Non-compliance. Where a State is found to... special conditions for high-risk grantees and the enforcement procedures of 49 CFR part 18, or the...

Guidelines for Managing Suspected Chemical and Biological Agent Incidents in Rail Tunnel Systems

DOT National Transportation Integrated Search

2002-03-01

These emergency management guidelines are designed to help transit managers (1) prepare and implement standard operating procedures (SOPs) for handling potential and actual chemical or biological agent attacks in their rail tunnel system and (2) unde...

40 CFR 68.75 - Management of change.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Management of change. 68.75 Section 68...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.75 Management of change. (a) The owner or operator shall establish and implement written procedures to manage changes (except for...

75 FR 4007 - Risk Management Controls for Brokers or Dealers With Market Access

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access AGENCY: Securities and... or other persons, to implement risk management controls and supervisory procedures reasonably... access may not utilize any pre-trade risk management controls (i.e., ``unfiltered'' or ``naked'' access...

47 CFR 1.6011 - Effective date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Implementation of Section 325(e) of the Communications Act: Procedures Governing Complaints Filed by Television Broadcast Stations... information collection requirements that are not effective until approved by the Office of Management and...

Response of School Districts to the New York State Concussion Awareness and Management Act: Review of Policies and Procedures.

PubMed

Kajankova, Maria; Oswald, Jennifer M; Terranova, Lauren M; Kaplen, Michael V; Ambrose, Anne F; Spielman, Lisa A; Gordon, Wayne A

2017-06-01

By 2014, all states implemented concussion laws that schools must translate into daily practice; yet, limited knowledge exists regarding implementation of these laws. We examined the extent to which concussion management policies and procedure (P&P) documents of New York State school districts comply with the State's Concussion Awareness and Management Act (the Act). We also aimed to identify barriers to compliance. Forty-seven school districts provided P&P documents. We examined compliance with the Act and the relationship between compliance and each district's demographics. Compliance varied across school districts, with higher overall compliance in large city school districts compared to county districts. However, there was low compliance for several critical items. We found no statistically significant relationship between compliance and demographics. School districts need to increase compliance with concussion legislation to ensure the adequate implementation necessary for the law to impact health and educational outcomes. The results provide important information to individuals charged with the responsibility of implementation and ultimately reducing the negative outcomes associated with brain injuries in schools. © 2017, American School Health Association.

Implementation and Evaluation of Weather Responsive Traffic Estimation and Prediction System

DOT National Transportation Integrated Search

2012-06-01

The objective of the project is to develop a framework and procedures for implementing and evaluating weather-responsive traffic management (WRTM) strategies using Traffic Estimation and Prediction System (TrEPS) methodologies. In a previous FHWA-fun...

Security breaches: tips for assessing and limiting your risks.

PubMed

Coons, Leeanne R

2011-01-01

As part of their compliance planning, medical practices should undergo a risk assessment to determine any vulnerability within the practice relative to security breaches. Practices should also implement safeguards to limit their risks. Such safeguards include facility access controls, information and electronic media management, use of business associate agreements, and education and enforcement. Implementation of specific policies and procedures to address security incidents is another critical step that medical practices should take as part of their security incident prevention plan. Medical practices should not only develop policies and procedures to prevent, detect, contain, and correct security violations, but should make sure that such policies and procedures are actually implemented in their everyday operations.

Consulting report on the NASA technology utilization network system

NASA Technical Reports Server (NTRS)

Hlava, Marjorie M. K.

1992-01-01

The purposes of this consulting effort are: (1) to evaluate the existing management and production procedures and workflow as they each relate to the successful development, utilization, and implementation of the NASA Technology Utilization Network System (TUNS) database; (2) to identify, as requested by the NASA Project Monitor, the strengths, weaknesses, areas of bottlenecking, and previously unaddressed problem areas affecting TUNS; (3) to recommend changes or modifications of existing procedures as necessary in order to effect corrections for the overall benefit of NASA TUNS database production, implementation, and utilization; and (4) to recommend the addition of alternative procedures, routines, and activities that will consolidate and facilitate the production, implementation, and utilization of the NASA TUNS database.

Information Security Management (ISM)

NASA Astrophysics Data System (ADS)

Šalgovičová, Jarmila; Prajová, Vanessa

2012-12-01

Currently, all organizations have to tackle the issue of information security. The paper deals with various aspects of Information Security Management (ISM), including procedures, processes, organizational structures, policies and control processes. Introduction of Information Security Management should be a strategic decision. The concept and implementation of Information Security Management in an organization are determined by the corporate needs and objectives, security requirements, the processes deployed as well as the size and structure of the organization. The implementation of ISM should be carried out to the extent consistent with the needs of the organization.

Conversion from Tree to Graph Representation of Requirements

NASA Technical Reports Server (NTRS)

Mayank, Vimal; Everett, David Frank; Shmunis, Natalya; Austin, Mark

2009-01-01

A procedure and software to implement the procedure have been devised to enable conversion from a tree representation to a graph representation of the requirements governing the development and design of an engineering system. The need for this procedure and software and for other requirements-management tools arises as follows: In systems-engineering circles, it is well known that requirements- management capability improves the likelihood of success in the team-based development of complex systems involving multiple technological disciplines. It is especially desirable to be able to visualize (in order to identify and manage) requirements early in the system- design process, when errors can be corrected most easily and inexpensively.

5 CFR 1330.405 - Procedures for certifying agency appraisal systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... individual and organizational performance, as appropriate; (3) Documentation showing that the appraisal... REGULATIONS WITH THE OFFICE OF PERSONNEL MANAGEMENT HUMAN RESOURCES MANAGEMENT Performance Appraisal...) Organizational and employee coverage information; (ii) Applicable administrative instructions and implementing...

Implementing a Group Contingency Behavior-Management System in Physical Education

ERIC Educational Resources Information Center

Healy, Sean; Hirsch, Shanna E.; Lloyd, John W.

2017-01-01

Behavior management issues may impede learning in physical education (PE), yet there is a paucity of evidence-based behavior-management programs studied in the PE environment to assist PE teachers to be better prepared to handle these issues. Classwide-function intervention teams (CW-FIT) is a group contingency procedure for managing student…

NASA Space Flight Program and Project Management Handbook

NASA Technical Reports Server (NTRS)

Blythe, Michael P.; Saunders, Mark P.; Pye, David B.; Voss, Linda D.; Moreland, Robert J.; Symons, Kathleen E.; Bromley, Linda K.

2014-01-01

This handbook is a companion to NPR 7120.5E, NASA Space Flight Program and Project Management Requirements and supports the implementation of the requirements by which NASA formulates and implements space flight programs and projects. Its focus is on what the program or project manager needs to know to accomplish the mission, but it also contains guidance that enhances the understanding of the high-level procedural requirements. (See Appendix C for NPR 7120.5E requirements with rationale.) As such, it starts with the same basic concepts but provides context, rationale, guidance, and a greater depth of detail for the fundamental principles of program and project management. This handbook also explores some of the nuances and implications of applying the procedural requirements, for example, how the Agency Baseline Commitment agreement evolves over time as a program or project moves through its life cycle.

78 FR 52808 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... access to customers or other persons, to implement risk management controls and supervisory procedures... requires brokers or dealers to establish, document, and maintain certain risk management controls and... of its risk management controls as part of its books and records in a manner consistent with Rule 17a...

A Review of Timeout Ribbons

ERIC Educational Resources Information Center

Kostewicz, Douglas E.

2010-01-01

Researchers and practitioners often employ timeout procedures to manage inappropriate classroom behavior. When implemented inappropriately, however, timeout can result in dangerous situations and have received increased scrutiny (i.e., seclusion). The timeout ribbon procedure can prevent some of the dangerous situations associated with other forms…

Equipment management user's handbook for property custodians

NASA Technical Reports Server (NTRS)

1993-01-01

The NASA Equipment Management User's Handbook for Property Custodians is issued as an instructional guide for personnel designated as property custodians and technical personnel involved in the acquisition, management, and use of NASA-owned equipment. This handbook provides general information and basic operational procedures for processing equipment transactions through the agency-wide NASA Equipment Management System (NEMS). Each NASA installation must prepare supplementary instructions for local requirements beyond the scope of NASA-wide policies and procedures contained herein, or as specified for local implementation in NHB 4200.1, 'NASA Equipment Management Manual.' NHB 4200.1 sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for the acquisition, management, and use of NASA-owned equipment. This handbook is a controlled document, issued in loose-leaf form and revised by page changes. Additional copies for internal use may be obtained through normal distribution.

32 CFR 316.6 - Procedures and responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the “Records Management System for Implementing the Privacy Act” as provided by the GSA and National..., the System Manager of any record system will assure that records pertaining to an individual will be... the individual when the record is disclosed. The System Manager may require the individual to furnish...

32 CFR 316.6 - Procedures and responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the “Records Management System for Implementing the Privacy Act” as provided by the GSA and National..., the System Manager of any record system will assure that records pertaining to an individual will be... the individual when the record is disclosed. The System Manager may require the individual to furnish...

32 CFR 316.6 - Procedures and responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the “Records Management System for Implementing the Privacy Act” as provided by the GSA and National..., the System Manager of any record system will assure that records pertaining to an individual will be... the individual when the record is disclosed. The System Manager may require the individual to furnish...

32 CFR 316.6 - Procedures and responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the “Records Management System for Implementing the Privacy Act” as provided by the GSA and National..., the System Manager of any record system will assure that records pertaining to an individual will be... the individual when the record is disclosed. The System Manager may require the individual to furnish...

A Qualitative Study Investigating Facility Managers' Perceptions of the Classroom Learning Environment

ERIC Educational Resources Information Center

Parr, Eric Shannon

2017-01-01

Facility managers have the challenge of adhering to community college policies and procedures while fulfilling requirements of administration, students, and teachers concerning specific needs of classroom aesthetics. The role of facility manager and how specific entities affect perceptions of the design and implementation of classroom aesthetics…

An integrated pavement data management and feedback system (PAMS) : final report.

DOT National Transportation Integrated Search

1987-04-01

This report discusses the implementation of a pavement condition rating (PCR) procedure to sample sections of the road network system. The resources needed are identified for such implementation. The uses of PCR data at the network and project level ...

The case for implementing activity based costing.

PubMed

Monge, Paul H; Bolinger-Perez, Nicole; Boysen, Kent

2012-01-01

ABC identifies profitable volumes to give managers information to better manage volumes. Managers must balance the demand for service while maintaining a reasonable profit margin. Disparate systems work extremely well for their intended purposes, but they do not communicate with one another. The strength of the data they hold individually may be leveraged when implementing ABC methodology. Mayo Clinic in Rochester, Minnesota implemented a pilot of ABC to evaluate CT services where there is a high volume, multiple service location for cost comparison, variety of patient acuity and service mix, and large capital investments.The goal was to reveal the actual cost of CT services at the procedural level.

18 CFR 725.6 - Principles, standards and procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Principles, standards and procedures. 725.6 Section 725.6 Conservation of Power and Water Resources WATER RESOURCES COUNCIL IMPLEMENTATION OF EXECUTIVE ORDERS 11988, FLOODPLAIN MANAGEMENT AND 11990, PROTECTION OF WETLANDS...

Changes in the cardiac rehabilitation workflow process needed for the implementation of a self-management system.

PubMed

Wiggers, Anne-Marieke; Vosbergen, Sandra; Kraaijenhagen, Roderik; Jaspers, Monique; Peek, Niels

2013-01-01

E-health interventions are of a growing importance for self-management of chronic conditions. This study aimed to describe the process adaptions that are needed in cardiac rehabilitation (CR) to implement a self-management system, called MyCARDSS. We created a generic workflow model based on interviews and observations at three CR clinics. Subsequently, a workflow model of the ideal situation after implementation of MyCARDSS was created. We found that the implementation will increase the complexity of existing working procedures because 1) not all patients will use MyCARDSS, 2) there is a transfer of tasks and responsibilities from professionals to patients, and 3) information in MyCARDSS needs to be synchronized with the EPR system for professionals.

Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

PubMed

von Krogh, Gunn; Nåden, Dagfinn

2008-04-01

To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

NASA UAS Traffic Management National Campaign Operations across Six UAS Test Sites

NASA Technical Reports Server (NTRS)

Rios, Joseph; Mulfinger, Daniel; Homola, Jeff; Venkatesan, Priya

2016-01-01

NASA's Unmanned Aircraft Systems Traffic Management research aims to develop policies, procedures, requirements, and other artifacts to inform the implementation of a future system that enables small drones to access the low altitude airspace. In this endeavor, NASA conducted a geographically diverse flight test in conjunction with the FAA's six unmanned aircraft systems Test Sites. A control center at NASA Ames Research Center autonomously managed the airspace for all participants in eight states as they flew operations (both real and simulated). The system allowed for common situational awareness across all stakeholders, kept traffic procedurally separated, offered messages to inform the participants of activity relevant to their operations. Over the 3- hour test, 102 flight operations connected to the central research platform with 17 different vehicle types and 8 distinct software client implementations while seamlessly interacting with simulated traffic.

How personal and standardized coordination impact implementation of integrated care.

PubMed

Benzer, Justin K; Cramer, Irene E; Burgess, James F; Mohr, David C; Sullivan, Jennifer L; Charns, Martin P

2015-10-02

Integrating health care across specialized work units has the potential to lower costs and increase quality and access to mental health care. However, a key challenge for healthcare managers is how to develop policies, procedures, and practices that coordinate care across specialized units. The purpose of this study was to identify how organizational factors impacted coordination, and how to facilitate implementation of integrated care. Semi-structured interviews were conducted in August 2009 with 30 clinic leaders and 35 frontline staff who were recruited from a convenience sample of 16 primary care and mental health clinics across eight medical centers. Data were drawn from a management evaluation of primary care-mental health integration in the US Department of Veterans Affairs. To protect informant confidentiality, the institutional review board did not allow quotations. Interviews identified antecedents of organizational coordination processes, and highlighted how these antecedents can impact the implementation of integrated care. Overall, implementing new workflow practices were reported to create conflicts with pre-existing standardized coordination processes. Personal coordination (i.e., interpersonal communication processes) between primary care leaders and staff was reported to be effective in overcoming these barriers both by working around standardized coordination barriers and modifying standardized procedures. This study identifies challenges to integrated care that might be solved with attention to personal and standardized coordination. A key finding was that personal coordination both between primary care and mental health leaders and between frontline staff is important for resolving barriers related to integrated care implementation. Integrated care interventions can involve both new standardized procedures and adjustments to existing procedures. Aligning and integrating procedures between primary care and specialty care requires personal coordination amongst leaders. Interpersonal relationships should be strengthened between staff when personal connections are important for coordinating patient care across clinical settings.

A General Procedure to Assess the Internal Structure of a Noncognitive Measure--The Student360 Insight Program (S360) Time Management Scale. Research Report. ETS RR-11-42

ERIC Educational Resources Information Center

Ling, Guangming; Rijmen, Frank

2011-01-01

The factorial structure of the Time Management (TM) scale of the Student 360: Insight Program (S360) was evaluated based on a national sample. A general procedure with a variety of methods was introduced and implemented, including the computation of descriptive statistics, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).…

18 CFR 725.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EXECUTIVE ORDERS 11988, FLOODPLAIN MANAGEMENT AND 11990, PROTECTION OF WETLANDS Introduction § 725.4... definitions listed in the Glossary of the Council's Floodplain Management Guidelines for Implementing E.O... Council's Principles, Standards and Procedures (P,S,&P), provision of financial assistance for State...

5 CFR 1303.2 - Authority and functions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1303.2 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES PUBLIC... general functions of the Office of Management and Budget, as provided by statute and executive order, are to develop and execute the budget, oversee implementation of Administration policies and programs...

Managers' views on and experiences with moral case deliberation in nursing teams.

PubMed

Weidema, Froukje C; Molewijk, A C Bert; Kamsteeg, Frans; Widdershoven, Guy A M

2015-11-01

Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences regarding facilitating MCD's implementation have not yet been studied. As part of an empirical qualitative study on implementing MCD in mental health care, a responsive evaluation design was used. Using former research findings (iterative procedures), a managers' focus group was organised. Managers appreciated MCD, fostering nurses' empowerment and critical reflection - according to managers, professional core competences. Managers found MCD a challenging intervention, resulting in dilemmas due to MCD's confidential and egalitarian nature. Managers value MCD's process-related outcomes, yet these are difficult to control/regulate. MCD urges managers to reflect on their role and (hierarchical) position both within MCD and in the nursing team. MCD is in line with transformative and participatory management, fostering dialogical interaction between management and nursing team. © 2015 John Wiley & Sons Ltd.

Experience of Implementing ISO 15189 Accreditation at a University Laboratory

PubMed Central

2015-01-01

The present article summarizes the authors’ experience with the implementation of a quality management system based on ISO 17025 and ISO 15189 standards at university laboratories. The accreditation of the analytical procedures at the Universidad Mariano Gálvez represented a challenge due to the unique nature of an educational institution and the difference in nature to the standards implemented. Sample handling and care of the patient were combined to achieve an integrated management system. We explain the development of the management system, the obstacles and benefits of the system and concluding that it is possible to design a management system based on ISO 15189 for the university lab that allowed delivering results assuring technical competence to patient care and welfare. PMID:27683499

Prognosis model for stand development

Treesearch

Albert R. Stage

1973-01-01

Describes a set of computer programs for developing prognoses of the development of existing stand under alternative regimes of management. Calibration techniques, modeling procedures, and a procedure for including stochastic variation are described. Implementation of the system for lodgepole pine, including assessment of losses attributed to an infestation of mountain...

Small Business Management Education. Entrepreneurship Education for Adults-Program Development and Implementation. Final Report.

ERIC Educational Resources Information Center

Minnesota Univ., St. Paul. Dept. of Agricultural Education.

A project was organized around a series of activities to prepare materials or disseminations for small business management education programs. Activities were as follow: (1) prepare needs assessment procedures for determining the number and types of businesses to be served by a small business management education program; prepare model…

40 CFR 51.302 - Implementation control strategies for reasonably attributable visibility impairment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... hearings to each affected Federal Land Manager, and other affected States, and must state where the public can inspect a summary prepared by the Federal Land Managers of their conclusions and recommendations... conducted in accordance with the procedures in § 51.103. (b) State and Federal Land Manager Coordination. (1...

Risk-Informed Decision Making: Application to Technology Development Alternative Selection

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

2010-01-01

NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

Managing Assessment.

ERIC Educational Resources Information Center

Further Education Development Agency, London (England).

This document, which is intended for curriculum managers at British further education colleges, presents guidelines for developing and implementing a college assessment policy based on the principle that the objectives of all assessment procedures and policies are as follows: enhance the assessment provision within colleges; ensure that assessment…

State and Federal project development procedures for bus rapid transit : managing differences and reducing implementation delays

DOT National Transportation Integrated Search

2011-08-01

This report documents an investigation into the transportation project development process in the : context of the implementation of bus rapid transit systems on the State Highway System as well as such : systems being part of the Federal New Starts ...

Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests)

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

Taslakian, Bedros, E-mail: btaslakian@gmail.com; Sebaaly, Mikhael Georges, E-mail: ms246@aub.edu.lb; Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb

2016-03-15

Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patientsmore » undergoing vascular and interventional radiology procedures.« less

Development, Implementation, and Evaluation of a Strategic Plan for Improving Physical Plant Management at Southwest Texas Junior College.

ERIC Educational Resources Information Center

Box, Wilford Winston

A study was conducted at Southwest Texas Junior College (STJC) to assess current management practices used by the physical plant maintenance department (PPMD) and to develop a strategic plan for physical plant management. Procedures included an analysis of current management practices and systems that affect physical resources, and periodic and…

44 CFR 1.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Purpose. 1.1 Section 1.1... GENERAL RULEMAKING; POLICY AND PROCEDURES General § 1.1 Purpose. (a) This part contains the basic policies... procedures for implementation of the Regulatory Flexibility Act which took effect January 1, 1981. (d) A FEMA...

44 CFR 1.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Purpose. 1.1 Section 1.1... GENERAL RULEMAKING; POLICY AND PROCEDURES General § 1.1 Purpose. (a) This part contains the basic policies... procedures for implementation of the Regulatory Flexibility Act which took effect January 1, 1981. (d) A FEMA...

44 CFR 1.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Purpose. 1.1 Section 1.1... GENERAL RULEMAKING; POLICY AND PROCEDURES General § 1.1 Purpose. (a) This part contains the basic policies... procedures for implementation of the Regulatory Flexibility Act which took effect January 1, 1981. (d) A FEMA...

44 CFR 1.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Purpose. 1.1 Section 1.1... GENERAL RULEMAKING; POLICY AND PROCEDURES General § 1.1 Purpose. (a) This part contains the basic policies... procedures for implementation of the Regulatory Flexibility Act which took effect January 1, 1981. (d) A FEMA...

An SPSS implementation of the nonrecursive outlier deletion procedure with shifting z score criterion (Van Selst & Jolicoeur, 1994).

PubMed

Thompson, Glenn L

2006-05-01

Sophisticated univariate outlier screening procedures are not yet available in widely used statistical packages such as SPSS. However, SPSS can accept user-supplied programs for executing these procedures. Failing this, researchers tend to rely on simplistic alternatives that can distort data because they do not adjust to cell-specific characteristics. Despite their popularity, these simple procedures may be especially ill suited for some applications (e.g., data from reaction time experiments). A user friendly SPSS Production Facility implementation of the shifting z score criterion procedure (Van Selst & Jolicoeur, 1994) is presented in an attempt to make it easier to use. In addition to outlier screening, optional syntax modules can be added that will perform tedious database management tasks (e.g., restructuring or computing means).

The implementation of a Hazard Analysis and Critical Control Point management system in a peanut butter ice cream plant.

PubMed

Hung, Yu-Ting; Liu, Chi-Te; Peng, I-Chen; Hsu, Chin; Yu, Roch-Chui; Cheng, Kuan-Chen

2015-09-01

To ensure the safety of the peanut butter ice cream manufacture, a Hazard Analysis and Critical Control Point (HACCP) plan has been designed and applied to the production process. Potential biological, chemical, and physical hazards in each manufacturing procedure were identified. Critical control points for the peanut butter ice cream were then determined as the pasteurization and freezing process. The establishment of a monitoring system, corrective actions, verification procedures, and documentation and record keeping were followed to complete the HACCP program. The results of this study indicate that implementing the HACCP system in food industries can effectively enhance food safety and quality while improving the production management. Copyright © 2015. Published by Elsevier B.V.

[Requirements for CE-marking of apps and wearables].

PubMed

Berensmann, Michael; Gratzfeld, Markus

2018-03-01

Depending on the intended use, apps and wearables can be medical devices. In such cases, the manufacturer has to provide evidence that the requirements stated in directive 93/42/EWG are fulfilled. Depending on the classification of the medical device, several so-called conformity assessment procedures are possible. Once the conformity assessment procedure has been finished successfully, the manufacturer attaches the CE-marking to the product. This assures that all requirements of the directive have been fulfilled and the manufacturer is therefore authorized to put the product onto the market in all member states of the European union. In this article, the possible and practical conformity assessment procedures for apps and wearables are described and their implementation is outlined.For medical devices with sufficiently high-risk classification, the manufacturer has to involve a Notified Body. For the conformity assessment procedure according to annex II, the manufacturer implements a full quality management system and compiles technical documentation. These are supervised and evaluated by Notified Body audits. Especially for startups, it is important for the development of apps and wearables to implement a quality management system early and to fulfill the regulatory requirements, for example, related to the software life-cycle model. This also includes considering accompanying processes during development like risk management, usability engineering, and clinical evaluation.Additionally, it should be pointed out, that according to the new medical device regulation almost all apps will fall at least into class IIa. Thus, the involvement of a Notified Body in the related conformity assessment procedures would be required. Apps that have already been put onto the market as class I devices, and are now upgraded to a higher class, need the approval of a notified body starting from 26 May 2020.

5 CFR 1304.4601 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Purpose. 1304.4601 Section 1304.4601 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES POST EMPLOYMENT CONFLICT OF... Government Act of 1978, 18 U.S.C. 207, and the Office of Personnel Management's implementing regulations, 5...

Ensuring IT service continuity in the face of increasing threats.

PubMed

Nair, Vishwanath

2014-01-01

How is IT service continuity related to business continuity management? Is it just a glorified disaster recovery procedure? Will IT service continuity help increase the assurance of IT services from the business owner to the customer? This paper is an attempt at answering these and many such questions. It is presented as a case study of IT service continuity management implementation at Emirates Group IT, Dubai. It takes the reader through the need for the process as felt by the business, through the learning acquired during implementation, to the practices deployed for managing the process on an ongoing basis. It provides a detailed view of the kind of pitfalls that could be encountered during implementation of the IT service continuity management process in a large-scale enterprise.

Business Management Practices and Requirements for Colorado School Districts: An Overview of Selected Colorado Business Management Practices and Requirements.

ERIC Educational Resources Information Center

Colorado State Dept. of Education, Denver.

Guidelines to help school district supervisors and business management personnel implement state-required financial policies and procedures are presented in this report. Steps to comply with Colorado regulations for budgeting, accounting, reporting, and auditing processes are discussed. Figures illustrate the budgeting cycle and schedule. (LMI)

Survival tactics for managing the hospital marketing effort.

PubMed

Schaupp, D L; Ponzurick, T G; Schaupp, F W

1994-01-01

Hospital marketing is an intricate and complex process. Especially difficult is the transition the hospital marketer must make from designing marketing strategies to implementing those strategies. This transition usually causes the marketer to call upon a different set of skills. These skills involve managing the personnel needed to implement the designed marketing strategy. Unfortunately, little in the way of formal training is provided the marketer for developing these management skills. Therefore, the authors have comprised a series of tactical procedures designed to assist the hospital marketer to survive this transition. Using these tactics for decision-making guidelines may help to improve the management of the hospital's marketing effort.

Health Care Financing Administration--Medicaid program; Medicaid management information systems. Final rule.

PubMed

1980-03-05

These regulations set forth a new procedure to improve Medicaid management by explicitly authorizing HCFA to expand or revise State Medicaid Management Information Systems (MMIS) as necessary to meet program needs. Under this procedure, HCFA will publish major new requirements for comment before deciding to adopt them, and will provide increased Federal matching and reasonable phase-in time for their implementation. HCFA will also periodically review ongoing systems to determine whether all system requirements and performance standards are being met and may reduce the level of Federal matching for those MMIS systems which do not meet prescribed standards.

To Improve the Learning Experience of the First Trimester Undergraduate Students in an Australian University's Offshore Campus: A Knowledge Management Methodology

ERIC Educational Resources Information Center

Leung, Nelson K. Y.; Shamsub, Hannarong; Tsang, Nicole; Au, Bill

2014-01-01

Due to the successful implementation of knowledge management (KM) in many commercial organizations, KM has been recently extended to higher education institutions (HEIs) to manage scholar knowledge, and institution policies and procedures. To address the lack of insight in regards to the engagement of tertiary students to manage knowledge at a…

[Recommendations for the control of documents and the establishment of a documentary system].

PubMed

Vinner, E

2013-06-01

The quality management system that must be implemented in a MBL to meet the requirements of the standard NF EN ISO 15189 is based, among other things, on the creation and use by staff of a documentary system approved and updated. This documentary system is constituted by external documents (standards, suppliers' documents...) and internal documents (quality manual, procedures, instructions, technical and quality recordings...). A procedure of the documentary system control must be formalized. The documentary system should be modeled in order to identify the various procedures to be drafted and the incurred risks in the case a document would be missing in this system. Each document must be indexed in a unique way and document management must be carried out rigorously. The use of document management software is a great help to manage the life cycle of documents.

A decision support system-based procedure for evaluation and monitoring of protected areas sustainability for the Mediterranean region

NASA Astrophysics Data System (ADS)

Pediaditi, K.; Buono, F.; Pompigna, F.; Bogliotti, C.; Nurlu, E.; Ladisa, G.; Petropoulos, G. P.

2011-10-01

Despite common acknowledgement of the value of protected areas as instruments in ensuring sustainability, and their promotion for the achievement of policies on halting the loss of biodiversity, there is no common approach today for monitoring and evaluating them. This paper presents a novel integrated nature conservation management procedure developed to monitor and evaluate the sustainability of Mediterranean protected areas. This procedure was successfully implemented and formally evaluated by protected area managers in six Mediterranean countries, results of which are presented here together with an overview of the web-based Decision Support System (DSS) developed to facilitate its wide adoption. The DSS and procedure has been designed and evaluated by managers as a useful tool, which facilitates and provides needed procedural guidance for protected area monitoring whilst minimizing input requirements to do so. The procedure and DSS were developed following a review of existing protected area assessment tools and a detailed primary investigation of the needs and capacity of its intended users. Essentially, the procedure and DSS guides provide the facilities for protected area managers, in following a participatory approach to develop a context-specific sustainability monitoring strategy, for their protected area. Consequently, the procedure is, by design, participatory, context specific, holistic and relevant to protected area management and institutional procedures. The procedure was piloted and formally evaluated in Greece, Italy, Turkey, Egypt, Malta and Cyprus. Feedback collected from the pilot evaluations is also summarised herein.

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals.

PubMed

Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta

2006-09-20

The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size - the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals.

Managing the three 'P's to improve patient safety: nursing administration's role in managing information technology.

PubMed

Simpson, Roy L

2004-08-01

The Institute of Medicine's landmark report asserted that medical error is seldom the fault of individuals, but the result of faulty healthcare policy/procedure systems. Numerous studies have shown that information technology (IT) can shore up weak systems. For nursing, IT plays a key role in eliminating nursing mistakes. However, managing IT is a function of managing the people who use it. For nursing administrators, successful IT implementations depend on adroit management of the three 'P's: People, processes and (computer) programs. This paper examines critical issues for managing each entity. It discusses the importance of developing trusting organizations, the requirements of process change, how to implement technology in harmony with the organization and the significance of vision.

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

Not Available

This study compared conditions, practices, and attitudes at underground bituminous coal mines having low injury incidence rates with those found at mines having high injury incidence rates. Several characteristics common to many of the low incidence rate mines that differentiate them from those having high incidence rates were identified. (1) Training programs: adequate and relevant training materials; qualified instructors; restricted classroom size to encourage student participation; and tailored to meet individual miner needs. (2) Management/labor relations tend to have a positive impact upon a mine's accident and injury experience when: both management and labor have a positive attitude toward safetymore » and health; open lines of communication permit management and labor to jointly reconcile problems affecting safety and health; representatives of labor become actively involved in issues concerning safety, health and production; and management and labor identify and accept their joint responsibility for correcting unsafe conditions and practices. (3) Safety and health conditions are improved when: standard operating procedures are established, understood, and implemented; management equitably enforces established policies concerning absenteeism, job assignments, and standard operating procedures; formal safety and health programs are communicated to all employees and subsequently implemented by management and labor; safety department has top management support in terms of funds, manpower, and the authority necessary to implement the safety and health program; mine plans are thoroughly reviewed by management, labor, and MSHA to insure that such plans incorporate measures to adequately control the physical environment of a coal mine; and MSHA inspection activity is most effective when the inspectors encourage increased cooperative interaction between themselves, mine management, and labor.« less

Standardization and program effect analysis (Study 2.4). Volume 3: Design-to-cost analysis

NASA Technical Reports Server (NTRS)

Shiokari, T.

1975-01-01

The program procedures that were incorporated into an on-going "design-to-cost" spacecraft program are examined. Program procedures are the activities that support the development and operations of the flight unit: contract management, documents, integration meetings, engineering, and testing. This report is limited to the program procedures that were implemented, with emphasis on areas that may depart from normal satellite development practices.

77 FR 64300 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Reef Fish Fishery of the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

...NMFS proposes to implement management measures described in Amendment 38 to the Fishery Management Plan for the Reef Fish Resources of the Gulf of Mexico (FMP) prepared by the Gulf of Mexico (Gulf) Fishery Management Council (Council). If implemented, this rule would modify post-season accountability measures (AMs) that affect shallow- water grouper species (SWG), change the trigger for AMs, and revise the Gulf reef fish framework procedure. The intent of this proposed rule is to achieve optimum yield (OY) while ensuring the fishery resources are utilized efficiently.

Barriers to the implementation of checklists in the office-based procedural setting.

PubMed

Shapiro, Fred E; Fernando, Rohesh J; Urman, Richard D

2014-01-01

Patient safety is critical for the patients, providers, and risk managers in the office-based procedural setting, and the same standard of care should be maintained regardless of the healthcare environment. Checklists may improve patient safety and potentially decrease risk. This study explored utilization of checklists in the office-based setting and the potential barriers to their implementation. A cross-sectional prospective study was performed by using a 19-question anonymous survey designed with REDCap®. Medical providers including physicians and nurses from 25 different offices that performed procedures participated, and 38 individual responses were included in the study. Only 50% of offices surveyed use safety checklists in their practice. Only 34% had checklists or equivalent protocol for emergencies such as anaphylaxis or failed airway. As many as 23.7% of respondents indicated that they encountered barriers to implementing checklists. The top barriers identified in the study were no incentive to use a checklist (77.8%), no mandate from a local or federal regulatory agency (44.4%), being too time consuming (33.3%), and lack of training (33.3%). Reasons identified that would encourage providers to use checklists included a clear mandate (36.8%) and evidence-based research (26.3%). Checklists are not being universally utilized in the office-based setting. There are barriers preventing their successful implementation. Risk managers may be able to improve patient safety and decrease risk by encouraging practitioners, possibly through incentives, to use customizable safety checklists. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

75 FR 69791 - Risk Management Controls for Brokers or Dealers With Market Access

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... relationship with the ultimate customer, can more effectively implement them. In addition, a broker or dealer... specific risk management controls and supervisory procedures to a customer that is a registered broker... such customer, based on its position in the transaction and relationship with the ultimate customer...

Management of Federal Information Resources. Circular No. A-130.

ERIC Educational Resources Information Center

Office of Management and Budget, Washington, DC.

Directed to the heads of executive departments and establishments, this circular establishes policy for the management of federal information resources. Procedural and analytic guidelines for implemented aspects of these policies are included as appendices. The policies apply to the information activities of all agencies of the executive branch of…

33 CFR 385.21 - Quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... will be produced by a Project Delivery Team. The quality control plan shall be included in the Project Management Plan and shall describe the procedures to be used to ensure compliance with technical and policy requirements during implementation. (b) During development of the Project Management Plan for each project, the...

75 FR 5537 - Fisheries of the Northeastern United States; Atlantic Mackerel, Squid, and Butterfish Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... Butterfish Fisheries; Specifications and Management Measures AGENCY: National Marine Fisheries Service (NMFS... implements 2010 specifications and management measures for Atlantic mackerel, squid, and butterfish (MSB... (Loligo), and butterfish at the same levels as 2009. This action also modifies accounting procedures for...

77 FR 49457 - Availability of the Final Environmental Assessment and Finding of No Significant Impact for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-16

... United States Section, Operational Procedures for Implementing Section 102 of NEPA, published in the... Bureau of Land Management Lands are available. A notice of finding of no significant impact dated January...). FOR FURTHER INFORMATION CONTACT: Gilbert Anaya, Division Chief, Environmental Management Division...

Managers' experience of success criteria and barriers to implementing mobile radiography services in nursing homes in Norway: a qualitative study.

PubMed

Kjelle, Elin; Lysdahl, Kristin Bakke; Olerud, Hilde Merete; Myklebust, Aud Mette

2018-04-25

In order to meet the future challenges posed by ageing populations, new technology, telemedicine and a more personalized healthcare system are needed. Earlier research has shown mobile radiography services to be highly beneficial for nursing home residents in addition to being cost-effective. Despite the benefits, mobile radiography services are uncommon in Europe and Norway. The purpose of this study was to explore success criteria and barriers in the process of implementing mobile radiography services, from the point of view of the hospital and municipal managers. Eleven semi-structured interviews were conducted with managers from five hospitals and six municipalities in Norway where mobile radiography services had been implemented. Core issues in the interview guide were barriers and facilitators in the different phases of implementation. The framework method for thematic analysis was used for analysing the data inductively in a research team. Five main categories were developed through the success criteria and barriers experienced by the participants: national health policy, regional and municipal policy and conditions, inter-organizational implementation projects, experienced outcome, and professional skills and personal characteristics. The categories were allocated into three higher-order classifications: macro, meso and micro levels. The main barriers experienced by the managers were financial, procedural and structural. In particular, the reimbursement system, lack of management across healthcare levels and the lack of compatible information systems acted as barriers. The main facilitators were external funding, enthusiastic individuals in the organizations and good collaboration between hospitals and municipalities. The managers experienced financial, structural and procedural barriers. The main success criteria in the process were external funding, and the support and engagement from the individuals in the organizations. This commitment was mainly facilitated by the intuitive appeal of mobile radiography. Changes in healthcare management and in the financial system might facilitate services across healthcare levels. In addition, compatible information systems across healthcare levels are needed in order to facilitate the use of new technology and mobile services.

Architecture design of a generic centralized adjudication module integrated in a web-based clinical trial management system.

PubMed

Zhao, Wenle; Pauls, Keith

2016-04-01

Centralized outcome adjudication has been used widely in multicenter clinical trials in order to prevent potential biases and to reduce variations in important safety and efficacy outcome assessments. Adjudication procedures could vary significantly among different studies. In practice, the coordination of outcome adjudication procedures in many multicenter clinical trials remains as a manual process with low efficiency and high risk of delay. Motivated by the demands from two large clinical trial networks, a generic outcome adjudication module has been developed by the network's data management center within a homegrown clinical trial management system. In this article, the system design strategy and database structure are presented. A generic database model was created to transfer different adjudication procedures into a unified set of sequential adjudication steps. Each adjudication step was defined by one activate condition, one lock condition, one to five categorical data items to capture adjudication results, and one free text field for general comments. Based on this model, a generic outcome adjudication user interface and a generic data processing program were developed within a homegrown clinical trial management system to provide automated coordination of outcome adjudication. By the end of 2014, this generic outcome adjudication module had been implemented in 10 multicenter trials. A total of 29 adjudication procedures were defined with the number of adjudication steps varying from 1 to 7. The implementation of a new adjudication procedure in this generic module took an experienced programmer 1 or 2 days. A total of 7336 outcome events had been adjudicated and 16,235 adjudication step activities had been recorded. In a multicenter trial, 1144 safety outcome event submissions went through a three-step adjudication procedure and reported a median of 3.95 days from safety event case report form submission to adjudication completion. In another trial, 277 clinical outcome events were adjudicated by a six-step procedure and took a median of 23.84 days from outcome event case report form submission to adjudication procedure completion. A generic outcome adjudication module integrated in the clinical trial management system made the automated coordination of efficacy and safety outcome adjudication a reality. © The Author(s) 2015.

Health care transition in Germany – standardization of procedures and improvement actions

PubMed Central

Pieper, Claudia; Kolankowska, Izabela

2011-01-01

Previous studies have assessed an increase in the number of people in need and emphasized the advantages of structured discharge management and health care transition. Therefore, our study evaluated the status quo of transition in a major German city after standardization of procedures and implementation of standard forms. Satisfaction with handling of standard forms and improvement of procedures was evaluated. Additionally, patients who had recently been hospitalized were asked about the hospital discharge process. The results show that the recent efforts of standardization helped to improve interface management for health care workers and patients and showed further improvement options. PMID:21811388

Wildland Fire Management Plan

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

Schwager, K.

The Wildland Fire Management Plan (FMP) for Brookhaven National Lab (BNL) is written to comply with Department of Energy (DOE) Integrated Safety Management Policy; Federal Wildland Fire Management Policy and Program Review; and Wildland and Prescribed Fire Management Policy and Implementation Procedures Reference Guide. This current plan incorporates changes resulting from new policies on the national level as well as significant changes to available resources and other emerging issues, and replaces BNL's Wildland FMP dated 2014.

Management and display of four-dimensional environmental data sets using McIDAS

NASA Technical Reports Server (NTRS)

Hibbard, William L.; Santek, David; Suomi, Verner E.

1990-01-01

Over the past four years, great strides have been made in the areas of data management and display of 4-D meteorological data sets. A survey was conducted of available and planned 4-D meteorological data sources. The data types were evaluated for their impact on the data management and display system. The requirements were analyzed for data base management generated by the 4-D data display system. The suitability of the existing data base management procedures and file structure were evaluated in light of the new requirements. Where needed, new data base management tools and file procedures were designed and implemented. The quality of the basic 4-D data sets was assured. The interpolation and extrapolation techniques of the 4-D data were investigated. The 4-D data from various sources were combined to make a uniform and consistent data set for display purposes. Data display software was designed to create abstract line graphic 3-D displays. Realistic shaded 3-D displays were created. Animation routines for these displays were developed in order to produce a dynamic 4-D presentation. A prototype dynamic color stereo workstation was implemented. A computer functional design specification was produced based on interactive studies and user feedback.

[Implementation of a patient data management system. Effects on intensive care documentation].

PubMed

Castellanos, I; Ganslandt, T; Prokosch, H U; Schüttler, J; Bürkle, T

2013-11-01

Patient data management systems (PDMS) enable digital documentation on intensive care units (ICU). A commercial PDMS was implemented in a 25-bed ICU replacing paper-based patient charting. The ICU electronic patient record is completely managed inside the PDMS. It compiles data from vital signs monitors, ventilators and further medical devices and facilitates some drug dose and fluid balance calculations as well as data reuse for administrative purposes. Ventilation time and patient severity scoring as well as coding of diagnoses and procedures is supported. Billing data transferred via interface to the central billing system of the hospital. Such benefits should show in measurable parameters, such as documented ventilator time, number of coded diagnoses and procedures and others. These parameters influence reimbursement in the German DRG system. Therefore, measurable changes in cost and reimbursement data of the ICU were expected. A retrospective analysis of documentation quality parameters, cost data and mortality rate of a 25-bed surgical ICU within a German university hospital 3 years before (2004-2006) and 5 years after (2007-2011) PDMS implementation. Selected parameters were documented electronically, consistently and reproducibly for the complete time span of 8 years including those years where no electronic patient recording was available. The following parameters were included: number of cleared DRG, cleared ventilator time, case mix (CM), case mix index (CMI), length of stay, number of coded diagnoses and procedures, detailed overview of a specific procedure code based on daily Apache II and TISS Core 10 scores, mortality, total ICU costs and revenues and partial profits for specific ICU procedures, such as renal replacement therapy and blood products. Systematic shifts were detected over the study period, such as increasing case numbers and decreasing length of stay as well as annual fluctuations in severity of disease seen in the CM and CMI. After PDMS introduction, the total number of coded diagnoses increased but the proportion of DRG relevant diagnoses dropped significantly. The number of procedures increased (not significantly) and the number of procedures per case did not rise significantly. The procedure 8-980 showed a significant increase after PDMS introduction whereas the DRG-relevant proportion of those procedures dropped insignificantly. The number of ventilator-associated DRG cases as well as the total ventilator time increased but not significantly. Costs and revenues increased slightly but profit varied considerably from year to year in the 5 years after system implementation. A small increase was observed per case, per nursing day and per case mix point. Additional revenues for specific ICU procedures increased in the years before and dropped after PDMS implementation. There was an insignificant increase in ICU mortality rate from 7.4 % in the year 2006 (before) to 8.5 % in 2007 (after PDMS implementation). In the following years mortality dropped below the base level. The implementation of the PDMS showed only small effects on documentation of reimbursement-relevant parameters which were too small to set off against the total investment. The method itself, a long-term follow-up of different parameters proved successful and can be adapted by other organizations. The quality of results depends on the availability of long-term parameters in good quality. No significant influence of PDMS on mortality was found.

[Quality management in emergency departments: Lack of uniform standards for fact-based controlling].

PubMed

Ries, M; Christ, M

2015-11-01

The general high occupancy of emergency departments during the winter months of 2014/2015 outlined deficits in health politics. Whether on the regional, province, or federal level, verifiable and accepted figures to enable in depth analysis and fact-based controlling of emergency care systems are lacking. As the first step, reasons for the current situation are outlined in order to developed concrete recommendations for individual hospitals. This work is based on a selective literature search with focus on quality management, ratio driven management, and process management within emergency departments as well as personal experience with implementation of a key ratio system in a German maximum care hospital. The insufficient integration of emergencies into the DRG systematic, the role as gatekeeper between inpatient and outpatient care sector, the decentralized organization of emergency departments in many hospitals, and the inconsistent representation within the medical societies can be mentioned as reasons for the lack of key ratio systems. In addition to the important role within treatment procedures, emergency departments also have an immense economic importance. Consequently, the management of individual hospitals should promote implementation of key ratio systems to enable controlling of emergency care processes. Thereby the perspectives finance, employees, processes as well as partners and patients should be equally considered. Within the process perspective, milestones could be used to enable detailed controlling of treatment procedures. An implementation of key ratio systems without IT support is not feasible; thus, existing digital data should be used and future data analysis should already be considered during implementation of new IT systems.

Object oriented development of engineering software using CLIPS

NASA Technical Reports Server (NTRS)

Yoon, C. John

1991-01-01

Engineering applications involve numeric complexity and manipulations of a large amount of data. Traditionally, numeric computation has been the concern in developing an engineering software. As engineering application software became larger and more complex, management of resources such as data, rather than the numeric complexity, has become the major software design problem. Object oriented design and implementation methodologies can improve the reliability, flexibility, and maintainability of the resulting software; however, some tasks are better solved with the traditional procedural paradigm. The C Language Integrated Production System (CLIPS), with deffunction and defgeneric constructs, supports the procedural paradigm. The natural blending of object oriented and procedural paradigms has been cited as the reason for the popularity of the C++ language. The CLIPS Object Oriented Language's (COOL) object oriented features are more versatile than C++'s. A software design methodology based on object oriented and procedural approaches appropriate for engineering software, and to be implemented in CLIPS was outlined. A method for sensor placement for Space Station Freedom is being implemented in COOL as a sample problem.

Managing in a Culture of Debate: Enhancing Administrative Effectiveness through Procedural Fairness

ERIC Educational Resources Information Center

Moshavi, Dan; Standifird, Stephen

2017-01-01

The contestability of ideas is at the heart of a healthy academic institution. As a result, administrators face the challenge of making and implementing difficult decisions in an environment that is designed to explicitly create thoughtful discord. We argue that procedural fairness--explaining how and why important decisions are made--is an…

Quality management system in radiotherapy in the light of regulations applicable in Poland

PubMed Central

2012-01-01

The need to establish conditions for safe irradiation was noted in Poland back in 1986 in the Atomic Law, but for over 16 years no regulations regarding this aspect were passed. The radiological incident in Bialystok (Poland) in 2001 undeniably accelerated the implementation of new legal regulations. Nevertheless, in the absence of national guidelines until 2002, most health care institutions resorted to the quality management system (QMS) model proposed by the ISO norm 9001:2000. Eventually, practice proved the theory and the aforementioned model was also implemented into Polish acts of law defining basic requirements for QMS in radiotherapy. The aim of this work is to review current national regulations regarding QMS in radiotherapy, in particular those referring to standard procedures, the establishment of a commission for procedures and performance of external and internal clinical audits in oncological radiotherapy, as well as to present the process of their implementation into the practice of health care institutions. PMID:23788867

The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

PubMed

Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew

2017-03-01

Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

Workplace managers' view of the role of co-workers in return-to-work.

PubMed

Dunstan, Debra A; MacEachen, Ellen

2016-11-01

Theoretical and empirical research findings attest to the workplace being a social environment in which co-workers have a critical influence on the employment outcomes and return-to-work (RTW) success of other employees. However, co-workers do not have a formal role in RTW planning. The aim of this study was to explore how managers responsible for developing and implementing RTW procedures view the role of co-workers in this process. An exploratory qualitative pilot study was conducted in Canada. Participants (1 male; 13 females; mean experience in RTW = 11.8 years) were workplace (n=8) or RTW managers (n=6) with direct oversight of RTW plans. The participants were recruited via invitation from a research institute and were drawn from three different provinces. Data were gathered via open-ended questions and were coded and subject to thematic analysis. Three key themes were identified: (1) Managers view RTW as having little relevance to co-workers but expect them to cooperate with the arrangements; (2) Formal procedures are inadequate when psychosocial barriers to work resumption are present, so managers use informal strategies to engage co-workers' emotional and social support; and (3) Managers have difficulty integrating RTW procedures with other legal obligations, such as privacy and confidentiality requirements. Existing arrangements for the development and implementation of RTW are sufficient most of the time, but may be inadequate when an injured worker presents with psychosocial barriers to work resumption. Implications for Rehabilitation Standard RTW arrangements can be inadequate when a RTW plan requires active co-worker support. Privacy and confidentiality provisions can result in managers using informal procedures for information exchange and to engage co-workers. The use of risk management strategies - assessment, consultation and communication - could be used to include co-workers when workplace issues threaten the success of a RTW plan.

49 CFR 192.1001 - What definitions apply to this subpart?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Integrity Management (IM) § 192.1001 What definitions apply to this subpart? The following definitions apply to this subpart: Excavation Damage means any impact that results in the need to repair or replace an... mechanisms or procedures the operator will use to implement its integrity management program and to ensure...

School Behavioral Threat Assessment and Management

ERIC Educational Resources Information Center

Louvar Reeves, Melissa A.; Brock, Stephen E.

2018-01-01

While schools are safer today than in years past, one act of school violence is one too many. Recent reports have conveyed the importance of schools developing and implementing protocols and procedures to prevent or mitigate school violence. To assist with this task, this article addresses behavioral threat assessment and management (BTAM) in the…

Resource Guide for Crisis Management in Schools.

ERIC Educational Resources Information Center

LaPointe, Richard T.; And Others

A crisis can occur at any time, whether or not a school's staff plans for it. This resource guide is a compilation of user-friendly examples of policies, procedures, guidelines, checklists, and forms to help Virginia schools develop and implement a systematic crisis-management plan. Chapter 1 provides an introductory overview of the essential…

The Visibility and Invisibility of Performance Management in Schools

ERIC Educational Resources Information Center

Page, Damien

2015-01-01

This article presents findings from a study of performance management in 10 schools, five primary and five secondary. The aim was to gain a snapshot of how headteachers are interpreting and implementing the reforms to the performance and capability procedures for teachers introduced in September 2013. The findings suggest that the evaluation of…

77 FR 3497 - Notice of Availability of a Draft Environmental Assessment and Finding of No Significant Impact...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-24

... Boundary and Water Commission (USIBWC) and Bureau of Land Management (BLM) Lands in Seldon Canyon, Do... through 1508); and the United States Section, Operational Procedures for Implementing Section 102 of NEPA... Water Commission and Bureau of Land Management Lands are available. An environmental impact statement...

Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

PubMed

Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

2014-07-01

The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

Causes and remedies for the dominant risk factors in Enterprise System implementation projects: the consultants' perspective.

PubMed

Lech, Przemysław

2016-01-01

The purpose of this research was to investigate the causes of the dominant risk factors, affecting Enterprise System implementation projects and propose remedies for those risk factors from the perspective of implementation consultants. The study used a qualitative research strategy, based on e-mail interviews, semi-structured personal interviews with consultants and participant observation during implementation projects. The main contribution of this paper is that it offers viable indications of how to mitigate the dominant risk factors. These indications were grouped into the following categories: stable project scope, smooth communication supported by the project management, dedicated, competent and decision-making client team, competent and engaged consultant project manager, schedule and budget consistent with the project scope, use of methodology and procedures, enforced and enabled by the project managers, competent and dedicated consultants. A detailed description is provided for each category.

[IMPLEMENTATION OF A QUALITY MANAGEMENT SYSTEM IN A NUTRITION UNIT ACCORDING TO ISO 9001:2008].

PubMed

Velasco Gimeno, Cristina; Cuerda Compés, Cristina; Alonso Puerta, Alba; Frías Soriano, Laura; Camblor Álvarez, Miguel; Bretón Lesmes, Irene; Plá Mestre, Rosa; Izquierdo Membrilla, Isabel; García-Peris, Pilar

2015-09-01

the implementation of quality management systems (QMS) in the health sector has made great progress in recent years, remains a key tool for the management and improvement of services provides to patients. to describe the process of implementing a quality management system (QMS) according to the standard ISO 9001:2008 in a Nutrition Unit. the implementation began in October 2012. Nutrition Unit was supported by Hospital Preventive Medicine and Quality Management Service (PMQM). Initially training sessions on QMS and ISO standards for staff were held. Quality Committee (QC) was established with representation of the medical and nursing staff. Every week, meeting took place among members of the QC and PMQM to define processes, procedures and quality indicators. We carry on a 2 months follow-up of these documents after their validation. a total of 4 processes were identified and documented (Nutritional status assessment, Nutritional treatment, Monitoring of nutritional treatment and Planning and control of oral feeding) and 13 operating procedures in which all the activity of the Unit were described. The interactions among them were defined in the processes map. Each process has associated specific quality indicators for measuring the state of the QMS, and identifying opportunities for improvement. All the documents associated with requirements of ISO 9001:2008 were developed: quality policy, quality objectives, quality manual, documents and records control, internal audit, nonconformities and corrective and preventive actions. The unit was certified by AENOR in April 2013. the implementation of a QMS causes a reorganization of the activities of the Unit in order to meet customer's expectations. Documenting these activities ensures a better understanding of the organization, defines the responsibilities of all staff and brings a better management of time and resources. QMS also improves the internal communication and is a motivational element. Explore the satisfaction and expectations of patients can include their view in the design of care processes. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

General RMP Guidance - Chapter 6: Prevention Program (Program 2)

EPA Pesticide Factsheets

Sound prevention practices are founded on safety information, hazard review, operating procedures, training, maintenance, compliance audits, and accident investigation. These must be integrated into a risk management system that you implement consistently.

Integrated Systems Health Management for Intelligent Systems

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Melcher, Kevin

2011-01-01

The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

Workflow Optimization in Vertebrobasilar Occlusion

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

Kamper, Lars, E-mail: lars.kamper@helios-kliniken.de; Meyn, Hannes; Rybacki, Konrad

2012-06-15

Objective: In vertebrobasilar occlusion, rapid recanalization is the only substantial means to improve the prognosis. We introduced a standard operating procedure (SOP) for interventional therapy to analyze the effects on interdisciplinary time management. Methods: Intrahospital time periods between hospital admission and neuroradiological intervention were retrospectively analyzed, together with the patients' outcome, before (n = 18) and after (n = 20) implementation of the SOP. Results: After implementation of the SOP, we observed statistically significant improvement of postinterventional patient neurological status (p = 0.017). In addition, we found a decrease of 5:33 h for the mean time period from hospital admissionmore » until neuroradiological intervention. The recanalization rate increased from 72.2% to 80% after implementation of the SOP. Conclusion: Our results underscore the relevance of SOP implementation and analysis of time management for clinical workflow optimization. Both may trigger awareness for the need of efficient interdisciplinary time management. This could be an explanation for the decreased time periods and improved postinterventional patient status after SOP implementation.« less

Man-rated flight software for the F-8 DFBW program

NASA Technical Reports Server (NTRS)

Bairnsfather, R. R.

1976-01-01

The design, implementation, and verification of the flight control software used in the F-8 DFBW program are discussed. Since the DFBW utilizes an Apollo computer and hardware, the procedures, controls, and basic management techniques employed are based on those developed for the Apollo software system. Program assembly control, simulator configuration control, erasable-memory load generation, change procedures and anomaly reporting are discussed. The primary verification tools are described, as well as the program test plans and their implementation on the various simulators. Failure effects analysis and the creation of special failure generating software for testing purposes are described.

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals

PubMed Central

Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta

2006-01-01

Background The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. Methods A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Results Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. Conclusion QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size – the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals. PMID:16987416

Guidelines for Implementing Change: A Case Study

NASA Astrophysics Data System (ADS)

Masekela, Belinda; Nienaber, Rita

To attain and sustain a competitive advantage organizations are continually faced with the need to change their structures, processes and technologies. Converting to new technology and implementing a new information management system in an organization results in inevitable changes in organizational procedures impacting on the people involved. A major problem encountered during this process is resistance to change, which may contribute to total failure of this system. Change management is the process that can be used to negate this impact and assist employees in transitioning to a new way of doing things.

The M68HC11 gripper controller software. Thesis

NASA Technical Reports Server (NTRS)

Tsai, Jodi Wei-Duk

1991-01-01

This thesis discusses the development of firmware for the 68HC11 gripper controller. A general description of the software and hardware interfaces is given. The C library interface for the gripper is then described and followed by a detailed discussion of the software architecture of the firmware. A procedure to assemble and download 68HC11 programs is presented in the form of a tutorial. The tools used to implement this environment are then described. Finally, the implementation of the configuration management scheme used to manage all CIRSSE software is presented.

Use and implementation of standard operating procedures and checklists in prehospital emergency medicine: a literature review.

PubMed

Chen, Chulin; Kan, Ting; Li, Shuang; Qiu, Chen; Gui, Li

2016-12-01

This review aimed to analyze published literature to introduce the use and implementation of standard operating procedures (SOPs) and checklists in prehospital emergency medicine and their impact on guideline adherence and patient outcome. An English literature search was carried out using the Cochrane Library, MEDLINE, EMBASE, Springer, Elsevier, and ProQuest databases. Original articles describing the use and implementation of SOPs or checklists in prehospital emergency medicine were included. Editorials, comments, letters, bulletins, news articles, conference abstracts, and notes were excluded from the analysis. Relevant information was extracted relating to application areas, development of SOPs/checklists, educational preparation and training regarding SOPs/checklists implementation, staff attitudes and the effects of SOPs/checklists use on guideline adherence and patient outcomes. The literature search found 2187 potentially relevant articles, which were narrowed down following an abstract review and a full text review. A final total of 13 studies were identified that described the use and implementation of SOPs (9 studies) and checklists (4 studies) in different areas of prehospital emergency medicine including prehospital management of patients with acute exacerbated chronic obstructive pulmonary disease and acute coronary syndrome, prehospital airway management, medical documentation, Emergency Medical Services triage, and transportation of patients. The use and implementation of SOPs and checklists in prehospital emergency medicine have shown some benefits of improving guidelines adherence and patient outcomes in airway management, patient records, identification and triage, and other prehospital interventions. More research in this area is necessary to optimize the future use and implementation of SOPs and checklists to improve emergency personnel performance and patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Privacy and security compliance in the E-healthcare marketplace.

PubMed

Lutes, M

2000-03-01

Complying with security and privacy regulations proposed by HHS in response to the Health Insurance Portability and Accountability Act (HIPAA) will require healthcare managers to address both internal and external business interactions and initiatives. The proposed regulations mandate certain procedures regarding administration, physical safeguards, technical security for data integrity and confidentiality, and technical security against unauthorized access. In particular, the proposed regulations require organizations to contractually ensure that vendors adhere to the regulations. Healthcare organizations also must implement training procedures for staff members who have contact with protected health information and designate a privacy officer to guard against improper disclosure of such information. Documented policies for organizational decision making are vital to an organization's efforts to implement procedures for compliance with the regulations.

Newly emerging resource efficiency manager programs

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

Wolf, S.; Howell, C.

1997-12-31

Many facilities in the northwest such as K--12 schools, community colleges, and military installations are implementing resource-efficiency awareness programs. These programs are generally referred to as resource efficiency manager (REM) or resource conservation manager (RCM) programs. Resource efficiency management is a systems approach to managing a facility`s energy, water, and solid waste. Its aim is to reduce utility budgets by focusing on behavioral changes, maintenance and operation procedures, resource accounting, education and training, and a comprehensive awareness campaign that involves everyone in the organization.

Interprofessional and interdisciplinary simulation-based training leads to safe sedation procedures in the emergency department.

PubMed

Sauter, Thomas C; Hautz, Wolf E; Hostettler, Simone; Brodmann-Maeder, Monika; Martinolli, Luca; Lehmann, Beat; Exadaktylos, Aristomenis K; Haider, Dominik G

2016-08-02

Sedation is a procedure required for many interventions in the Emergency department (ED) such as reductions, surgical procedures or cardioversions. However, especially under emergency conditions with high risk patients and rapidly changing interdisciplinary and interprofessional teams, the procedure caries important risks. It is thus vital but difficult to implement a standard operating procedure for sedation procedures in any ED. Reports on both, implementation strategies as well as their success are currently lacking. This study describes the development, implementation and clinical evaluation of an interprofessional and interdisciplinary simulation-based sedation training concept. All physicians and nurses with specialised training in emergency medicine at the Berne University Department of Emergency Medicine participated in a mandatory interdisciplinary and interprofessional simulation-based sedation training. The curriculum consisted of an individual self-learning module, an airway skill training course, three simulation-based team training cases, and a final practical learning course in the operating theatre. Before and after each training session, self-efficacy, awareness of emergency procedures, knowledge of sedation medication and crisis resource management were assessed with a questionnaire. Changes in these measures were compared via paired tests, separately for groups formed based on experience and profession. To assess the clinical effect of training, we collected patient and team satisfaction as well as duration and complications for all sedations in the ED within the year after implementation. We further compared time to beginning of procedure, time for duration of procedure and time until discharge after implementation with the one year period before the implementation. Cohen's d was calculated as effect size for all statistically significant tests. Fifty staff members (26 nurses and 24 physicians) participated in the training. In all subgroups, there is a significant increase in self-efficacy and knowledge with high effect size (d z  = 1.8). The learning is independent of profession and experience level. In the clinical evaluation after implementation, we found no major complications among the sedations performed. Time to procedure significantly improved after the introduction of the training (d = 0.88). Learning is independent of previous working experience and equally effective in raising the self-efficacy and knowledge in all professional groups. Clinical outcome evaluation confirms the concepts safety and feasibility. An interprofessional and interdisciplinary simulation-based sedation training is an efficient way to implement a conscious sedation concept in an ED.

The assessment and management of chemotherapy-induced nausea and vomiting among cancer patients in a chemotherapy ward: a best practice implementation project.

PubMed

Gu, Lingli; Li, Jing

2016-03-01

Chemotherapy-induced nausea and vomiting (CINV) are considered to be two of the most distressing side-effects of chemotherapy. They have a negative impact on a patient's quality of life and can influence the continuance of treatment. Owing to the lack of effective management of CINV, regular assessment and management of CINV is recommended for patients undergoing chemotherapy. The aim of this project was to integrate the available evidence on the assessment and management of CINV into practice, and implement strategies to improve compliance with evidence-based practice. The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the best available evidence on the assessment and management of CINV. The program was divided into three phases and conducted over four months in the chemotherapy ward, Fudan University Shanghai Cancer Center, Shanghai, China. Sixty patients and 14 oncology nurses were involved in this project. The results of the follow-up cycle showed that the compliance rates regarding patient education, risk factors evaluation and non-pharmacologic managements were 100%, 100% and 80%, respectively. The rate of validated tools being used by patients and nurses improved by 93% and 97%, respectively. This project demonstrated that the use of pre- and post-best practice audits is an effective method for incorporating evidence into practice in a chemotherapy ward. The practice of assessing and managing CINV was significantly improved. The next step is to develop strategies for sustaining the new procedures of CINV assessment and management.

Database management systems for process safety.

PubMed

Early, William F

2006-03-17

Several elements of the process safety management regulation (PSM) require tracking and documentation of actions; process hazard analyses, management of change, process safety information, operating procedures, training, contractor safety programs, pre-startup safety reviews, incident investigations, emergency planning, and compliance audits. These elements can result in hundreds of actions annually that require actions. This tracking and documentation commonly is a failing identified in compliance audits, and is difficult to manage through action lists, spreadsheets, or other tools that are comfortably manipulated by plant personnel. This paper discusses the recent implementation of a database management system at a chemical plant and chronicles the improvements accomplished through the introduction of a customized system. The system as implemented modeled the normal plant workflows, and provided simple, recognizable user interfaces for ease of use.

Wyoming Department of Transportation geographic information system implementation project

DOT National Transportation Integrated Search

2000-01-01

A geographic information system (GIS) was needed by the Wyoming Department of Transportation (WYDOT) to complement existing information management procedures and leverage the spatial components of its data. WYDOT contracted with Environmental Systems...

Identifying Functional Requirements for Flexible Airspace Management Concept Using Human-In-The-Loop Simulations

NASA Technical Reports Server (NTRS)

Lee, Paul U.; Bender, Kim; Pagan, Danielle

2011-01-01

Flexible Airspace Management (FAM) is a mid- term Next Generation Air Transportation System (NextGen) concept that allows dynamic changes to airspace configurations to meet the changes in the traffic demand. A series of human-in-the-loop (HITL) studies have identified procedures and decision support requirements needed to implement FAM. This paper outlines a suggested FAM procedure and associated decision support functionality based on these HITL studies. A description of both the tools used to support the HITLs and the planned NextGen technologies available in the mid-term are presented and compared. The mid-term implementation of several NextGen capabilities, specifically, upgrades to the Traffic Management Unit (TMU), the initial release of an en route automation system, the deployment of a digital data communication system, a more flexible voice communications network, and the introduction of a tool envisioned to manage and coordinate networked ground systems can support the implementation of the FAM concept. Because of the variability in the overall deployment schedule of the mid-term NextGen capabilities, the dependency of the individual NextGen capabilities are examined to determine their impact on a mid-term implementation of FAM. A cursory review of the different technologies suggests that new functionality slated for the new en route automation system is a critical enabling technology for FAM, as well as the functionality to manage and coordinate networked ground systems. Upgrades to the TMU are less critical but important nonetheless for FAM to be fully realized. Flexible voice communications network and digital data communication system could allow more flexible FAM operations but they are not as essential.

The Effect of Domain and Technical Expertise on the Training Outcomes for Case Management Systems in High Domain Expertise Fields

ERIC Educational Resources Information Center

Epstein, Steven L.

2017-01-01

The successful implementation of an enterprise system requires training and end users in the new systems and procedures. There has been no research reporting a relationship between Domain Expertise (DE) and the successful implementation of an enterprise system. This study sought to begin filling this knowledge gap by exploring the relationship…

Bringing Up an Online System: Experiences at the University of Alaska. Project Management: A Key to Successful Organization and Implementation.

ERIC Educational Resources Information Center

Gaylord, Thomas A.

The adoption of an information systems implementation strategy that emphasized user involvement at the University of Alaska, the only public university in the state, is discussed. The university sought to provide an online Student Information System (SIS) that provided convenient procedures for registering, tracking, and grading students, as well…

76 FR 43616 - Procedures for Implementing the National Environmental Policy Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

... Studies. 4. NASA HQ 09/23/2009 ARRA Implementation of Venture-Class Mission, HQ ID-1095. 5. LaRC, VA 11/20.../2009 Develop Air Traffic Management Concepts. 5. NASA HQ 12/23/2009 ARRA-Funded Activities (HQ ID-1119... Composition, Cloud, Climate Coupling (TC-4). 3. WFF, VA 03/28/2008 ARCTAS Mission. The third proposed CatEx...

2 CFR 1.200 - Purpose of chapters I and II.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (and thereby implement the Federal Financial Assistance Management Improvement Act of 1999, Pub. L. 106... Introduction toSubtitle A § 1.200 Purpose of chapters I and II. (a) Chapters I and II of subtitle A provide OMB... procedures for management of the agencies' grants and agreements. (b) There are two chapters for publication...

Addressing Bullying Problems in Irish Schools and in Cyberspace: A Challenge for School Management

ERIC Educational Resources Information Center

Corcoran, Lucie; Mc Guckin, Conor

2014-01-01

Background: School management, in Ireland and also internationally, are currently faced with the problem of peer aggression among students both in a traditional school context and in a cyber context. Although Irish school principals are obliged to implement policy and procedures to counter bullying among students, there is a need for guidance that…

Towards More Efficient Student Course Evaluations for Use at Management Level

ERIC Educational Resources Information Center

Rønsholdt, Bent; Brohus, Henrik

2014-01-01

In order to obtain an accreditation, the university management must implement a quality assurance system and be able to document that quality policy and procedures are followed and acted upon as appropriate. One element in this system is monitoring students' satisfaction. In this paper, we describe a method of acquiring the necessary information…

Responsibility for managing healthcare-associated infections: where does the buck stop?

PubMed

Duerden, B I

2009-12-01

The prevention and control of healthcare-associated infections (HCAIs) requires a tripartite partnership between clinicians and carers, managers and government/Department of Health (DoH) across the whole health and social care community. Mandatory surveillance of meticillin-resistant Staphylococcus aureus bacteraemia and Clostridium difficile infection has shown a significant fall from peak numbers in 2003/04 and 2006, respectively, and there is now a zero tolerance approach to preventable infections and poor practice. Success so far has been based on senior management commitment, enhanced real-time surveillance, implementation of clinical protocols (high impact interventions, prudent prescribing), improved hand hygiene and environmental cleaning, and training and audit, backed up by a heightened performance management focus through targets and legislation (Code of Practice). DoH improvement teams have supported National Health Service trusts in implementing change. Responsibility for managing HCAI is a combination of managerial responsibility based upon compliance assurance that procedures and protocols are being implemented and personal professional responsibility of all clinicians and other healthcare workers.

Critical systems for public health management of floods, North Dakota.

PubMed

Wiedrich, Tim W; Sickler, Juli L; Vossler, Brenda L; Pickard, Stephen P

2013-01-01

Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build public health response capabilities. Five of the 15 public health preparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding.

Reflections on the implementation of governance structures for early-stage clinical innovation.

PubMed

Cowie, Luke; Sandall, Jane; Ehrich, Kathryn

2013-12-01

This paper seeks to further explore the question of how best to monitor and govern innovative clinical procedures in their earliest phase of development. We examine the potential value of proposed governance frameworks, such as the IDEAL model, and examine the functioning of a novel procedures review committee. The paper draws upon 20 qualitative, semi-structured interviews. Nine interviews were conducted with members of a committee that was established as a means of governing innovative procedures within a large National Health Service Foundation Trust hospital in the UK. Eleven interviews were conducted with health providers involved with the development of a variety of novel clinical procedures. Prominent themes from the data include the potential willingness of clinicians to engage with regulatory frameworks for innovative procedures, existing ways in which clinicians and others attempt to ensure patient's safety and manage uncertainty in the context of novel procedures, views on the potential benefits and drawbacks of engaging with a review committee for novel procedures, and the pragmatic considerations and potential unintended consequences that are entailed in the implementation of regulatory requirements for the monitoring of innovative procedures. The views of committee members and clinical innovators help us to understand the practical issues of implementing governance structures for novel clinical procedures. The data illustrate those factors that must be taken into account if governance is to support innovation rather than act as an inhibiting factor in the development of new clinical procedures. © 2012 John Wiley & Sons Ltd.

[Nursing service certification. Norm UNE-EN-ISO 9001-2008].

PubMed

Salazar de la Guerra, R; Ferrer Arnedo, C; Labrador Domínguez, M J; Sangregorio Matesanz, A

2014-01-01

To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process. The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements. The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%. The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays.

PubMed

Rossum, Huub H van; Kemperman, Hans

2017-07-26

General application of a moving average (MA) as continuous analytical quality control (QC) for routine chemistry assays has failed due to lack of a simple method that allows optimization of MAs. A new method was applied to optimize the MA for routine chemistry and was evaluated in daily practice as continuous analytical QC instrument. MA procedures were optimized using an MA bias detection simulation procedure. Optimization was graphically supported by bias detection curves. Next, all optimal MA procedures that contributed to the quality assurance were run for 100 consecutive days and MA alarms generated during working hours were investigated. Optimized MA procedures were applied for 24 chemistry assays. During this evaluation, 303,871 MA values and 76 MA alarms were generated. Of all alarms, 54 (71%) were generated during office hours. Of these, 41 were further investigated and were caused by ion selective electrode (ISE) failure (1), calibration failure not detected by QC due to improper QC settings (1), possible bias (significant difference with the other analyzer) (10), non-human materials analyzed (2), extreme result(s) of a single patient (2), pre-analytical error (1), no cause identified (20), and no conclusion possible (4). MA was implemented in daily practice as a continuous QC instrument for 24 routine chemistry assays. In our setup when an MA alarm required follow-up, a manageable number of MA alarms was generated that resulted in valuable MA alarms. For the management of MA alarms, several applications/requirements in the MA management software will simplify the use of MA procedures.

Architecture design of a generic centralized adjudication module integrated in a web-based clinical trial management system

PubMed Central

Zhao, Wenle; Pauls, Keith

2015-01-01

Background Centralized outcome adjudication has been used widely in multi-center clinical trials in order to prevent potential biases and to reduce variations in important safety and efficacy outcome assessments. Adjudication procedures could vary significantly among different studies. In practice, the coordination of outcome adjudication procedures in many multicenter clinical trials remains as a manual process with low efficiency and high risk of delay. Motivated by the demands from two large clinical trial networks, a generic outcome adjudication module has been developed by the network’s data management center within a homegrown clinical trial management system. In this paper, the system design strategy and database structure are presented. Methods A generic database model was created to transfer different adjudication procedures into a unified set of sequential adjudication steps. Each adjudication step was defined by one activate condition, one lock condition, one to five categorical data items to capture adjudication results, and one free text field for general comments. Based on this model, a generic outcome adjudication user interface and a generic data processing program were developed within a homegrown clinical trial management system to provide automated coordination of outcome adjudication. Results By the end of 2014, this generic outcome adjudication module had been implemented in 10 multicenter trials. A total of 29 adjudication procedures were defined with the number of adjudication steps varying from 1 to 7. The implementation of a new adjudication procedure in this generic module took an experienced programmer one or two days. A total of 7,336 outcome events had been adjudicated and 16,235 adjudication step activities had been recorded. In a multicenter trial, 1144 safety outcome event submissions went through a three-step adjudication procedure and reported a median of 3.95 days from safety event case report form submission to adjudication completion. In another trial, 277 clinical outcome events were adjudicated by a six-step procedure and took a median of 23.84 days from outcome event case report form submission to adjudication procedure completion. Conclusions A generic outcome adjudication module integrated in the clinical trial management system made the automated coordination of efficacy and safety outcome adjudication a reality. PMID:26464429

WE-G-BRC-02: Risk Assessment for HDR Brachytherapy

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

Mayadev, J.

2016-06-15

Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less

WE-G-BRC-01: Risk Assessment for Radiosurgery

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

Kim, G.

2016-06-15

Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less

WE-G-BRC-03: Risk Assessment for Physics Plan Review

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

Parker, S.

2016-06-15

Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less

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

NONE

Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less

Integrated Systems Health Management for Intelligent Systems

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Melcher, Kevin

2011-01-01

The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

45 CFR 164.304 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health Information § 164... and procedures, to manage the selection, development, implementation, and maintenance of security...'s or business associate's workforce in relation to the protection of that information...

45 CFR 164.304 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health Information § 164... and procedures, to manage the selection, development, implementation, and maintenance of security...'s workforce in relation to the protection of that information. Authentication means the...

45 CFR 164.304 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health Information § 164... and procedures, to manage the selection, development, implementation, and maintenance of security...'s workforce in relation to the protection of that information. Authentication means the...

45 CFR 164.304 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health Information § 164... and procedures, to manage the selection, development, implementation, and maintenance of security...'s workforce in relation to the protection of that information. Authentication means the...

45 CFR 164.304 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health Information § 164... and procedures, to manage the selection, development, implementation, and maintenance of security...'s or business associate's workforce in relation to the protection of that information...

MyHealthAtVanderbilt: policies and procedures governing patient portal functionality

PubMed Central

Rosenbloom, S Trent; Stenner, Shane P; Anders, Shilo; Muse, Sue; Johnson, Kevin B; Jirjis, Jim; Jackson, Gretchen Purcell

2011-01-01

Explicit guidelines are needed to develop safe and effective patient portals. This paper proposes general principles, policies, and procedures for patient portal functionality based on MyHealthAtVanderbilt (MHAV), a robust portal for Vanderbilt University Medical Center. We describe policies and procedures designed to govern popular portal functions, address common user concerns, and support adoption. We present the results of our approach as overall and function-specific usage data. Five years after implementation, MHAV has over 129 800 users; 45% have used bi-directional messaging; 52% have viewed test results and 45% have viewed other medical record data; 30% have accessed health education materials; 39% have scheduled appointments; and 29% have managed a medical bill. Our policies and procedures have supported widespread adoption and use of MHAV. We believe other healthcare organizations could employ our general guidelines and lessons learned to facilitate portal implementation and usage. PMID:21807648

Los Alamos National Laboratory emergency management plan. Revision 1

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

Ramsey, G.F.

1998-07-15

The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents,more » transportation accidents, electrical accidents, and natural disasters.« less

[Modern operations management in workflow operation. Spectrum of responsibilities and challenges for the future].

PubMed

Riedl, S

2002-02-01

The operating unit is one of the cost-intensive facilities in a surgical clinic with a pacemaking function for most of the internal procedures. The power of performance of the operating unit is based on the co-operation of all disciplines and professions involved. The key to management of the operating unit is not only to co-ordinate the daily procedures, but also to interact with support personnel. To ensure successful OR management, the internal structure of the OR must fit the clinical tasks and the available quantity of personnel in each profession must be co-ordinated. Sufficient utilization of resources and equipment must be guaranteed without cost-intensive over-capacities and patient flow must be orientated to OR capacities. The development of such a business structure requires the management to clearly define the goal, to know the actual on-site data in detail with regard to the idiosyncratic workings of each speciality and to clearly assign the competence of each member of the team working in the OR. Co-ordination of the operating unit is the main task of OR management, which must ensure the following: transparent and co-ordinated schedule management in the various operative specialities, goal-directed changes of the schedule with incorporation of emergencies, as well as effective organization of staff. In order to realize these tasks, it is reasonable to implement interdisciplinary rules of procedures. In addition, the assignment of a neutral decision-making body within the OR and the creation of an information center for all OR personnel. The challenge of OR organization in the future is to implement more effective documentation systems and active controlling within the OR. One can ensure adequate utilization of resources in the OR with prospectively oriented planning. Better transparence of operations in the OR contributes to increased efficiency. Implementation of quality management is the foundation for a successfully operating surgical hospital. Not only the productivity of individual members of the staff, but also the precise documentation of the quality of results will become important parameters in a successful surgical hospital, whose nucleus is the OR.

Policies and procedures in the workplace: how health care organizations compare.

PubMed

Loo, R

1993-01-01

Many organizations are implementing programs and services to manage the human and economic costs of stress. A mail survey was conducted of 500 randomly selected Canadian organizations having at least 500 employees. The survey tapped four major areas: organizational policies and procedures for managing stress; programs and services offered; perceived benefits and constraints for the organization; and projected future directions in this area. Analyses of returns from 210 organizations-43 health and 167 non-health-revealed various findings. For example, over half of health care organizations have policies and procedures as opposed to less than half of non-health care organizations. Also, health care organizations place greater emphasis on smoking cessation, weight control programs and on stress management training. Although some Canadian organizations are addressing stress, much more could and should be done, especially by organizations that do not yet recognize the impact of stress on employees and their work performance.

Procedural Quantum Programming

NASA Astrophysics Data System (ADS)

Ömer, Bernhard

2002-09-01

While classical computing science has developed a variety of methods and programming languages around the concept of the universal computer, the typical description of quantum algorithms still uses a purely mathematical, non-constructive formalism which makes no difference between a hydrogen atom and a quantum computer. This paper investigates, how the concept of procedural programming languages, the most widely used classical formalism for describing and implementing algorithms, can be adopted to the field of quantum computing, and how non-classical features like the reversibility of unitary transformations, the non-observability of quantum states or the lack of copy and erase operations can be reflected semantically. It introduces the key concepts of procedural quantum programming (hybrid target architecture, operator hierarchy, quantum data types, memory management, etc.) and presents the experimental language QCL, which implements these principles.

Health Project Management. A Manual of Procedures for Formulating and Implementing Health Projects.

ERIC Educational Resources Information Center

Bainbridge, J.; Sapirie, S.

The manual presents 16 main steps for health project management, from project formulation through termination. The manual defines a health project as a temporary intensive effort to set up and put into operation a new or revised service that will result in the reduction of specific health or health-related problems. (Typical examples include the…

Economic and organizational sustainability of a negative-pressure portable device for the prevention of surgical-site complications

PubMed Central

Foglia, Emanuela; Ferrario, Lucrezia; Garagiola, Elisabetta; Signoriello, Giuseppe; Pellino, Gianluca; Croce, Davide; Canonico, Silvestro

2017-01-01

Purpose Surgical-site complications (SSCs) affect patients’ clinical pathway, prolonging their hospitalization and incrementing their management costs. The present study aimed to assess the economic and organizational implications of a portable device for negative-pressure wound therapy (NPWT) implementation, compared with the administration of pharmacological therapies alone for preventing surgical complications in patients undergoing general, cardiac, obstetrical–gynecological, or orthopedic surgical procedures. Patients and methods A total of 8,566 hospital procedures, related to the year 2015 from one hospital, were evaluated considering infection risk index, occurrence rates of SSCs, drug therapies, and surgical, diagnostic, and specialist procedures and hematological exams. Activity-based costing and budget impact analyses were implemented for the economic assessment. Results Patients developing an SSC absorbed i) 64.27% more economic resources considering the length of stay (€ 8,269±2,096 versus € 5,034±2,901, p<0.05) and ii) 42.43% more economic resources related to hematological and diagnostic procedures (€ 639±117 versus € 449±72, p<0.05). If the innovative device had been used over the 12-month time period, it would have decreased the risk of developing SSCs; the hospital would have realized an average reduction in health care expenditure equal to −0.69% (−€ 483,787.92) and an organizational saving in terms of length of stay equal to −1.10% (−898 days), thus allowing 95 additional procedures. Conclusion The implementation of a portable device for NPWT would represent an effective and sustainable strategy for reducing the management costs of patients. Economic and organizational savings could be reinvested, thus i) treating a wider population and ii) reducing waiting lists, with a higher effectiveness in terms of a decrease in complications. PMID:28652788

Considerations in the design of a communication network for an autonomously managed power system

NASA Technical Reports Server (NTRS)

Mckee, J. W.; Whitehead, Norma; Lollar, Louis

1989-01-01

The considerations involved in designing a communication network for an autonomously managed power system intended for use in space vehicles are examined. An overview of the design and implementation of a communication network implemented in a breadboard power system is presented. An assumption that the monitoring and control devices are distributed but physically close leads to the selection of a multidrop cable communication system. The assumption of a high-quality communication cable in which few messages are lost resulted in a simple recovery procedure consisting of a time out and retransmit process.

44 CFR 10.11 - Environmental information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Environmental information. 10... OF HOMELAND SECURITY GENERAL ENVIRONMENTAL CONSIDERATIONS Agency Implementing Procedures § 10.11 Environmental information. Interested persons may contact the Environmental Officer or the Regional...

44 CFR 10.11 - Environmental information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Environmental information. 10... OF HOMELAND SECURITY GENERAL ENVIRONMENTAL CONSIDERATIONS Agency Implementing Procedures § 10.11 Environmental information. Interested persons may contact the Environmental Officer or the Regional...

45 CFR 164.308 - Administrative safeguards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health... accordance with § 164.306: (1)(i) Standard: Security management process. Implement policies and procedures to... to the confidentiality, integrity, and availability of electronic protected health information held...

45 CFR 164.308 - Administrative safeguards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health... accordance with § 164.306: (1)(i) Standard: Security management process. Implement policies and procedures to... to the confidentiality, integrity, and availability of electronic protected health information held...

44 CFR 79.3 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION GRANTS § 79.3...-related hazard mitigation programs and grants, including: (1) Issue program implementation procedures, as... governments regarding the mitigation and grants management process; (5) Review and approve State, Indian...

Scale development of safety management system evaluation for the airline industry.

PubMed

Chen, Ching-Fu; Chen, Shu-Chuan

2012-07-01

The airline industry relies on the implementation of Safety Management System (SMS) to integrate safety policies and augment safety performance at both organizational and individual levels. Although there are various degrees of SMS implementation in practice, a comprehensive scale measuring the essential dimensions of SMS is still lacking. This paper thus aims to develop an SMS measurement scale from the perspective of aviation experts and airline managers to evaluate the performance of company's safety management system, by adopting Schwab's (1980) three-stage scale development procedure. The results reveal a five-factor structure consisting of 23 items. The five factors include documentation and commands, safety promotion and training, executive management commitment, emergency preparedness and response plan and safety management policy. The implications of this SMS evaluation scale for practitioners and future research are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Implementing the dynamic appraisal of situational aggression in mental health units.

PubMed

Lantta, Tella; Daffern, Michael; Kontio, Raija; Välimäki, Maritta

2015-01-01

The aims of this study are to explain the intervention of implementing a structured violence risk assessment procedure in mental health inpatient units using the Ottawa Model of Research Use (OMRU) as a guiding framework and to consider nurses' perspectives of its clinical utility and implementation process. Patient aggression toward staff is a global concern in mental health units. The limited extant literature exploring the use of structured violence risk assessments in mental health units, although small and inconsistent, reveals some positive impacts on the incidence of aggression and staff's use of restrictive interventions. Although numerous violence risk assessment instruments have been developed and tested, their systematic implementation and use are still limited. A project titled "Safer Working Management" (111298) was conducted in a Finnish hospital district, across 3 mental health units. The 6 steps of OMRU were followed during implementation of the Dynamic Appraisal of Situational Aggression (DASA). Nurses' views toward structured violence risk assessment procedures varied. Although implementation of the DASA was seen as a useful method to increase discussions with patients and nursing staff, some staff preferred their own clinical judgment for assessment of violence risk. It is possible to use a specific model to promote the implementation of risk assessment instruments in mental health units. However, the complex mental health inpatient environment and the difficulties in understanding and managing aggressive patients present challenges for the implementation of structured violence risk assessment methods. The OMRU provides a tool for clinical nurse specialists to guide implementation process in mental health units. Clinical nurse specialists must promote training for staff regarding use of new innovations, such as the DASA. Implementation processes should be reviewed so that clinical nurse specialists can lead and support mental health staff to properly use structured violence risk assessment measures.

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities.

PubMed

Savvas, Steven; Toye, Christine; Beattie, Elizabeth; Gibson, Stephen J

2014-12-01

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Aeropropulsion facilities configuration control: Procedures manual

NASA Technical Reports Server (NTRS)

Lavelle, James J.

1990-01-01

Lewis Research Center senior management directed that the aeropropulsion facilities be put under configuration control. A Configuration Management (CM) program was established by the Facilities Management Branch of the Aeropropulsion Facilities and Experiments Division. Under the CM program, a support service contractor was engaged to staff and implement the program. The Aeronautics Directorate has over 30 facilities at Lewis of various sizes and complexities. Under the program, a Facility Baseline List (FBL) was established for each facility, listing which systems and their documents were to be placed under configuration control. A Change Control System (CCS) was established requiring that any proposed changes to FBL systems or their documents were to be processed as per the CCS. Limited access control of the FBL master drawings was implemented and an audit system established to ensure all facility changes are properly processed. This procedures manual sets forth the policy and responsibilities to ensure all key documents constituting a facilities configuration are kept current, modified as needed, and verified to reflect any proposed change. This is the essence of the CM program.

Urban water infrastructure asset management - a structured approach in four water utilities.

PubMed

Cardoso, M A; Silva, M Santos; Coelho, S T; Almeida, M C; Covas, D I C

2012-01-01

Water services are a strategic sector of large social and economic relevance. It is therefore essential that they are managed rationally and efficiently. Advanced water supply and wastewater infrastructure asset management (IAM) is key in achieving adequate levels of service in the future, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution. This paper presents a methodology for supporting the development of urban water IAM, developed during the AWARE-P project as well as an appraisal of its implementation in four water utilities. Both water supply and wastewater systems were considered. Due to the different contexts and features of the utilities, the main concerns vary from case to case; some problems essentially are related to performance, others to risk. Cost is a common deciding factor. The paper describes the procedure applied, focusing on the diversity of drivers, constraints, benefits and outcomes. It also points out the main challenges and the results obtained through the implementation of a structured procedure for supporting urban water IAM.

Optimization of business processes in banks through flexible workflow

NASA Astrophysics Data System (ADS)

Postolache, V.

2017-08-01

This article describes an integrated business model of a commercial bank. There are examples of components that go into its composition: wooden models and business processes, strategic goals, organizational structure, system architecture, operational and marketing risk models, etc. The practice has shown that the development and implementation of the integrated business model of the bank significantly increase operating efficiency and its management, ensures organizational and technology stable development. Considering the evolution of business processes in the banking sector, should be analysed their common characteristics. From the author’s point of view, a business process is a set of various activities of a commercial bank in which “Input” is one or more financial and material resources, as a result of this activity and “output” is created by banking product, which is some value to consumer. Using workflow technology, management business process efficiency issue is a matter of managing the integration of resources and sequence of actions aimed at achieving this goal. In turn, it implies management of jobs or functions’ interaction, synchronizing of the assignments periods, reducing delays in the transmission of the results etc. Workflow technology is very important for managers at all levels, as they can use it to easily strengthen the control over what is happening in a particular unit, and in the bank as a whole. The manager is able to plan, to implement rules, to interact within the framework of the company’s procedures and tasks entrusted to the system of the distribution function and execution control, alert on the implementation and issuance of the statistical data on the effectiveness of operating procedures. Development and active use of the integrated bank business model is one of the key success factors that contribute to long-term and stable development of the bank, increase employee efficiency and business processes, implement the strategic objectives.

NASA information resources management handbook

NASA Technical Reports Server (NTRS)

1992-01-01

This National Aeronautics and Space Administration (NASA) Handbook (NHB) implements recent changes to Federal laws and regulations involving the acquisition, management, and use of Federal Information Processing (FIP) resources. This document defines NASA's Information Resources Management (IRM) practices and procedures and is applicable to all NASA personnel. The dynamic nature of the IRM environment requires that the controlling management practices and procedures for an Agency at the leading edge of technology, such as NASA, must be periodically updated to reflect the changes in this environment. This revision has been undertaken to accommodate changes in the technology and the impact of new laws and regulations dealing with IRM. The contents of this document will be subject to a complete review annually to determine its continued applicability to the acquisition, management, and use of FIP resources by NASA. Updates to this document will be accomplished by page changes. This revision cancels NHB 2410.1D, dated April 1985.

48 CFR 939.7002 - Contractor acquisition of information technology.

Code of Federal Regulations, 2013 CFR

2013-10-01

... information technology. 939.7002 Section 939.7002 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Implementing DOE Policies and Procedures 939.7002 Contractor acquisition of information technology. (a) Management and operating (M&O...

48 CFR 939.7002 - Contractor acquisition of information technology.

Code of Federal Regulations, 2014 CFR

2014-10-01

... information technology. 939.7002 Section 939.7002 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Implementing DOE Policies and Procedures 939.7002 Contractor acquisition of information technology. (a) Management and operating (M&O...

48 CFR 939.7002 - Contractor acquisition of information technology.

Code of Federal Regulations, 2011 CFR

2011-10-01

... information technology. 939.7002 Section 939.7002 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Implementing DOE Policies and Procedures 939.7002 Contractor acquisition of information technology. (a) Management and operating (M&O...

48 CFR 939.7002 - Contractor acquisition of information technology.

Code of Federal Regulations, 2012 CFR

2012-10-01

... information technology. 939.7002 Section 939.7002 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Implementing DOE Policies and Procedures 939.7002 Contractor acquisition of information technology. (a) Management and operating (M&O...

36 CFR 1222.34 - How must agencies maintain records?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping Requirements § 1222.34 How must agencies maintain records? Agencies must implement a records maintenance program so... electronic records, segregable. Agency records maintenance programs must: (a) Institute procedures for...

48 CFR 939.7002 - Contractor acquisition of information technology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information technology. 939.7002 Section 939.7002 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Implementing DOE Policies and Procedures 939.7002 Contractor acquisition of information technology. (a) Management and operating (M&O...

Implementation of Theeuropeanwater Framework Directive In France: New Challenges For River Basin Organisat Ion, Planning and Participation

NASA Astrophysics Data System (ADS)

Allain, S.

The European Water Framework Directive (2000/60/EC) establishes a system of participatory river basin planning for national and international basins. The French institutional framework for water management is already very close to this system: the 1964 Water Law actually set up basin bodies, the Agences de l'Eau ("Water Agencies"), at the level of large river basins, and multipartite basin commissions, the Comités de Bassin ("River Basin Authorities"), in order to monitor the Agences de l'Eau's policies; besides, the 1992 Water Law created a planning procedure at this level, the Schéma Directeur d'Aménagement et de Gestion des Eaux (SDAGE : "General Water Management Plan"), aiming to determine general orientations for the management of water resources and having to be defined by the Comités de Bassin. At first glance therefore, the implementation of the European Water Framework Directive should not raise a lot of problems in France. However, a quick analysis of the current situation shows that it is not so obvious : if the French Water Policy set up two basin organisations, neither of them deals concretely with the management of the water resources, and the implementation of water management plans depends on many stakeholders; the SDAGE itself only partially meets the demands of the Directive, regarding e. g. the economic analysis; finally, in spite of the creation of multipartite basin commissions, the public participation is very restricted. Such an analysis leads to pay more attention to the relations to establish between organisation, planning and participation at the level of large river basins. An analysis of other elements of the French institutional framework can help us in this way : another planning procedure was actually created by the 1992 Water Law, the Schéma d'Aménagement et de Gestion des Eaux (SAGE : "Water Management Plan"), aiming to fix general objectives to manage the water resources at the level of small river basins, and having to be defined and implemented by a new tripartite entity, the Commission Locale de l'Eau (CLE : Local Water Commission), which can be considered as a real river basin organisation; an empirical analysis of the implementation of such a procedure can offer therefore many new insights and the paper will present the results of an analysis of 10 case studies. But it will be also necessary to put such an experience side by side with the political will to develop public debates and to extend the roles of the Commission Nationale du Débat Public ("Public Debate National Commission").

Managing the Implementation of Mission Operations Automation

NASA Technical Reports Server (NTRS)

Sodano, R.; Crouse, P.; Odendahl, S.; Fatig, M.; McMahon, K.; Lakin, J.

2006-01-01

Reducing the cost of mission operations has necessitated a high level of automation both on spacecraft and ground systems. While automation on spacecraft is implemented during the design phase, ground system automation tends to be implemented during the prime mission operations phase. Experience has shown that this tendency for late automation development can be hindered by several factors: additional hardware and software resources may need to be procured; software must be developed and tested on a non-interference basis with primary operations with limited manpower; and established procedures may not be suited for automation requiring substantial rework. In this paper we will review the experience of successfully automating mission operations for seven on-orbit missions: the Compton Gamma Ray Observatory (CGRO), the Rossi X-Ray Timing Explorer (RXTE), the Advanced Composition Explorer (ACE), the Far Ultraviolet Spectroscopic Explorer (FUSE), Interplanetary Physics Laboratory (WIND), Polar Plasma Laboratory (POLAR), and the Imager for Magnetopause-to-Aurora Global Exploration (IMAGE). We will provide lessons learned in areas such as: spacecraft recorder management, procedure development, lights out commanding from the ground system vs. stored command loads, spacecraft contingency response time, and ground station interfaces. Implementing automation strategies during the mission concept and spacecraft integration and test phase as the most efficient method will be discussed.

Integrated System Health Management: Foundational Concepts, Approach, and Implementation

NASA Technical Reports Server (NTRS)

Figueroa, Fernando

2009-01-01

Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. This paper presents concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a subsystem. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: ISHM Model of a system; detection of anomaly indicators; determination and confirmation of anomalies; diagnostic of causes and determination of effects; consistency checking cycle; sharing of health information; sharing of display information; storage and retrieval of health information; and example implementation.

A MATLAB toolbox for the efficient estimation of the psychometric function using the updated maximum-likelihood adaptive procedure.

PubMed

Shen, Yi; Dai, Wei; Richards, Virginia M

2015-03-01

A MATLAB toolbox for the efficient estimation of the threshold, slope, and lapse rate of the psychometric function is described. The toolbox enables the efficient implementation of the updated maximum-likelihood (UML) procedure. The toolbox uses an object-oriented architecture for organizing the experimental variables and computational algorithms, which provides experimenters with flexibility in experimental design and data management. Descriptions of the UML procedure and the UML Toolbox are provided, followed by toolbox use examples. Finally, guidelines and recommendations of parameter configurations are given.

Writing standard operating procedures (SOPs) for cryostorage protocols: using shoot meristem cryopreservation as an example.

PubMed

Harding, Keith; Benson, Erica E

2015-01-01

Standard operating procedures are a systematic way of making sure that biopreservation processes, tasks, protocols, and operations are correctly and consistently performed. They are the basic documents of biorepository quality management systems and are used in quality assurance, control, and improvement. Methodologies for constructing workflows and writing standard operating procedures and work instructions are described using a plant cryopreservation protocol as an example. This chapter is pertinent to other biopreservation sectors because how methods are written, interpreted, and implemented can affect the quality of storage outcomes.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania.

PubMed

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G M; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-12-30

A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

PubMed

Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

Time-Motion Analysis of Clinical Nursing Documentation During Implementation of an Electronic Operating Room Management System for Ophthalmic Surgery

PubMed Central

Read-Brown, Sarah; Sanders, David S.; Brown, Anna S.; Yackel, Thomas R.; Choi, Dongseok; Tu, Daniel C.; Chiang, Michael F.

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design. PMID:24551402

Vaccine cold chain: Part 2. Training personnel and program management.

PubMed

Rogers, Bonnie; Dennison, Kim; Adepoju, Nikki; Dowd, Shelia; Uedoi, Kenneth

2010-09-01

The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program. Copyright 2010, SLACK Incorporated.

Linking Six Sigma to simulation: a new roadmap to improve the quality of patient care.

PubMed

Celano, Giovanni; Costa, Antonio; Fichera, Sergio; Tringali, Giuseppe

2012-01-01

Improving the quality of patient care is a challenge that calls for a multidisciplinary approach, embedding a broad spectrum of knowledge and involving healthcare professionals from diverse backgrounds. The purpose of this paper is to present an innovative approach that implements discrete-event simulation (DES) as a decision-supporting tool in the management of Six Sigma quality improvement projects. A roadmap is designed to assist quality practitioners and health care professionals in the design and successful implementation of simulation models within the define-measure-analyse-design-verify (DMADV) or define-measure-analyse-improve-control (DMAIC) Six Sigma procedures. A case regarding the reorganisation of the flow of emergency patients affected by vertigo symptoms was developed in a large town hospital as a preliminary test of the roadmap. The positive feedback from professionals carrying out the project looks promising and encourages further roadmap testing in other clinical settings. The roadmap is a structured procedure that people involved in quality improvement can implement to manage projects based on the analysis and comparison of alternative scenarios. The role of Six Sigma philosophy in improvement of the quality of healthcare services is recognised both by researchers and by quality practitioners; discrete-event simulation models are commonly used to improve the key performance measures of patient care delivery. The two approaches are seldom referenced and implemented together; however, they could be successfully integrated to carry out quality improvement programs. This paper proposes an innovative approach to bridge the gap and enrich the Six Sigma toolbox of quality improvement procedures with DES.

A contemporary case study illustrating the integration of health information technologies into the organisation and clinical practice of radiation oncology.

PubMed

Miller, Alexis Andrew; Phillips, Aaron K

The development of software in radiation oncology departments has seen the increase in capability from the Record and Verify software focused on patient safety to a fully-fledged Oncology Information System (OIS). This paper reports on the medical aspects of the implementation of a modern Oncology Information System (IMPAC MultiAccess, also known as the Siemens LANTIS) in a New Zealand hospital oncology department. The department was successful in translating paper procedures into electronic procedures, and the report focuses on the changes in approach to organisation and data use that occurred. The difficulties that were faced, which included procedural re-design, management of change, removal of paper, implementation cost, integration with the HIS, quality assurance and datasets, are highlighted along with the local solutions developed to overcome these problems.

Activities identification for activity-based cost/management applications of the diagnostics outpatient procedures.

PubMed

Alrashdan, Abdalla; Momani, Amer; Ababneh, Tamador

2012-01-01

One of the most challenging problems facing healthcare providers is to determine the actual cost for their procedures, which is important for internal accounting and price justification to insurers. The objective of this paper is to find suitable categories to identify the diagnostic outpatient medical procedures and translate them from functional orientation to process orientation. A hierarchal task tree is developed based on a classification schema of procedural activities. Each procedure is seen as a process consisting of a number of activities. This makes a powerful foundation for activity-based cost/management implementation and provides enough information to discover the value-added and non-value-added activities that assist in process improvement and eventually may lead to cost reduction. Work measurement techniques are used to identify the standard time of each activity at the lowest level of the task tree. A real case study at a private hospital is presented to demonstrate the proposed methodology. © 2011 National Association for Healthcare Quality.

Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.

18 CFR 1312.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ARCHAEOLOGICAL RESOURCES: UNIFORM REGULATIONS § 1312.1 Purpose. (a) The regulations in this part implement... establishing the uniform definitions, standards, and procedures to be followed by all Federal land managers in... not impose any new restrictions on activities permitted under other laws, authorities, and regulations...

32 CFR 229.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ARCHAEOLOGICAL RESOURCES: UNIFORM REGULATIONS § 229.1 Purpose. (a) The regulations in this part implement... establishing the uniform definitions, standards, and procedures to be followed by all Federal land managers in... not impose any new restrictions on activities permitted under other laws, authorities, and regulations...

36 CFR 296.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ARCHAEOLOGICAL RESOURCES: UNIFORM REGULATIONS § 296.1 Purpose. (a) The regulations in this part implement... establishing the uniform definitions, standards, and procedures to be followed by all Federal land managers in... not impose any new restrictions on activities permitted under other laws, authorities, and regulations...

28 CFR Appendix A to Part 61 - Bureau of Prisons Procedures Relating to the Implementation of the National Environmental Policy Act

Code of Federal Regulations, 2012 CFR

2012-07-01

... efforts associated with the leasing, purchase, design, construction, management, operation and maintenance.... Decisionmakers shall verify the consideration of all available options in the EIS with a comparative analysis of...

28 CFR Appendix A to Part 61 - Bureau of Prisons Procedures Relating to the Implementation of the National Environmental Policy Act

Code of Federal Regulations, 2011 CFR

2011-07-01

... efforts associated with the leasing, purchase, design, construction, management, operation and maintenance.... Decisionmakers shall verify the consideration of all available options in the EIS with a comparative analysis of...

28 CFR Appendix A to Part 61 - Bureau of Prisons Procedures Relating to the Implementation of the National Environmental Policy Act

Code of Federal Regulations, 2013 CFR

2013-07-01

... efforts associated with the leasing, purchase, design, construction, management, operation and maintenance.... Decisionmakers shall verify the consideration of all available options in the EIS with a comparative analysis of...

28 CFR Appendix A to Part 61 - Bureau of Prisons Procedures Relating to the Implementation of the National Environmental Policy Act

Code of Federal Regulations, 2014 CFR

2014-07-01

... efforts associated with the leasing, purchase, design, construction, management, operation and maintenance.... Decisionmakers shall verify the consideration of all available options in the EIS with a comparative analysis of...

28 CFR Appendix A to Part 61 - Bureau of Prisons Procedures Relating to the Implementation of the National Environmental Policy Act

Code of Federal Regulations, 2010 CFR

2010-07-01

... efforts associated with the leasing, purchase, design, construction, management, operation and maintenance.... Decisionmakers shall verify the consideration of all available options in the EIS with a comparative analysis of...

Best management practices used by KYTC for on-site erosion control.

DOT National Transportation Integrated Search

2006-11-01

New erosion control procedures (ECP) have recently been implemented by the Kentucky Transportation Cabinet (KYTC). Previously, consultants and designers developed the ECP as a part of the design plans. In many cases these did not work in the field. T...

Organization Development: A Case Study in Blockages.

ERIC Educational Resources Information Center

McIntyre, Martin

1981-01-01

Organization Development is a management science that defines and solves organizational problems. Procedures include: (1) diagnosis of problem; (2) gathering of data related to problem; (3) obtaining feedback; (4) developing various change strategies; (5) developing an action plan; and (6) implementing the plan. (CJ)

10 CFR 70.72 - Facility changes and change process.

Code of Federal Regulations, 2010 CFR

2010-01-01

... management system to evaluate, implement, and track each change to the site, structures, processes, systems, equipment, components, computer programs, and activities of personnel. This system must be documented in... licensed material; (3) Modifications to existing operating procedures including any necessary training or...

10 CFR 70.72 - Facility changes and change process.

Code of Federal Regulations, 2011 CFR

2011-01-01

... management system to evaluate, implement, and track each change to the site, structures, processes, systems, equipment, components, computer programs, and activities of personnel. This system must be documented in... licensed material; (3) Modifications to existing operating procedures including any necessary training or...

10 CFR 70.72 - Facility changes and change process.

Code of Federal Regulations, 2012 CFR

2012-01-01

... management system to evaluate, implement, and track each change to the site, structures, processes, systems, equipment, components, computer programs, and activities of personnel. This system must be documented in... licensed material; (3) Modifications to existing operating procedures including any necessary training or...

10 CFR 70.72 - Facility changes and change process.

Code of Federal Regulations, 2014 CFR

2014-01-01

... management system to evaluate, implement, and track each change to the site, structures, processes, systems, equipment, components, computer programs, and activities of personnel. This system must be documented in... licensed material; (3) Modifications to existing operating procedures including any necessary training or...

10 CFR 70.72 - Facility changes and change process.

Code of Federal Regulations, 2013 CFR

2013-01-01

... management system to evaluate, implement, and track each change to the site, structures, processes, systems, equipment, components, computer programs, and activities of personnel. This system must be documented in... licensed material; (3) Modifications to existing operating procedures including any necessary training or...

PC based temporary shielding administrative procedure (TSAP)

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

Olsen, D.E.; Pederson, G.E.; Hamby, P.N.

1995-03-01

A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison`s six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative proceduremore » and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met.« less

Informatics tools to improve clinical research study implementation.

PubMed

Brandt, Cynthia A; Argraves, Stephanie; Money, Roy; Ananth, Gowri; Trocky, Nina M; Nadkarni, Prakash M

2006-04-01

There are numerous potential sources of problems when performing complex clinical research trials. These issues are compounded when studies are multi-site and multiple personnel from different sites are responsible for varying actions from case report form design to primary data collection and data entry. We describe an approach that emphasizes the use of a variety of informatics tools that can facilitate study coordination, training, data checks and early identification and correction of faulty procedures and data problems. The paper focuses on informatics tools that can help in case report form design, procedures and training and data management. Informatics tools can be used to facilitate study coordination and implementation of clinical research trials.

Tank waste remediation system systems engineering management plan

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

Peck, L.G.

1998-01-08

This Systems Engineering Management Plan (SEMP) describes the Tank Waste Remediation System (TWRS) implementation of the US Department of Energy (DOE) systems engineering policy provided in 97-IMSD-193. The SEMP defines the products, process, organization, and procedures used by the TWRS Project to implement the policy. The SEMP will be used as the basis for tailoring the systems engineering applications to the development of the physical systems and processes necessary to achieve the desired end states of the program. It is a living document that will be revised as necessary to reflect changes in systems engineering guidance as the program evolves.more » The US Department of Energy-Headquarters has issued program management guidance, DOE Order 430. 1, Life Cycle Asset Management, and associated Good Practice Guides that include substantial systems engineering guidance.« less

An integrated approach for the management of demolition waste in Cyprus.

PubMed

Kourmpanis, Basilis; Papadopoulos, Achilleas; Moustakas, Konstantinos; Kourmoussis, Fotis; Stylianou, Marinos; Loizidou, Maria

2008-12-01

This study investigated the generation and management of demolition waste (DW) in Cyprus. A methodology has been developed and applied for the estimation of the quantities of the waste stream under examination, since quantitative primary data were not available. The existing situation relating to the practices applied for the management of DW was investigated and assessed. Furthermore, a multi-criteria analysis method (PROMETHEE II) was developed and applied in order to examine alternative systems that could be implemented for the management of the DW in the country. In particular, nine management systems (scenarios) were examined, evaluated and ranked according to their efficiency using seventeen individual criteria, divided into four groups (social-legislative, environmental, economic and technical). The ranking of the alternative waste management scenarios indicated that the optimum management system for possible implementation in the island included complete selective demolition procedures and transfer of mixed recyclable materials to the recycling centre and non-recyclable material to landfill.

Ecological control line: A decade of exploration and an innovative path of ecological land management for megacities in China.

PubMed

Hong, Wuyang; Yang, Chengyun; Chen, Liuxin; Zhang, Fangfang; Shen, Shaoqing; Guo, Renzhong

2017-04-15

Ecological control line is a system innovation in the field of ecological environment protection in China and it has become as an important strategy of national ecological protection. Ten years have passed since the first ecological control line in Shenzhen was delimited in 2005. This study examines the connotations of ecological control line and the current study status in China and abroad, and then takes a brief description about the delimitation background and existing problems of the ecological control line in Shenzhen. The problem-solving strategy is gradually transforming from extensive management to refined management. This study proposes a differential ecological space management model that merges the space system, management system, and support system. The implementation paths include the following five aspects: delimiting ecological bottom lines to protect core ecological resources; formulating access systems for new construction projects to strictly control new construction; implementing construction land inventory reclamation assisted by market means; regulating boundary adjusting procedures and processes; and constructing ecological equity products by using multiple means to implement rights relief. Finally, this study illustrates the progress of the implementation and discusses the rigorousness and flexibility problems of ecological control line and calls for the promotion of the legislation. The management model and implementation paths proposed in this study have referential significance for developing countries and megacities to achieve ecological protection and sustainable development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Advances in pleural disease management including updated procedural coding.

PubMed

Haas, Andrew R; Sterman, Daniel H

2014-08-01

Over 1.5 million pleural effusions occur in the United States every year as a consequence of a variety of inflammatory, infectious, and malignant conditions. Although rarely fatal in isolation, pleural effusions are often a marker of a serious underlying medical condition and contribute to significant patient morbidity, quality-of-life reduction, and mortality. Pleural effusion management centers on pleural fluid drainage to relieve symptoms and to investigate pleural fluid accumulation etiology. Many recent studies have demonstrated important advances in pleural disease management approaches for a variety of pleural fluid etiologies, including malignant pleural effusion, complicated parapneumonic effusion and empyema, and chest tube size. The last decade has seen greater implementation of real-time imaging assistance for pleural effusion management and increasing use of smaller bore percutaneous chest tubes. This article will briefly review recent pleural effusion management literature and update the latest changes in common procedural terminology billing codes as reflected in the changing landscape of imaging use and percutaneous approaches to pleural disease management.

Just-in-time: maximizing its success potential.

PubMed

Johnston, S K

1990-08-01

The effective implementation and use of JIT manufacturing practices depends largely on the education, training, and commitment of all levels of management to a fundamental quality-first policy. Management must transfer and demonstrate that commitment to every level and extension of the manufacturing endeavor. As a company establishes and reaches toward that goal, the move to JIT manufacturing practices becomes rational and justifiable. Failing to establish and commit to a quality directive greatly diminishes the potential benefits of JIT. If all levels of manufacturing participate in the JIT planning, implementing, and maintenance procedure, the realization of positive change and improvement drives the process. Total participation makes the task of JIT implementation not only possible, but practical. Enhanced mutual respect for all concerned is a likely consequence, advancing the productive environment.

Routines for change: how managers can use absorptive capacity to adopt and implement evidence-based practice.

PubMed

Innis, Jennifer; Berta, Whitney

2016-09-01

This paper uses the construct of absorptive capacity to understand how nurse managers can facilitate the adoption and use of evidence-based practice within health-care organisations. How health-care organisations adopt and implement innovations such as new evidence-based practices will depend on their absorptive, or learning, capacity. Absorptive capacity manifests as routines, which are the practices, procedures and customs that organisational members use to carry out work and to make work-related decisions. Using the construct of absorptive capacity as well as a recent literature review of how health-care organisations take on best practices, we illustrate how the uptake and use of new knowledge, such as evidence-based practices, can be facilitated through the use of routines. This paper highlights routines that nurse managers can use to foster environments where evidence-based practices can be readily identified, and strategies for facilitating their adoption and implementation. The construct of absorptive capacity and the use of routines can be used to examine the ways in which nurse managers can adopt, implement and evaluate the use of evidence-based practices. © 2016 John Wiley & Sons Ltd.

Report: EPA Has Not Implemented Adequate Management Procedures to Address Potential Fraudulent Environmental Data

EPA Pesticide Factsheets

Report #14-P-0270, May 29, 2014. The EPA is not ensuring that fraudulent laboratory environmental data is being communicated to appropriate program offices and data users, reviewed, and analyzed for its impact on human health and the environment.

Motivation through Routine Documentation

ERIC Educational Resources Information Center

Koth, Laurie J.

2016-01-01

This informed commentary article offers a simple, effective classroom management strategy in which the teacher uses routine documentation to motivate students both to perform academically and to behave in a manner consistent with established classroom rules and procedures. The pragmatic strategy is grounded in literature, free to implement,…

39 CFR 223.2 - Channels of communication, headquarters with area offices.

Code of Federal Regulations, 2010 CFR

2010-07-01

...). Whether published on paper or online, such policies must be coordinated with other appropriate... functional unit managers and used to implement programs and business activities. Whether published on paper or online, such procedures must be coordinated with other appropriate organizations before issuance...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... to exceed 15 months; and (5) Establish and implement procedures for when a different controller..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

45 CFR 1304.51 - Management systems and procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 1304.51 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...) Communications—general. Grantee and delegate agencies must establish and implement systems to ensure that timely...

National Aeronautics Research and Development Plan

DTIC Science & Technology

2010-02-01

aeronautics research to improve aviation safety, air transportation, and reduce the environmental impacts of aviation; • Promotes the advancement of fuel...Reduce the Adverse Impacts of Weather on Air Traffic Management Decisions...Operational Procedures to Decrease the Significant Environmental Impacts of the Aviation System. . . 42 Future Implementation

20 CFR 628.205 - Governor's coordination and special services plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Job Opportunities and Basic Skills (JOBS) program; the certification of the implementation of the... performance; program administration; program financial management and audit resolution procedures; capacity... information described in paragraph (c)(1) of this section shall be provided to SDA's in sufficient time for...

A Comparative Assessment of Knowledge Management Education Across the United States Department of Defense

DTIC Science & Technology

2007-03-01

portal, AKO. The Army is also creating Battle Command Knowledge Cells staffed with Knowledge Management Officers ( KMO ) to facilitate KM within...battle commands. To increase their effectiveness, the Army has a draft Standard Operation Procedures (SOP) document to assist KMOs in establishing and...cultivating KM programs. This draft document includes instruction on implementing a KM program in a unit, worksheets to assist KMOs with knowledge

Combat Mission Training Research at the 58th Special Operations Wing: A Summary

DTIC Science & Technology

1998-07-01

Air Force Base during 1995-1997. The first study examined the relationship between crew resource management ( CRM ) processes and mission performance for...next three sections, we summarize the three major empirical studies that were conducted: (a) measuring crew resource management ( CRM ) behaviors... customized measurement procedures and data collection instruments. At the squadron level, there are two problems in implementing an effective CRM training

U.S. Geological Survey Unmanned Aircraft Systems (UAS) Roadmap 2014

USGS Publications Warehouse

Cress, Jill J.; Hutt, Michael E.; Sloan, Jeff L.; Bauer, Mark A.; Feller, Mark R.; Goplen, Susan E.

2015-01-01

This Roadmap provides operational procedures and lessons learned from completed proof-of-concept UAS missions in areas such as wildlife management, resource monitoring, and public land inspections. This information provides not only an implementation framework but can also help increase the awareness by resource managers, scientists, and others of the ability of UAS technology to advance data quality, improve personnel safety, and reduce data acquisition costs.

Concept of Draft International Standard for a Unified Approach to Space Program Quality Assurance

NASA Astrophysics Data System (ADS)

Stryzhak, Y.; Vasilina, V.; Kurbatov, V.

2002-01-01

For want of the unified approach to guaranteed space project and product quality assurance, implementation of many international space programs has become a challenge. Globalization of aerospace industry and participation of various international ventures with diverse quality assurance requirements in big international space programs requires for urgent generation of unified international standards related to this field. To ensure successful fulfillment of space missions, aerospace companies should design and process reliable and safe products with properties complying or bettering User's (or Customer's) requirements. Quality of the products designed or processed by subcontractors (or other suppliers) should also be in compliance with the main user (customer)'s requirements. Implementation of this involved set of unified requirements will be made possible by creating and approving a system (series) of international standards under a generic title Space Product Quality Assurance based on a system consensus principle. Conceptual features of the baseline standard in this system (series) should comprise: - Procedures for ISO 9000, CEN and ECSS requirements adaptation and introduction into space product creation, design, manufacture, testing and operation; - Procedures for quality assurance at initial (design) phases of space programs, with a decision on the end product made based on the principle of independence; - Procedures to arrange incoming inspection of products delivered by subcontractors (including testing, audit of supplier's procedures, review of supplier's documentation), and space product certification; - Procedures to identify materials and primary products applied; - Procedures for quality system audit at the component part, primary product and materials supplier facilities; - Unified procedures to form a list of basic performances to be under configuration management; - Unified procedures to form a list of critical space product components, and unified procedures to define risks related to the specific component application and evaluate safety for the entire program implementation. In the eyes of the authors, those features together with a number of other conceptual proposals should constitute a unified standard-technical basis for implementing international space programs.

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

PubMed

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

2014-11-25

Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p < 0.001). The median number of KT strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership, staff engagement, and dedicated time and resources were identified as facilitating effective implementation of the strategies. Further research is required to better understand implementation outcomes, such as feasibility and fidelity, how context influences the effectiveness of multifaceted KT strategies, and the sustainability of improved pain practices and outcomes over time.

A multi-criteria decision analysis of management alternatives for anaerobically digested kraft pulp mill sludge

PubMed Central

Eikelboom, Martijn; Lopes, Alice do Carmo Precci; Silva, Claudio Mudadu; Rodrigues, Fábio de Ávila; Zanuncio, José Cola

2018-01-01

The Multi-Criteria Decision Analysis (MCDA) procedure was used to compare waste management options for kraft pulp mill sludge following its anaerobic digestion. Anaerobic digestion of sludge is advantageous because it produces biogas that may be used to generate electricity, heat and biofuels. However, adequate management of the digested sludge is essential. Landfill disposal is a non-sustainable waste management alternative. Kraft pulp mill digested sludge applied to land may pose risks to the environment and public health if the sludge has not been properly treated. This study is aimed to compare several recycling alternatives for anaerobically digested sludge from kraft pulp mills: land application, landfill disposal, composting, incineration, pyrolysis/gasification, and biofuel production by algae. The MCDA procedure considered nine criteria into three domains to compare digested sludge recycling alternatives in a kraft pulp mill: environmental (CO2 emission, exposure to pathogens, risk of pollution, material and energy recovery), economic (overall costs, value of products) and technical (maintenance and operation, feasibility of implementation). The most suitable management options for digested sludge from kraft pulp mills were found to be composting and incineration (when the latter was coupled with recycling ash to the cement industry). Landfill disposal was the worst option, presenting low performance in feasibility of implementation, risk of pollution, material and energy recovery. PMID:29298296

[Process-oriented quality management in the hospital].

PubMed

Wolters, H G

1998-03-01

Procedures and experiences concerning the implementation of quality management in a midsize hospital with 6 medical disciplines are described. Quality of infrastructure was checked with lists and the quality of medical performance assessed by means of standardized numerical audit with all professional groups. Weaknesses were identified by comparing the result to each quality indicator with target standards. As examples, causal relations and consequences of deficiencies in clinical care documentation, scheme of preoperative diagnosis, co-ordination of surgical procedures and handling of complications are given in more detail. Obstacles were rated depending on frequency and risk potential, sometimes cost effectiveness. Members of all professional groups and departments involved participated in trouble solving teams to which external expert assistance was provided. For example, interventions leading to improved co-ordination of surgical activities and their impacts are specified. Improving systematically the quality of clinical procedures is one gateway to establish quality management in hospitals continuously and thoroughly becoming an integrated part of the corporate culture. Investment of resources is necessary but justified by midrange benefits.

In acceptance we trust? Conceptualising acceptance as a viable approach to NGO security management.

PubMed

Fast, Larissa A; Freeman, C Faith; O'Neill, Michael; Rowley, Elizabeth

2013-04-01

This paper documents current understanding of acceptance as a security management approach and explores issues and challenges non-governmental organisations (NGOs) confront when implementing an acceptance approach to security management. It argues that the failure of organisations to systematise and clearly articulate acceptance as a distinct security management approach and a lack of organisational policies and procedures concerning acceptance hinder its efficacy as a security management approach. The paper identifies key and cross-cutting components of acceptance that are critical to its effective implementation in order to advance a comprehensive and systematic concept of acceptance. The key components of acceptance illustrate how organisational and staff functions affect positively or negatively an organisation's acceptance, and include: an organisation's principles and mission, communications, negotiation, programming, relationships and networks, stakeholder and context analysis, staffing, and image. The paper contends that acceptance is linked not only to good programming, but also to overall organisational management and structures. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Automated Procurement System (APS): Project management plan (DS-03), version 1.2

NASA Technical Reports Server (NTRS)

Murphy, Diane R.

1994-01-01

The National Aeronautics and Space Administration (NASA) Marshall Space Flight Center (MSFC) is implementing an Automated Procurement System (APS) to streamline its business activities that are used to procure goods and services. This Project Management Plan (PMP) is the governing document throughout the implementation process and is identified as the APS Project Management Plan (DS-03). At this point in time, the project plan includes the schedules and tasks necessary to proceed through implementation. Since the basis of APS is an existing COTS system, the implementation process is revised from the standard SDLC. The purpose of the PMP is to provide the framework for the implementation process. It discusses the roles and responsibilities of the NASA project staff, the functions to be performed by the APS Development Contractor (PAI), and the support required of the NASA computer support contractor (CSC). To be successful, these three organizations must work together as a team, working towards the goals established in this Project Plan. The Project Plan includes a description of the proposed system, describes the work to be done, establishes a schedule of deliverables, and discusses the major standards and procedures to be followed.

A multi-stakeholder framework for urban runoff quality management: Application of social choice and bargaining techniques.

PubMed

Ghodsi, Seyed Hamed; Kerachian, Reza; Zahmatkesh, Zahra

2016-04-15

In this paper, an integrated framework is proposed for urban runoff management. To control and improve runoff quality and quantity, Low Impact Development (LID) practices are utilized. In order to determine the LIDs' areas and locations, the Non-dominated Sorting Genetic Algorithm-II (NSGA-II), which considers three objective functions of minimizing runoff volume, runoff pollution and implementation cost of LIDs, is utilized. In this framework, the Storm Water Management Model (SWMM) is used for stream flow simulation. The non-dominated solutions provided by the NSGA-II are considered as management scenarios. To select the most preferred scenario, interactions among the main stakeholders in the study area with conflicting utilities are incorporated by utilizing bargaining models including a non-cooperative game, Nash model and social choice procedures of Borda count and approval voting. Moreover, a new social choice procedure, named pairwise voting method, is proposed and applied. Based on each conflict resolution approach, a scenario is identified as the ideal solution providing the LIDs' areas, locations and implementation cost. The proposed framework is applied for urban water quality and quantity management in the northern part of Tehran metropolitan city, Iran. Results show that the proposed pairwise voting method tends to select a scenario with a higher percentage of reduction in TSS (Total Suspended Solid) load and runoff volume, in comparison with the Borda count and approval voting methods. Besides, the Nash method presents a management scenario with the highest cost for LIDs' implementation and the maximum values for percentage of runoff volume reduction and TSS removal. The results also signify that selection of an appropriate management scenario by stakeholders in the study area depends on the available financial resources and the relative importance of runoff quality improvement in comparison with reducing the runoff volume. Copyright © 2016 Elsevier B.V. All rights reserved.

Risk analysis of computer system designs

NASA Technical Reports Server (NTRS)

Vallone, A.

1981-01-01

Adverse events during implementation can affect final capabilities, schedule and cost of a computer system even though the system was accurately designed and evaluated. Risk analysis enables the manager to forecast the impact of those events and to timely ask for design revisions or contingency plans before making any decision. This paper presents a structured procedure for an effective risk analysis. The procedure identifies the required activities, separates subjective assessments from objective evaluations, and defines a risk measure to determine the analysis results. The procedure is consistent with the system design evaluation and enables a meaningful comparison among alternative designs.

A MATLAB toolbox for the efficient estimation of the psychometric function using the updated maximum-likelihood adaptive procedure

PubMed Central

Richards, V. M.; Dai, W.

2014-01-01

A MATLAB toolbox for the efficient estimation of the threshold, slope, and lapse rate of the psychometric function is described. The toolbox enables the efficient implementation of the updated maximum-likelihood (UML) procedure. The toolbox uses an object-oriented architecture for organizing the experimental variables and computational algorithms, which provides experimenters with flexibility in experimental design and data management. Descriptions of the UML procedure and the UML Toolbox are provided, followed by toolbox use examples. Finally, guidelines and recommendations of parameter configurations are given. PMID:24671826

Overcorrection: Reviewed, revisited and revised

PubMed Central

MacKenzie-Keating, Sandra E.; McDonald, Linda

1990-01-01

Overcorrection is a widely used behavior management procedure, the success of which has been well documented. However, overcorrection is not a simple, single procedure. Rather, it is a complex combination of procedures that often make it a complicated strategy to understand conceptually and to implement correctly. The complex nature of overcorrection combined with the use of multiple labels has created much confusion and debate among both researchers and practitioners. A number of issues relating to overcorrection are examined and evaluated. A proposal is made for revising the present overcorrection terminology. Finally, directions for future research are suggested. PMID:22478048

Automation at the University of Georgia Libraries.

ERIC Educational Resources Information Center

Christoffersson, John G.

1979-01-01

Presents the design procedures, bibliographic system, file structures, acquisitions and circulation systems, functional implementation, and future development of the Managing Resources for University Libraries (MARVEL) data base at the University of Georgia Libraries, which accepts MARC input from OCLC and Library of Congress (LC) MARC tapes. (CWM)

Research Study

ERIC Educational Resources Information Center

Glick, Ashley

2010-01-01

Background: Action Research about my 2nd grade classroom in the Buffalo School District. I examined three areas of interest and tried to find some conclusions related to behavior management. Purpose: The purpose of this study is how will implementing procedures, rules, and consequences help improve student behavior. Research Design: Descriptive;…

16 CFR 16.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Purpose and scope. 16.1 Section 16.1 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ADVISORY COMMITTEE MANAGEMENT § 16.1 Purpose and scope. (a) The regulations in this part implement the Federal...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

76 FR 34075 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

...) determines, recommends, and implements procedural changes needed to maintain effective management of CDC... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and...

Under Secretary of Defense (Comptroller) > Financial Management > Reports

Science.gov Websites

Performance Reports Accounting Policy Guidance for Implementing Temporary Early Retirement Authority (TERA ) Procedures DoD Reimbursable Rates Foreign Currency Fluctuation Report Regulations Accounting Policy Guidance , accounting for, disbursing and reporting retirement payments for those chosen for early retirement under the

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2012 CFR

2012-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2011 CFR

2011-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2014 CFR

2014-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

49 CFR 192.631 - Control room management.

Code of Federal Regulations, 2013 CFR

2013-10-01

... at intervals not to exceed 15 months; and (5) Establish and implement procedures for when a different..., but at intervals not exceeding 15 months, to determine the effectiveness of the plan; (5) Monitor the...) (regarding fatigue), (i) (regarding compliance validation), and (j) (regarding compliance and deviations) of...

40 CFR 256.22 - Recommendations for State regulatory powers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste... prohibit new open dumps and close or upgrade all existing open dumps. (a) Solid waste disposal standards... solid waste disposal facility. These procedures should include identification of future land use or the...

40 CFR 256.22 - Recommendations for State regulatory powers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Solid Waste... prohibit new open dumps and close or upgrade all existing open dumps. (a) Solid waste disposal standards... solid waste disposal facility. These procedures should include identification of future land use or the...

Automated Procurement System (APS) revised project management plan (DS-03)

NASA Technical Reports Server (NTRS)

Murphy, Diane R.

1995-01-01

The Project Plan is the governing document for the implementation of the Automated Procurement System (APS). It includes a description of the proposed system, describes the work to be done, establishes a schedule of deliverables, and discusses the major standards and procedures to be followed.

32 CFR 518.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... information from all Army information systems (automated and manual) in support of Army Information Management... FREEDOM OF INFORMATION ACT PROGRAM General Provisions § 518.1 Purpose. This part provides policies and procedures for implementation of the Freedom of Information Act (5 U.S.C. 552, as amended) and Department of...

32 CFR 518.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... information from all Army information systems (automated and manual) in support of Army Information Management... FREEDOM OF INFORMATION ACT PROGRAM General Provisions § 518.1 Purpose. This part provides policies and procedures for implementation of the Freedom of Information Act (5 U.S.C. 552, as amended) and Department of...

32 CFR 518.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... information from all Army information systems (automated and manual) in support of Army Information Management... FREEDOM OF INFORMATION ACT PROGRAM General Provisions § 518.1 Purpose. This part provides policies and procedures for implementation of the Freedom of Information Act (5 U.S.C. 552, as amended) and Department of...

32 CFR 518.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... information from all Army information systems (automated and manual) in support of Army Information Management... FREEDOM OF INFORMATION ACT PROGRAM General Provisions § 518.1 Purpose. This part provides policies and procedures for implementation of the Freedom of Information Act (5 U.S.C. 552, as amended) and Department of...

32 CFR 518.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... information from all Army information systems (automated and manual) in support of Army Information Management... FREEDOM OF INFORMATION ACT PROGRAM General Provisions § 518.1 Purpose. This part provides policies and procedures for implementation of the Freedom of Information Act (5 U.S.C. 552, as amended) and Department of...

45 CFR 1304.51 - Management systems and procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... annual self- assessment; and (iii) The development of written plan(s) for implementing services in each of the program areas covered by this part (e.g., Early Childhood Development and Health Services... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

A Measurement Plane for Optical Networks to Manage Emergency Events

NASA Astrophysics Data System (ADS)

Tego, E.; Carciofi, C.; Grazioso, P.; Petrini, V.; Pompei, S.; Matera, F.; Attanasio, V.; Nastri, E.; Restuccia, E.

2017-11-01

In this work, we show a wide geographical area optical network test bed, adopting the mPlane measurement plane for monitoring its performance and to manage software defined network approaches, with some specific tests and procedures dedicated to respond to disaster events and to support emergency networks. Such a test bed includes FTTX accesses, and it is currently implemented to support future 5G wireless services with slicing procedures based on Carrier Ethernet. The characteristics of this platform have been experimentally tested in the case of a damage-causing link failure and traffic congestion, showing a fast reactions to these disastrous events, allowing the user to recharge the initial QoS parameters.

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

Storage management in Ada. Three reports. Volume 1: Storage management in Ada as a risk to the development of reliable software. Volume 2: Relevant aspects of language. Volume 3: Requirements of the language versus manifestations of current implementations

NASA Technical Reports Server (NTRS)

Auty, David

1988-01-01

The risk to the development of program reliability is derived from the use of a new language and from the potential use of new storage management techniques. With Ada and associated support software, there is a lack of established guidelines and procedures, drawn from experience and common usage, which assume reliable behavior. The risk is identified and clarified. In order to provide a framework for future consideration of dynamic storage management on Ada, a description of the relevant aspects of the language is presented in two sections: Program data sources, and declaration and allocation in Ada. Storage-management characteristics of the Ada language and storage-management characteristics of Ada implementations are differentiated. Terms that are used are defined in a narrow and precise sense. The storage-management implications of the Ada language are described. The storage-management options available to the Ada implementor and the implications of the implementor's choice for the Ada programmer are also described.

Navy/Marine Corps Manager’s Desktop Guide for CALS Implementation. 2nd Edition

DTIC Science & Technology

1993-06-30

significant process and productivity that CALS initiatives are providing within the Navy infrastructure. CALS programs are on-line and working in today’s Navy...era of declining budgets, CALS is most important in enhancing logistic support productivity to maintain operations and improve readiness. Our...is to be accomplished through the general adoption of a set of procedures and staridards for the production , access, management, maintenance, and

Integrated Advanced Sounding Unit-A (AMSU-A). Configuration Management Plan

NASA Technical Reports Server (NTRS)

Cavanaugh, J.

1996-01-01

The purpose of this plan is to identify the baseline to be established during the development life cycle of the integrated AMSU-A, and define the methods and procedures which Aerojet will follow in the implementation of configuration control for each established baseline. Also this plan establishes the Configuration Management process to be used for the deliverable hardware, software, and firmware of the Integrated AMSU-A during development, design, fabrication, test, and delivery.

An Experimental Performance Measurement of Implemented Wireless Access Point for Interworking Wi-Fi and HSDPA Networks

NASA Astrophysics Data System (ADS)

Byun, Tae-Young

This paper presents a prototype of WAP(Wireless Access Point) that provides the wireless Internet access anywhere. Implemented WAP can be equipped with various wireless WAN interfaces such as WCDMA and HSDPA. WAP in the IP mechanism has to process connection setup procedure to one wireless WAN. Also, WAP can provide connection management procedures to reconnect interrupted connection automatically. By using WAP, several mobile devices such as netbook, UMPC and smart-phone in a moving vehicle can access to HSDPA network simultaneously. So, it has more convenient for using the WAP when there are needs to access wireless Internet more than two mobile devices in restricted spaces such as car, train and ship.

Intervention strategies for the management of human error

NASA Technical Reports Server (NTRS)

Wiener, Earl L.

1993-01-01

This report examines the management of human error in the cockpit. The principles probably apply as well to other applications in the aviation realm (e.g. air traffic control, dispatch, weather, etc.) as well as other high-risk systems outside of aviation (e.g. shipping, high-technology medical procedures, military operations, nuclear power production). Management of human error is distinguished from error prevention. It is a more encompassing term, which includes not only the prevention of error, but also a means of disallowing an error, once made, from adversely affecting system output. Such techniques include: traditional human factors engineering, improvement of feedback and feedforward of information from system to crew, 'error-evident' displays which make erroneous input more obvious to the crew, trapping of errors within a system, goal-sharing between humans and machines (also called 'intent-driven' systems), paperwork management, and behaviorally based approaches, including procedures, standardization, checklist design, training, cockpit resource management, etc. Fifteen guidelines for the design and implementation of intervention strategies are included.

Integrated Work Management: Overview, Course 31881

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

Simpson, Lewis Edward

Integrated work management (IWM) is the process used for formally implementing the five-step process associated with integrated safety management (ISM) and integrated safeguards and security management (ISSM) at Los Alamos National Laboratory (LANL). IWM also directly supports the LANL Environmental Management System (EMS). IWM helps all workers and managers perform work safely and securely and in a manner that protects people, the environment, property, and the security of the nation. The IWM process applies to all work activities at LANL, from working in the office to designing experiments to assembling and detonating explosives. The primary LANL document that establishes andmore » describes IWM requirements is Procedure (P) 300, Integrated Work Management.« less

[The critical incident reporting system as an instrument of risk management for better patient safety].

PubMed

Panzica, M; Krettek, C; Cartes, M

2011-09-01

The probability that an inpatient will be harmed by a medical procedure is at least 3% of all patients. As a consequence, hospital risk management has become a central management task in the health care sector. The critical incident reporting system (CIRS) as a voluntary instrument for reporting (near) incidents plays a key role in the implementation of a risk management system. The goal of the CIRS is to register system errors without assigning guilt or meting out punishment and at the same time increasing the number of voluntary reports.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

PubMed Central

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki GM; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-01-01

Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey. PMID:19116022

Designing Therapeutic Recreation Programs in the Community.

ERIC Educational Resources Information Center

Carter, Marcia Jean; And Others

This publication is designed to assist in the development of therapeutic recreation services in the community and may also be used in the preparation of procedural manuals or risk management plans. Therapeutic recreation is defined as the process of assessment, planning, implementation, and evaluation, applied through a helping relationship to…

78 FR 15978 - Blackstone Alternative Investment Funds, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

... of a Subadvised Series' assets, and (c) implement procedures reasonably designed to ensure that Sub... open-end management investment company. The Trust may offer one or more series of shares (each, a ``Series'') with its own distinct investment objectives, policies and restrictions.\\1\\ Each Series has, or...

Applied Behavior Analysis: Current Myths in Public Education

ERIC Educational Resources Information Center

Fielding, Cheryl; Lowdermilk, John; Lanier, Lauren L.; Fannin, Abigail G.; Schkade, Jennifer L.; Rose, Chad A.; Simpson, Cynthia G.

2013-01-01

The effective use of behavior management strategies and related policies continues to be a debated issue in public education. Despite overwhelming evidence espousing the benefits of the implementation of procedures derived from principles based on the science of applied behavior analysis (ABA), educators often indicate many common misconceptions…

76 FR 4216 - Airworthiness Directives; SOCATA Model TBM 700 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... docket on the Internet at http://www.regulations.gov or in person at the Docket Management Facility, U.S...-21. A definitive solution has been released to production aeroplanes by implementation of SOCATA... of civil aircraft in air commerce by prescribing regulations for practices, methods, and procedures...

10 CFR 4.570 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 501 of the Rehabilitation Act of 1973 (29 U.S.C. 791). (c) The Civil Rights Program Manager, Office of Small Business and Civil Rights, shall be responsible for coordinating implementation of this section... the right to appeal. (h) Appeals of the findings of fact and conclusions of law or remedies must be...

Using Positive Behavior Support to Design Effective Classrooms

ERIC Educational Resources Information Center

Anderson, Cynthia M.; Spaulding, Scott A.

2007-01-01

A number of evidence-based classroom management approaches, procedures, and programs have been developed and presented over the years. In this article the authors synthesize recommendations from various sources, focusing on evidence-based strategies that can be implemented in a systematic manner. They focus specifically on universal strategies,…

78 FR 25743 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

... Accounting and the Office of Budget. Specifically, the OCFO: (1) Manages the financial risk of the agency, (2... the agency's financial activities and accounting practices; (5) performs reviews and training in high... implements CDC-wide budgetary, accounting, and fiscal systems and procedures and prepares financial reports...

Early Detection and Diagnosis of Hearing Impairment: A United Kingdom Perspective.

ERIC Educational Resources Information Center

Bamford, John M.; McSporran, Eileen

1993-01-01

The incidence of congenital hearing loss in the United Kingdom is noted, and the use of a universal behavioral hearing screen at the age of seven or eight months, implemented by Health Visitors, is described. Procedures involved in identification, diagnosis, and management are discussed. (JDD)

Environmental Technology Verification Program Materials Management and Remediation Center Generic Protocol for Verification of In Situ Chemical Oxidation

EPA Science Inventory

The protocol provides generic procedures for implementing a verification test for the performance of in situ chemical oxidation (ISCO), focused specifically to expand the application of ISCO at manufactured gas plants with polyaromatic hydrocarbon (PAH) contamination (MGP/PAH) an...

The Secondary School Principalship and the Challenge of Change.

ERIC Educational Resources Information Center

Tompkins, Ellsworth; Trump, J. Lloyd

In his role as the manager of educational change, the secondary school principal is responsible for determining programs and procedures, enlisting teacher aid in those determinations, resolving staff resistance to change, identifying staff members as effective change agents, and working with them to implement change. To produce significant gains…

Management of Chronic Infectious Diseases in School Children. Revised Edition.

ERIC Educational Resources Information Center

Illinois State Board of Education, Springfield.

This manual contains current guidelines for Illinois school personnel to follow when working with children who have infectious diseases. The first chapter focuses on school district development of policies and procedures and program implementation. The next chapter provides information on characteristics, mode of transmission, prevention, and…

Implementation and impact of a consensus diagnostic and management algorithm for complicated pneumonia in children.

PubMed

Pillai, Dinesh; Song, Xiaoyan; Pastor, William; Ottolini, Mary; Powell, David; Wiedermann, Bernhard L; DeBiasi, Roberta L

2011-12-01

Variable treatment exists for children with bacterial pneumonia complications such as pleural effusion and empyema. Subspecialists at an urban academic tertiary children's hospital created a literature-based diagnosis and management algorithm for complicated pneumonia in children. We proposed that algorithm implementation would reduce use of computed tomography (CT) for diagnosis of pleural infection, thereby decreasing radiation exposure, without increased adverse outcomes. A cross-sectional study was undertaken in children (3 months to 20 years old) with principal or secondary diagnosis codes for empyema and/or pleural effusion in conjunction with bacterial pneumonia. Study cohorts consisted of subjects admitted 15 months before (cohort 1, n = 83) and after (cohort 2, n = 87) algorithm implementation. Data were collected using clinical and financial data systems. Imaging studies and procedures were identified using Current Procedural Terminology codes. Statistical analysis included χ test, linear and ordinal regression, and analysis of variance. Age (P = 0.56), sex (P = 0.30), diagnoses (P = 0.12), and severity level (P = 0.84) were similar between cohorts. There was a significant decrease in CT use in cohort 2 (cohort 1, 60% vs cohort 2, 17.2%; P = 0.001) and reduction in readmission rate (7.7% vs 0%; P = 0.01) and video-assisted thoracoscopic surgery procedures (44.6% vs 28.7; P = 0.03), without concomitant increases in vancomycin use (34.9% vs 34.5%; P = 0.95) or hospital length of stay (6.4 vs 7.6 days; P = 0.4). Among patients who received video-assisted thoracoscopic surgery drainage (n = 57), there were no significant differences between cohorts in median time from admission to video-assisted thoracoscopic surgery (2 days; P = 0.29) or median duration of chest tube drainage (3 vs 4 days; P = 0.10). There was a statistically nonsignificant trend for higher rate of pathogen identification in cohort 2 (cohort 1, 33% vs cohort 2, 54.1%; P = 0.12); Streptococcus pneumonia was the most commonly identified pathogen in both cohorts (37.5% vs 27%; P = 0.23). Implementation of an institutional complicated pneumonia management algorithm reduced CT scan use/radiation exposure, VATS procedures, and readmission rate in children with a diagnosis of pleural infection, without associated increases in length of stay or vancomycin use. This algorithm provides the framework for future prospective quality improvement studies in pediatric patients with complicated pneumonia.

Load research manual. Volume 2: Fundamentals of implementing load research procedures

NASA Astrophysics Data System (ADS)

1980-11-01

This manual will assist electric utilities and state regulatory authorities in investigating customer electricity demand as part of cost-of-service studies, rate design, marketing research, system design, load forecasting, rate reform analysis, and load management research. Load research procedures are described in detail. Research programs at three utilities are compared: Carolina Power and Light Company, Long Island Lighting Company, and Southern California Edison Company. A load research bibliography and glossaries of load research and statistical terms are also included.

Data management in large-scale collaborative toxicity studies: how to file experimental data for automated statistical analysis.

PubMed

Stanzel, Sven; Weimer, Marc; Kopp-Schneider, Annette

2013-06-01

High-throughput screening approaches are carried out for the toxicity assessment of a large number of chemical compounds. In such large-scale in vitro toxicity studies several hundred or thousand concentration-response experiments are conducted. The automated evaluation of concentration-response data using statistical analysis scripts saves time and yields more consistent results in comparison to data analysis performed by the use of menu-driven statistical software. Automated statistical analysis requires that concentration-response data are available in a standardised data format across all compounds. To obtain consistent data formats, a standardised data management workflow must be established, including guidelines for data storage, data handling and data extraction. In this paper two procedures for data management within large-scale toxicological projects are proposed. Both procedures are based on Microsoft Excel files as the researcher's primary data format and use a computer programme to automate the handling of data files. The first procedure assumes that data collection has not yet started whereas the second procedure can be used when data files already exist. Successful implementation of the two approaches into the European project ACuteTox is illustrated. Copyright © 2012 Elsevier Ltd. All rights reserved.

Promoting North-South partnership in space data use and applications: Case study - East African countries space programs/projects new- concepts in document management

NASA Astrophysics Data System (ADS)

Mlimandago, S.

This research paper have gone out with very simple and easy (several) new concepts in document management for space projects and programs which can be applied anywhere both in the developing and developed countries. These several new concepts are and have been applied in Tanzania, Kenya and Uganda and found out to bear very good results using simple procedures. The intergral project based its documentation management approach from the outset on electronic document sharing and archiving. The main objective of having new concepts was to provide a faster and wider availability of the most current space information to all parties rather than creating a paperless office. Implementation of the new concepts approach required the capturing of documents in an appropriate and simple electronic format at source establishing new procedures for project wide information sharing and the deployment of a new generation of simple procedure - WEB - based tools. Key success factors were the early adoption of Internet technologies and simple procedures for improved information flow new concepts which can be applied anywhere both in the developed and the developing countries.

4D Dynamic Required Navigation Performance Final Report

NASA Technical Reports Server (NTRS)

Finkelsztein, Daniel M.; Sturdy, James L.; Alaverdi, Omeed; Hochwarth, Joachim K.

2011-01-01

New advanced four dimensional trajectory (4DT) procedures under consideration for the Next Generation Air Transportation System (NextGen) require an aircraft to precisely navigate relative to a moving reference such as another aircraft. Examples are Self-Separation for enroute operations and Interval Management for in-trail and merging operations. The current construct of Required Navigation Performance (RNP), defined for fixed-reference-frame navigation, is not sufficiently specified to be applicable to defining performance levels of such air-to-air procedures. An extension of RNP to air-to-air navigation would enable these advanced procedures to be implemented with a specified level of performance. The objective of this research effort was to propose new 4D Dynamic RNP constructs that account for the dynamic spatial and temporal nature of Interval Management and Self-Separation, develop mathematical models of the Dynamic RNP constructs, "Required Self-Separation Performance" and "Required Interval Management Performance," and to analyze the performance characteristics of these air-to-air procedures using the newly developed models. This final report summarizes the activities led by Raytheon, in collaboration with GE Aviation and SAIC, and presents the results from this research effort to expand the RNP concept to a dynamic 4D frame of reference.

Alignment of high-throughput sequencing data inside in-memory databases.

PubMed

Firnkorn, Daniel; Knaup-Gregori, Petra; Lorenzo Bermejo, Justo; Ganzinger, Matthias

2014-01-01

In times of high-throughput DNA sequencing techniques, performance-capable analysis of DNA sequences is of high importance. Computer supported DNA analysis is still an intensive time-consuming task. In this paper we explore the potential of a new In-Memory database technology by using SAP's High Performance Analytic Appliance (HANA). We focus on read alignment as one of the first steps in DNA sequence analysis. In particular, we examined the widely used Burrows-Wheeler Aligner (BWA) and implemented stored procedures in both, HANA and the free database system MySQL, to compare execution time and memory management. To ensure that the results are comparable, MySQL has been running in memory as well, utilizing its integrated memory engine for database table creation. We implemented stored procedures, containing exact and inexact searching of DNA reads within the reference genome GRCh37. Due to technical restrictions in SAP HANA concerning recursion, the inexact matching problem could not be implemented on this platform. Hence, performance analysis between HANA and MySQL was made by comparing the execution time of the exact search procedures. Here, HANA was approximately 27 times faster than MySQL which means, that there is a high potential within the new In-Memory concepts, leading to further developments of DNA analysis procedures in the future.

A tiered quality assurance review process for clinical data management standard operating procedures in an academic health center.

PubMed

Ittenbach, Richard F; Baker, Cynthia L; Corsmo, Jeremy J

2014-05-01

Standard operating procedures (SOPs) were once considered the province of the pharmaceutical industry but are now viewed as a key component of quality assurance programs. To address variability and increase the rigor of clinical data management (CDM) operations, the Cincinnati Children's Hospital Medical Center (CCHMC) decided to create CDM SOPs. In response to this challenge, and as part of a broader institutional initiative, the CCHMC leadership established an executive steering committee to oversee the development and implementation of CDM SOPs. This resulted in the creation of a quality assurance review process with three review panels: an SOP development team (16 clinical data managers and technical staff members), a faculty review panel (8 senior faculty and administrators), and an expert advisory panel (3 national CDM experts). This innovative, tiered review process helped ensure that the new SOPs would be created and implemented in accord with good CDM practices and standards. Twelve fully vetted, institutionally endorsed SOPs and one CDM template resulted from the intensive, iterative 10-month process (December 2011 to early October 2012). Phased implementation, which incoporated the CDM SOPs into the existing audit process for certain types of clinical research studies, was on schedule at the time of this writing. Once CCHMC researchers have had the opportunity to use the SOPs over time and across a broad range of research settings and conditions, the SOPs will be revisited and revalidated.

Implementation of the first adaptive management plan for a European migratory waterbird population: The case of the Svalbard pink-footed goose Anser brachyrhynchus

USGS Publications Warehouse

Madsen, Jesper; Williams, James Henty; Johnson, Fred A.; Tombre, Ingunn M.; Dereliev, Sergey; Kuijken, Eckhart

2017-01-01

An International Species Management Plan for the Svalbard population of the pink-footed goose was adopted under the Agreement on the Conservation of African-Eurasian Migratory Waterbirds in 2012, the first case of adaptive management of a migratory waterbird population in Europe. An international working group (including statutory agencies, NGO representatives and experts) agreed on objectives and actions to maintain the population in favourable conservation status, while accounting for biodiversity, economic and recreational interests. Agreements include setting a population target to reduce agricultural conflicts and avoid tundra degradation, and using hunting in some range states to maintain stable population size. As part of the adaptive management procedures, adjustment to harvest is made annually subject to population status. This has required streamlining of monitoring and assessment activities. Three years after implementation, indicators suggest the attainment of management results. Dialogue, consensus-building and engagement among stakeholders represent the major process achievements.

A Recipe for Streamlining Mission Management

NASA Technical Reports Server (NTRS)

Mitchell, Andrew E.; Semancik, Susan K.

2004-01-01

This paper describes a project's design and implementation for streamlining mission management with knowledge capture processes across multiple organizations of a NASA directorate. Thc project's focus is on standardizing processes and reports; enabling secure information access and case of maintenance; automating and tracking appropriate workflow rules through process mapping; and infusing new technologies. This paper will describe a small team's experiences using XML technologies through an enhanced vendor suite of applications integrated on Windows-based platforms called the Wallops Integrated Scheduling and Document Management System (WISDMS). This paper describes our results using this system in a variety of endeavors, including providing range project scheduling and resource management for a Range and Mission Management Office; implementing an automated Customer Feedback system for a directorate; streamlining mission status reporting across a directorate; and initiating a document management, configuration management and portal access system for a Range Safety Office's programs. The end result is a reduction of the knowledge gap through better integration and distribution of information, improved process performance, automated metric gathering, and quicker identification of problem areas and issues. However, the real proof of the pudding comes through overcoming the user's reluctance to replace familiar, seasoned processes with new technology ingredients blended with automated procedures in an untested recipe. This paper shares some of the team's observations that led to better implementation techniques, as well as an IS0 9001 Best Practices citation. This project has provided a unique opportunity to advance NASA's competency in new technologies, as well as to strategically implement them within an organizational structure, while wetting the appetite for continued improvements in mission management.

Underground storage tank management plan

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

NONE

1994-09-01

The Underground Storage Tank (UST) Management Program at the Oak Ridge Y-12 Plant was established to locate UST systems in operation at the facility, to ensure that all operating UST systems are free of leaks, and to establish a program for the removal of unnecessary UST systems and upgrade of UST systems that continue to be needed. The program implements an integrated approach to the management of UST systems, with each system evaluated against the same requirements and regulations. A common approach is employed, in accordance with Tennessee Department of Environment and Conservation (TDEC) regulations and guidance, when corrective actionmore » is mandated. This Management Plan outlines the compliance issues that must be addressed by the UST Management Program, reviews the current UST inventory and compliance approach, and presents the status and planned activities associated with each UST system. The UST Management Plan provides guidance for implementing TDEC regulations and guidelines for petroleum UST systems. (There are no underground radioactive waste UST systems located at Y-12.) The plan is divided into four major sections: (1) regulatory requirements, (2) implementation requirements, (3) Y-12 Plant UST Program inventory sites, and (4) UST waste management practices. These sections describe in detail the applicable regulatory drivers, the UST sites addressed under the Management Program, and the procedures and guidance used for compliance with applicable regulations.« less

[Recommendations for inspections of the French nuclear safety authority].

PubMed

Rousse, C; Chauvet, B

2015-10-01

The French nuclear safety authority is responsible for the control of radiation protection in radiotherapy since 2002. Controls are based on the public health and the labour codes and on the procedures defined by the controlled health care facility for its quality and safety management system according to ASN decision No. 2008-DC-0103. Inspectors verify the adequacy of the quality and safety management procedures and their implementation, and select process steps on the basis of feedback from events notified to ASN. Topics of the inspection are communicated to the facility at the launch of a campaign, which enables them to anticipate the inspectors' expectations. In cases where they are not physicians, inspectors are not allowed to access information covered by medical confidentiality. The consulted documents must therefore be expunged of any patient-identifying information. Exchanges before the inspection are intended to facilitate the provision of documents that may be consulted. Finally, exchange slots between inspectors and the local professionals must be organized. Based on improvements achieved by the health care centres and on recommendations from a joint working group of radiotherapy professionals and the nuclear safety authority, changes will be made in the control procedure that will be implemented when developing the inspection program for 2016-2019. Copyright © 2015. Published by Elsevier SAS.

North Carolina Medicaid recipient management lock-in program: the pharmacist's perspective.

PubMed

Werth, S Rose; Sachdeva, Nidhi; Roberts, Andrew W; Garrettson, Mariana; Ringwalt, Chris; Moss, Leslie A; Pikoulas, Theodore; Skinner, Asheley Cockrell

2014-11-01

The misuse and abuse of prescription opioids have become an urgent health issue in North Carolina (NC), particularly among Medicaid patients who suffer high rates of morbidity and mortality due to abuse and overdose. The NC Division of Medical Assistance (DMA) implemented a recipient management lock-in program, which limits identified patients for a 12-month period to 1 prescriber and 1 pharmacy for benzodiazepine, opiate, and certain anxiolytic prescriptions in order to prevent misuse and reduce overutilization of Medicaid benefits.  To (a) evaluate pharmacists' perceptions of the implementation of the NC recipient management lock-in program (MLIP) and (b) determine how the beliefs and attitudes of pharmacists could promote or inhibit its success.  We conducted 12 structured phone interviews with NC pharmacists serving lock-in patients. Interview responses were analyzed through construct analysis, which identified themes organized into 3 domains: organization and implementation, perceived effectiveness, and acceptability.  Most respondents reported a positive experience with the program but expressed doubt concerning its impact on prescription drug abuse. The program successfully utilized the pharmacist role as a gatekeeper of controlled substances, and the procedures of the program required no active effort on pharmacists' part. However, respondents suggested that the DMA improve communication and outreach to address pharmacists' lack of knowledge about the program's purpose and confusion over remediating problems that arise with lock-in patients. The DMA should also address the ways in which the program can interfere with access to health care and treatment, allow patients to see multiple physicians within the same clinic, and clarify procedures for patients whose complex health issues require multiple specialists.  Although possible improvements were identified, the NC MLIP has strong potential for success as it utilizes pharmacists' medication gate-keeping role, while minimizing the effort required for successful implementation.

Interservice Procedures for Instructional Systems Development. Phase 4 and 5. Implement and Control

DTIC Science & Technology

1975-08-01

FIGUREIZ.2: Flowchart ot Block]Z.1: IMPLEMENT INSTRUCTIONAL MANAGEMENT PLAN BLOCK IV.2: CONDUCT INSTRUCTION LEA Oa.lNUt kaP INSTRUCTIONAL INIIANAI EL...DOCUMENTATION 2.1 [ BTAIN REQUIRED _ _ I 2.J2 CONDUCT INSTRUCTION 1 1 AND DOCUMENT OBSERVATIONS 2.3 ACTIVITIES 2.4 I BLOCK FIGURE ]V.3: Flowchart of...not have the entry skills. The entry skills determi- nation is important to know whether to place the students at the beginn - ing or provide

Bridging the gap between preventive and restorative dentistry: identification of caries risk factors and strategies for minimizing risk.

PubMed

Maragliano-Muniz, Pamela

2013-10-01

Following the introduction of CAMBRA (Caries Management by Risk Assessment) in 2007, a number of recommendations for office protocols were introduced, and many companies have formulated products and procedures for implementing CAMBRA. As a result, the implementation of a caries management program can be confounding and overwhelming to a dental practitioner. Understanding risk factors as they contribute to the caries process can help mitigate confusion and guide the practitioner when selecting materials for their practice. Ultimately, knowing how the risk factors play a role in the progression of dental caries will lead to appropriate risk management and product recommendations. The purpose of this article is to discuss the contribution of risk factors to the caries process and to introduce strategies that restorative dentists can utilize to minimize caries risk.

Report of the FELASA Working Group on evaluation of quality systems for animal units.

PubMed

Howard, B; van Herck, H; Guillen, J; Bacon, B; Joffe, R; Ritskes-Hoitinga, M

2004-04-01

This report compares and considers the merits of existing, internationally available quality management systems suitable for implementation in experimental animal facilities. These are: the Good Laboratory Practice Guidelines, ISO 9000:2000 (International Organization for Standardization) and AAALAC International (Association for Assessment and Accreditation of Laboratory Animal Care International). Good laboratory practice (GLP) is a legal requirement for institutions undertaking non-clinical health and environmental studies for the purpose of registering or licensing for use and which have to be 'GLP-compliant'. GLP guidelines are often only relevant for and obtainable by those institutions. ISO is primarily an external business standard, which provides a management tool to master and optimize a business activity; it aims to implement and enhance 'customer satisfaction'. AAALAC is primarily a peer-reviewed system of accreditation which evaluates the organization and procedures in programmes of animal care and use to ensure the appropriate use of animals, safeguard animal well-being (ensuring state-of-the-art housing, management, procedural techniques, etc.) as well as the management of health and safety of staff. Management needs to determine, on the basis of a facility's specific goals, whether benefits would arise from the introduction of a quality system and, if so, which system is most appropriate. The successful introduction of a quality system confers peer-recognition against an independent standard, thereby providing assurance of standards of animal care and use, improving the quality of animal studies, and contributing to the three Rs-reduction, refinement and replacement.

Information technology as a tool for the Italian Institute of Social Security (INPS) in the management of social security and civil disability: Pro and cons.

PubMed

Sammicheli, Michele; Scaglione, Marcella

2018-01-01

We examine, from a medical-legal perspective, the pro and cons of the information technology procedures that the Italian Institute of Social Security (INPS) has implemented to manage the provision of social disability assistance, meaning that separate from the payment of pension contributions, being welfare, anchored to an administrative requirement by way of the compulsory payment of a minimum social security contribution.

The moderating influence of procedural fairness on the relationship between work-life conflict and organizational commitment.

PubMed

Siegel, Phyllis A; Post, Corinne; Brockner, Joel; Fishman, Ariel Y; Garden, Charlee

2005-01-01

To help employees better manage work-life conflict, organizations have introduced various initiatives, which have met with mixed results. The present studies examined the utility of a procedurally based approach to understanding employees' reactions to work-life conflict. The authors examined whether the fairness of procedures used by organizational authorities to plan and implement decisions moderates the (inverse) relationship between work-life conflict and employees' organizational commitment. Three studies using different methodologies showed support for the moderating role played by procedural fairness. That is, the tendency for greater work-life conflict to lead to lower commitment was significantly less pronounced when procedural fairness was high rather than low. Theoretical contributions to the work-life conflict and organizational justice literatures are discussed, as are practical implications.

Development of a methodology for strategic environmental assessment: application to the assessment of golf course installation policy in Taiwan.

PubMed

Chen, Ching-Ho; Wu, Ray-Shyan; Liu, Wei-Lin; Su, Wen-Ray; Chang, Yu-Min

2009-01-01

Some countries, including Taiwan, have adopted strategic environmental assessment (SEA) to assess and modify proposed policies, plans, and programs (PPPs) in the planning phase for pursuing sustainable development. However, there were only some sketchy steps focusing on policy assessment in the system of Taiwan. This study aims to develop a methodology for SEA in Taiwan to enhance the effectiveness associated with PPPs. The proposed methodology comprises an SEA procedure involving PPP management and assessment in various phases, a sustainable assessment framework, and an SEA management system. The SEA procedure is devised based on the theoretical considerations by systems thinking and the regulative requirements in Taiwan. The positive and negative impacts on ecology, society, and economy are simultaneously considered in the planning (including policy generation and evaluation), implementation, and control phases of the procedure. This study used the analytic hierarchy process, Delphi technique, and systems analysis to develop a sustainable assessment framework. An SEA management system was built based on geographic information system software to process spatial, attribute, and satellite image data during the assessment procedure. The proposed methodology was applied in the SEA of golf course installation policy in 2001 as a case study, which was the first SEA in Taiwan. Most of the 82 existing golf courses in 2001 were installed on slope lands and caused a serious ecological impact. Assessment results indicated that 15 future golf courses installed on marginal lands (including buffer zones, remedied lands, and wastelands) were acceptable because the comprehensive environmental (ecological, social, and economic) assessment value was better based on environmental characteristics and management regulations of Taiwan. The SEA procedure in the planning phase for this policy was completed but the implementation phase of this policy was not begun because the related legislation procedure could not be arranged due to a few senators' resistance. A self-review of the control phase was carried out in 2006 using this methodology. Installation permits for 12 courses on slope lands were terminated after 2001 and then 27 future courses could be installed on marginal lands. The assessment value of this policy using the data on ecological, social, and economic conditions from 2006 was higher than that using the data from 2001. The analytical results illustrate that the proposed methodology can be used to effectively and efficiently assist the related authorities for SEA.

28 CFR Appendix D to Part 61 - Office of Justice Assistance, Research, and Statistics Procedures Relating to the Implementation...

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the NEPA process and policies of the agencies can be obtained from: Policy and Management Planning... funded efforts; training programs, court improvement projects, research, and gathering statistical data. (2) Minor renovation projects or remodeling. (c) Actions which normally require environmental...

28 CFR Appendix D to Part 61 - Office of Justice Assistance, Research, and Statistics Procedures Relating to the Implementation...

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the NEPA process and policies of the agencies can be obtained from: Policy and Management Planning... funded efforts; training programs, court improvement projects, research, and gathering statistical data. (2) Minor renovation projects or remodeling. (c) Actions which normally require environmental...

28 CFR Appendix D to Part 61 - Office of Justice Assistance, Research, and Statistics Procedures Relating to the Implementation...

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the NEPA process and policies of the agencies can be obtained from: Policy and Management Planning... funded efforts; training programs, court improvement projects, research, and gathering statistical data. (2) Minor renovation projects or remodeling. (c) Actions which normally require environmental...

A Cooperative Training Program for Students with Severe Behavior Problems: Description and Comparative Evaluation.

ERIC Educational Resources Information Center

Reganick, Karol A.

The Cooperative Training Program was implemented with 20 students having severe behavior problems, to augment a classroom employability curriculum. Educators and business managers at a local Perkins restaurant worked cooperatively to design a new curriculum and recruitment procedure to benefit both students and the business. A continuous and…

Procedures for Managing Innovations. Analysis of Literature and Selected Bibliography. Analysis and Bibliography Series, No. 7.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Educational Management, Eugene, OR.

This rview focuses on the innovation process in local schools. Emphasis is placed on (1) how local schools implement innovations, (2) facilitators and inhibitors of innovation, and (3) unmet needs in assisting schools to adopt innovations. A 78-item bibliography of rlated literature is included. (RA)

A Risk-Analysis Approach to Implementing Web-Based Assessment

ERIC Educational Resources Information Center

Ricketts, Chris; Zakrzewski, Stan

2005-01-01

Computer-Based Assessment is a risky business. This paper proposes the use of a model for web-based assessment systems that identifies pedagogic, operational, technical (non web-based), web-based and financial risks. The strategies and procedures for risk elimination or reduction arise from risk analysis and management and are the means by which…

The Design and Implementation of INGRES.

ERIC Educational Resources Information Center

Stonebraker, Michael; And Others

The currently operational version of the INGRES data base management system gives a relational view of data, supports two high level, non-procedural data sublanguages, and runs as a collection of user processes on top of a UNIX operating system. The authors stress the design decisions and tradeoffs in relation to (1) structuring the system into…

The Effective Teacher's Guide: 50 Ways to Engage Students and Promote Interactive Learning. Second Edition

ERIC Educational Resources Information Center

Frey, Nancy

2010-01-01

This popular guide offers a wealth of innovative, research-based strategies for making K-12 classrooms the best learning environments they can be. Easy-to-implement best practices are presented for establishing a classroom management plan, organizing procedures and materials, building a respectful community, fostering peer collaboration, and…

76 FR 39132 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... NRC action to submit an information collection request to the Office of Management and Budget (OMB... authorizes agencies to issue regulations to implement FAR policies and procedures internally and to include... quality, utility, and clarity of the information to be collected? 4. How can the burden of the information...

The Relationship Factor: Making or Breaking Successful Transitions for Youth at Risk

ERIC Educational Resources Information Center

Powell, Norman W.; Marshall, Amy

2011-01-01

Whenever educators are asked to identify the major problems they face, behavior management is near the top of the list. Research shows that effective teachers are able to build relationships with students and implement well-developed classroom procedures (Holt, Hargrove, & Harris, 2011, p. 18). Yet schools give scant attention to developing…

Developing Customized Programs for Steel and Other Heavy Industries: A Case Study.

ERIC Educational Resources Information Center

Day, Philip R., Jr.

1984-01-01

This article discusses the successful implementation of a unique customized training program for steel and other industries. A contextual framework for understanding both the process and the product is presented. Traditional labor management problems are examined as well as the DACUM (Developing a Curriculum) procedure of identifying job-related…

Swallowing Mechanics Associated with Artificial Airways, Bolus Properties, and Penetration-Aspiration Status in Trauma Patients

ERIC Educational Resources Information Center

Dietsch, Angela M.; Rowley, Christopher B.; Solomon, Nancy Pearl; Pearson, William G., Jr.

2017-01-01

Purpose: Artificial airway procedures such as intubation and Sare common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in…

30 CFR 250.1916 - What criteria for mechanical integrity must my SEMS program meet?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What criteria for mechanical integrity must my SEMS program meet? 250.1916 Section 250.1916 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT... mechanical integrity must my SEMS program meet? You must develop and implement written procedures that...

Integrated risk assessment and screening analysis of drinking water safety of a conventional water supply system.

PubMed

Sun, F; Chen, J; Tong, Q; Zeng, S

2007-01-01

Management of drinking water safety is changing towards an integrated risk assessment and risk management approach that includes all processes in a water supply system from catchment to consumers. However, given the large number of water supply systems in China and the cost of implementing such a risk assessment procedure, there is a necessity to first conduct a strategic screening analysis at a national level. An integrated methodology of risk assessment and screening analysis is thus proposed to evaluate drinking water safety of a conventional water supply system. The violation probability, indicating drinking water safety, is estimated at different locations of a water supply system in terms of permanganate index, ammonia nitrogen, turbidity, residual chlorine and trihalomethanes. Critical parameters with respect to drinking water safety are then identified, based on which an index system is developed to prioritize conventional water supply systems in implementing a detailed risk assessment procedure. The evaluation results are represented as graphic check matrices for the concerned hazards in drinking water, from which the vulnerability of a conventional water supply system is characterized.

Implementation Plan. Environmental Restoration and Waste Management Programmatic Environmental Impact Statement

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

Not Available

1994-01-01

In accordance with the Department of Energy`s National Environmental Policy Act implementing procedures in Volume 10 of the Code of Federal Regulations, Section 1021,312, the Environmental Restoration and Waste Management Programmatic Environmental Impact Statement Implementation Plan has two primary purposes: to provide guidance for the preparation of the Programmatic Environmental Impact Statement and to record the issues resulting from the scoping and the extended public participation process. The Implementation Plan identifies and discusses the following: background of Environmental Restoration and Waste Management activities, the purpose of the Programmatic Environmental Impact Statement, and the relationship of the Programmatic Environmental Impact Statementmore » to other Departmental initiatives (Chapter 1); need and purposes for action (Chapter 2); scoping process and results of the public participation program in defining the scope of the Programmatic Environmental Impact Statement, including a summary of the comments received and their disposition (Chapter 3); planned scope and content of the Programmatic Environmental Impact Statement (Chapter 4); consultations with other agencies and the role of cooperating agencies (Chapter 5); planned schedule of major Programmatic Environmental Impact Statement milestones (Chapter 6); and responsibilities for preparation of the Programmatic Environmental Impact Statement (Chapter 7).« less

Development of a data management front-end for use with a LANDSAT-based information system

NASA Technical Reports Server (NTRS)

Turner, B. J.

1982-01-01

The development and implementation of a data management front-end system for use with a LANDSAT based information system that facilitates the processsing of both LANDSAT and ancillary data was examined. The final tasks, reported on here, involved; (1) the implementation of the VICAR image processing software system at Penn State and the development of a user-friendly front-end for this system; (2) the implementation of JPL-developed software based on VICAR, for mosaicking LANDSAT scenes; (3) the creation and storage of a mosiac of 1981 summer LANDSAT data for the entire state of Pennsylvania; (4) demonstrations of the defoliation assessment procedure for Perry and Centre Counties, and presentation of the results at the 1982 National Gypsy Moth Review Meeting, and (5) the training of Pennsylvania Bureau of Forestry personnel in the use of the defoliation analysis system.

A Data Management System for International Space Station Simulation Tools

NASA Technical Reports Server (NTRS)

Betts, Bradley J.; DelMundo, Rommel; Elcott, Sharif; McIntosh, Dawn; Niehaus, Brian; Papasin, Richard; Mah, Robert W.; Clancy, Daniel (Technical Monitor)

2002-01-01

Groups associated with the design, operational, and training aspects of the International Space Station make extensive use of modeling and simulation tools. Users of these tools often need to access and manipulate large quantities of data associated with the station, ranging from design documents to wiring diagrams. Retrieving and manipulating this data directly within the simulation and modeling environment can provide substantial benefit to users. An approach for providing these kinds of data management services, including a database schema and class structure, is presented. Implementation details are also provided as a data management system is integrated into the Intelligent Virtual Station, a modeling and simulation tool developed by the NASA Ames Smart Systems Research Laboratory. One use of the Intelligent Virtual Station is generating station-related training procedures in a virtual environment, The data management component allows users to quickly and easily retrieve information related to objects on the station, enhancing their ability to generate accurate procedures. Users can associate new information with objects and have that information stored in a database.

Building a bonfire that remains stoked: sustainment of a contingency management intervention developed through collaborative design.

PubMed

Hartzler, Bryan

2015-08-06

Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process. At conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting's five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework. This qualitative analysis suggested the intervention was regarded as: (1) cost-effective and clinically useful relative to prior practices, (2) a strong fit with existing service structure and staffing resources, (3) procedurally uncomplicated, with staff consistently implementing it as intended, (4) providing site-specific data to sufficiently inform decisions about its sustainment, and (5) offering palpable benefits to staff-patient interactions. The current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.

Impact of System-Wide King LT Airway Implementation on Orotracheal Intubation.

PubMed

Hilton, Michael T; Wayne, Max; Martin-Gill, Christian

2016-01-01

Orotracheal intubation is a key component of prehospital airway management and success rates are dependent on procedural experience. Supraglottic airway devices are increasingly being used in the prehospital setting. As a result, paramedics may have fewer opportunities for performing intubation, limiting their proficiency in the procedure. We aimed to determine the trends in intubation versus supraglottic airway use over an 8 year period. We also aimed to determine the association between system-wide introduction of King LT guidelines and ETI success rates. We performed a retrospective observational study of 37 Emergency Medical Services (EMS) agencies in a 10 county region of Southwestern Pennsylvania. Cases between January 1, 2005 and December 31, 2012 were included if an advanced airway procedure was performed. We determined trends in advanced airway placement and compared the proportion of cases with first pass intubation success before and after the King LT was introduced and promoted by statewide protocol starting in 2007. Use of airway devices before and after King LT implementation were presented using descriptive statistics and compared using Pearson's Chi-square or Fishers Exact test as appropriate. We compared first pass success rate of orotracheal intubation between study periods using multivariable logistic regression, controlling for other factors that may impact success of orotracheal intubation (year, EMS agency, age category, traumatic injury, and cardiac arrest). There were 712 cases of orotracheal intubation before and 2,835 cases after introduction of the King LT. The proportion of cases ultimately managed with orotracheal intubation before and after 2007 decreased from 72.3% (95% CI 68.9-75.6%) to 67.1% (95% CI 65.3-68.8%) (p = 0.007). In the multivariable analysis, success of orotracheal intubation was not associated with implementation of the King LT airway (OR 1.02, 95% CI 0.74-1.41). Fewer patients with advanced airway management received orotracheal intubation since introduction of the King LT. In spite of this modest change in airway management, there has not been a change in orotracheal intubation success rate since introduction of this supraglottic device as a primary or rescue airway in this regional EMS setting.

An Environmental Management Model of Thermal Waters in Entre Ríos Province, Argentina

NASA Astrophysics Data System (ADS)

Pablo, Mársico Daniel; Luís, Díaz Eduardo; Ivana, Zecca; Oscar, Dallacosta; Antonio, Paz-González

2015-04-01

Deep exploratory drillings, i.e. those with more than 500 meters depth, have been performed in the Entre Ríos province, Argentina, in order to ascertain the presence of thermal water. Drilling began in 1994, and until now there have been 18 polls with very variable results in terms of mineralization, resource flow, and temperature. The aim of this study was to present a management model, which should allow operators of thermal complexes to further develop procedures for safeguarding the biodiversity of the ecosystems involved, both during exploration and exploitation activities. The environmental management Plan proposed is constituted by a set of technical procedures that are formulated and should be performed during the stages of exploration and exploitation of the resource, and consists of: environmental monitoring, environmental audit, public information and contingency programs. This Plan describes the measures and proposals aimed at protecting environmental quality in the area of influence of a thermal complex project, ensuring that its execution remains environmentally responsibly, and allowing implementation of specific actions to prevent or correct environmental impacts, as predicted in the evaluation of the Environmental Program. The audit of environmental impact includes and takes into account natural factors, such as water, soil, atmosphere, flora and fauna, and also cultural factors. The technical audit Plan was prepared in order to get a systematic structure and organization of the verification process, and also with regard to document the degree of implementation of the proposed mitigation measures. Finally, an environmental contingency program was implemented, and its objective was to consider the safeguarding of life and its natural environment. Thus, a guide has been developed with the main actions to be taken on a contingency, since forecast increases the efficiency of the response. The methodology developed here was adopted as the procedure required by the authority for the application and regulation of the hydro-geo-thermal resources of the province of Entre Ríos, and it is also useful for the control and protection of the resource.

[Building and implementation of management system in laboratories of the National Institute of Hygiene].

PubMed

Rozbicka, Beata; Brulińska-Ostrowska, Elzbieta

2008-01-01

The rules of good laboratory practice have always been observed in the laboratories of National Institute of Hygiene (NIH) and the reliability of the results has been carefully cared after when performing tests for clients. In 2003 the laboratories performing analyses related to food safety were designated as the national reference laboratories. This, added to the necessity of compliance with work standards and requirements of EU legislation and to the need of confirmation of competence by an independent organisation, led to a decision to seek accreditation of Polish Centre of Accreditation (PCA). The following stages of building and implementation of management system were presented: training, modifications of Institute's organisational structure, elaboration of management system's documentation, renovation and refurbishment of laboratory facilities, implementation of measuring and test equipment's supervision, internal audits and management review. The importance of earlier experiences and achievements with regard to validation of analytical methods and guarding of the quality of the results through organisation and participation in proficiency tests was highlighted. Current status of accreditation of testing procedures used in NIH laboratories that perform analyses in the field of chemistry, microbiology, radiobiology and medical diagnostic tests was presented.

What is case management in palliative care? An expert panel study

PubMed Central

2012-01-01

Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent. PMID:22709349

The U.S. Geological Survey Geologic Collections Management System (GCMS)—A master catalog and collections management plan for U.S. Geological Survey geologic samples and sample collections

USGS Publications Warehouse

,

2015-01-01

The general consideration for implementation of the GCMS is that all active USGS geologic sample repositories will form the core of GCMS and that participating science centers will develop procedures based on proposed GCMS methodologies. The GCMS is a collective resource for the entire USGS community and the users who discover the geologic materials kept in these repositories and seek to access them.

Solid waste management in the hospitality industry: a review.

PubMed

Pirani, Sanaa I; Arafat, Hassan A

2014-12-15

Solid waste management is a key aspect of the environmental management of establishments belonging to the hospitality sector. In this study, we reviewed literature in this area, examining the current status of waste management for the hospitality sector, in general, with a focus on food waste management in particular. We specifically examined the for-profit subdivision of the hospitality sector, comprising primarily of hotels and restaurants. An account is given of the causes of the different types of waste encountered in this sector and what strategies may be used to reduce them. These strategies are further highlighted in terms of initiatives and practices which are already being implemented around the world to facilitate sustainable waste management. We also recommended a general waste management procedure to be followed by properties of the hospitality sector and described how waste mapping, an innovative yet simple strategy, can significantly reduce the waste generation of a hotel. Generally, we found that not many scholarly publications are available in this area of research. More studies need to be carried out on the implementation of sustainable waste management for the hospitality industry in different parts of the world and the challenges and opportunities involved. Copyright © 2014 Elsevier Ltd. All rights reserved.

An unwanted visitor. Aggressive infection control strategies are needed to shorten the hospital visit of the easily spread norovirus.

PubMed

Albers, Marilyn K

2004-11-01

Norovirus is the name for a group of Norwalk-like viruses that cause acute gastroenteritis of rapid onset. A recent outbreak at a tertiary care facility in Alberta provided an opportunityfor staff and management to review their outbreak protocol and improve their infection prevention and control procedures. The outbreak caused illness in 32 of 73 exposed patients as well as 42 staff members. None of the infected patients or staff developed complications. The source of norovirus contamination was probably associated with a symptomatic food services staff member serving food cafeteria style in a satellite patient dining room. Food service procedures and serving techniques were reviewed; although no breaks in technique were identified, correct food handling procedures were reviewed with staff. Subsequent patient and staff cases were probably related to the cross contamination of environmental surfaces and patient care equipment. The director of nursing and the infection control practitioner led the investigation and management of the outbreak. An Outbreak Management Committee was also formed to reinforce routine infection prevention practices and implement infection control strategies. Communication strategies for staff, patients and visitors were quickly devised and implemented. Gaps in the outbreak protocol were identified and resolved promptly Four permanent changes were made: the use of alcohol hand rinse in designated locations; the development of a comprehensive e-mail to facilitate site-wide communication; the development of teamwork checklists and accountabilities; and the establishment of criteria for use in outbreak situations to proactively determine essential and non-essential therapies and treatments.

Improved cost monitoring and control through the Earned Value Management System

NASA Astrophysics Data System (ADS)

Hunter, Howard; Fitzgerald, Richard; Barlow, Dewey

2014-01-01

As economic pressure and competition for budget among federal agencies has increased, there has been an increasing need for more granular data and robust management information systems. This is especially true for the execution of major civilian space programs. This need has resulted in new program management requirements being implemented in an attempt to limit cost and schedule growth. In particular, NASA Procedural Requirements (NPR) 7120.5D requires the implementation of an Earned Value Management System (EVMS) compliant with the requirements of American National Standards Institute (ANSI)/Electronic Industries Alliance Standard 748-B. The Radiation Belt Storm Probes (RBSP) program management team at The Johns Hopkins University Applied Physics Laboratory (JHU/APL) made a decision to implement an EVMS on RBSP during Phase B—a year earlier than specified in the contractual Phase C reporting requirement as defined in the NPR. This decision was made so that the project would have the benefit of 12 months of training and hands-on implementation during Phase B. Although there were a number of technical and process hurdles encountered during Phase B and into Phase C, the system was working well when the Integrated Baseline Review (IBR) was held in August 2009. The IBR was a success because it met the review requirements. It was also clear to all IBR participants that the EVMS was providing value to the project management team. Although the IBR pointed out some areas of concern regarding process and ANSI compliance, the system had markedly improved the project's ability to monitor cost and schedule. This, in turn, allowed the project team to foresee problems in advance, formulate corrective actions, and implement course corrections without causing significant adverse impact to the project. Opponents of EVMS systems often communicate the unfavorable opinion that EVMS systems create unnecessary cost and administration. Although it is undeniable that EVMS implementation does not occur without cost, the cost is minimal in comparison to the benefits of successful implementation. This paper will focus on the implementation of EVMS on the RBSP project, explain EV processes and the implementation's cost, and analyze the benefits of EVMS to provide insight into cost/benefit considerations for other projects considering EVMS implementation. This paper will do this by focusing on the following points: (1) RBSP is the first full-up implementation of earned value management (EVM) at JHU/APL; (2) RBSP EVM started in Phase B; (3) RBSP EVM implementation has been working well in Phase C/D; (4) RBSP EVM implementation has been recognized by Goddard Space Flight Center and NASA Headquarters as successful; and (5) an assessment of the benefits of EVMS to the project management team and sponsor shows that the system's benefits outweigh the cost of implementation.

NASA Automatic Information Security Handbook

NASA Technical Reports Server (NTRS)

1993-01-01

This handbook details the Automated Information Security (AIS) management process for NASA. Automated information system security is becoming an increasingly important issue for all NASA managers and with rapid advancements in computer and network technologies and the demanding nature of space exploration and space research have made NASA increasingly dependent on automated systems to store, process, and transmit vast amounts of mission support information, hence the need for AIS systems and management. This handbook provides the consistent policies, procedures, and guidance to assure that an aggressive and effective AIS programs is developed, implemented, and sustained at all NASA organizations and NASA support contractors.

The implementation of a quality assurance procedure for the Veterinary Services of France.

PubMed

Gerster, F; Guerson, N; Moreau, V; Mulnet, O; Provot, S; Salabert, C

2003-08-01

Due to the increasing complexity of food production systems and the concerns that these systems raise, there has been increasing demand from the general public for more State control of these processes. In France, it is the official Veterinary Services who are responsible for food safety and who must respond to these demands. The Veterinary Service is formulating a quality assurance procedure in accordance with standard EN 45004-ISO 17020, which determines the requirements that inspection bodies must follow to be recognised, at national, European and international level, as competent and reliable. As part of this procedure, the Veterinary Service will review requirements in terms of organisation, functions, qualifications and resources. The progress of inspection service orders, from their conception by the Central Administration, to their implementation by decentralised services, must be carefully managed. It is essential that service orders be implemented effectively and systematically by using recognised methods and issuing adequate inspection reports. The training and qualifications of inspectors are very important: their skills must remain up-to-date so that there is always a network of qualified staff, that is, staff who have an understanding of production processes and who have recognised competences in terms of initial training, continuous professional development and adequate experience. The quality systems implemented will only meet expectations if they are continuously monitored by means of regular evaluations. For this reason, both internal and external audits are performed. These new practices contribute to establishing a basis for the improvement of internal evaluation. In order to facilitate the implementation of a quality assurance procedure for inspection services, several tools, that are linked with the information system of the government department responsible for food, are, or will be, at the disposal of the decentralised Veterinary Services, i.e. a national database, mail and service order processing software, and inspection procedures.

Progress on quality management in the German health system – a long and winding road

PubMed Central

Breckenkamp, Juergen; Wiskow, Christiane; Laaser, Ulrich

2007-01-01

The interest in quality management in health care has increased in the last decades as the financial crises in most health systems generated the need for solutions to contain costs while maintaining quality of care. In Germany the development of quality management procedures has been closely linked with health care reforms. Starting in the early nineties quality management issues gained momentum in reform legislation only 10 years later. This review summarizes recent developments in medical quality management as related to the federal reform legislation in Germany. It provides an overview on the infrastructure, actors and on the current discussion concerning quality management in medical care. Germany had to catch up on implementing quality management in the health system compared to other countries. Considerable progress has been made, however, it is recognized that the full integration of quality management will require long-term commitment in developing methods, instruments and communication procedures. The most ambitious project at present is the development of a comprehensive comparative quality management system for hospitals at national level, including public reporting. For the time being medical quality management in Germany is dealt with as a technical and professional issue while the aspects of patient orientation and transparency need further advancement. PMID:17550593

MIRADS-2 Implementation Manual

NASA Technical Reports Server (NTRS)

1975-01-01

The Marshall Information Retrieval and Display System (MIRADS) which is a data base management system designed to provide the user with a set of generalized file capabilities is presented. The system provides a wide variety of ways to process the contents of the data base and includes capabilities to search, sort, compute, update, and display the data. The process of creating, defining, and loading a data base is generally called the loading process. The steps in the loading process which includes (1) structuring, (2) creating, (3) defining, (4) and implementing the data base for use by MIRADS are defined. The execution of several computer programs is required to successfully complete all steps of the loading process. This library must be established as a cataloged mass storage file as the first step in MIRADS implementation. The procedure for establishing the MIRADS Library is given. The system is currently operational for the UNIVAC 1108 computer system utilizing the Executive Operating System. All procedures relate to the use of MIRADS on the U-1108 computer.

Quality Management Framework for Total Diet Study centres in Europe.

PubMed

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

2018-02-01

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

[Implementation of modern operating room management -- experiences made at an university hospital].

PubMed

Hensel, M; Wauer, H; Bloch, A; Volk, T; Kox, W J; Spies, C

2005-07-01

Caused by structural changes in health care the general need for cost control is evident for all hospitals. As operating room is one of the most cost-intensive sectors in a hospital, optimisation of workflow processes in this area is of particular interest for health care providers. While modern operating room management is established in several clinics yet, others are less prepared for economic challenges. Therefore, the operating room statute of the Charité university hospital useful for other hospitals to develop an own concept is presented. In addition, experiences made with implementation of new management structures are described and results obtained over the last 5 years are reported. Whereas the total number of operation procedures increased by 15 %, the operating room utilization increased more markedly in terms of time and cases. Summarizing the results, central operating room management has been proved to be an effective tool to increase the efficiency of workflow processes in the operating room.

A Step Towards Conservation for Interior Alaska Tribes

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

Kimberly Carlo

2012-07-07

This project includes a consortium of tribes. The tribes include Hughes (representing the consortium) Birch Creek, Huslia, and Allakaket. The project proposed by Interior Regional Housing Authority (IRHA) on behalf of the villages of Hughes, Birch Creek, Huslia and Allakaket is to develop an energy conservation program relevant to each specific community, educate tribe members and provide the tools to implement the conservation plan. The program seeks to achieve both energy savings and provide optimum energy requirements to support each tribe's mission. The energy management program will be a comprehensive program that considers all avenues for achieving energy savings, frommore » replacing obsolete equipment, to the design and construction of energy conservation measures, the implementation of energy saving operation and maintenance procedures, the utilization of a community-wide building energy management system, and a commitment to educating the tribes on how to decrease energy consumption. With the implementation of this program and the development of an Energy Management Plan, these communities can then work to reduce the high cost of living in rural Alaska.« less

[Impact of 3 years of contract implementation on the quality of cataract surgery].

PubMed

Begiristain, J; Elizalde, B; Ibarluzea, J; Mendicute, J; Sola, C

1999-01-01

To assess the adequacy to clinical practice of cataract procedures contracted in the Gipuzkoa Health Area (in public as well as concerted hospitals) from 1995. A second aim is to identify the achievements obtained three years after its implementation comparing the data with those of 1994, a year before. Before its implementation a multidisciplinar team established the number of surgical procedures to be contracted each year by age and sex, as well as the technical and quality conditions (out-patient surgery, loco-regional anaesthetic, facoemulsification, etc.). Data used for the assessment: Cataracts Registry of the Ophthalmologic Unit, Patient Management Categories and surgical waiting lists. During the period studied, 8,073 cataract operations were performed, 9% higher than expected. The distribution by age and sex was as estimated. Technical and quality standards were fulfilled, except for the surgical waiting list, in at least 75% of the procedures. The surgical technique mainly used was facoenmulsification, increasing from 15% in 1994 to 76.5% in 1997. The contracting of cataract surgery has allowed the assessment, reordering, and establishment of standards of care for all the professionals involved in the process. There were improvements in clinical practice during the period studied. This has given raise to the homogenisation of care in all the units following technical and quality standards, meaning better equity for the patients in need of the procedure.

MED-SUV Data Life Cycle

NASA Astrophysics Data System (ADS)

Sangianantoni, Agata; Puglisi, Giuseppe; Spampinato, Letizia; Tulino, Sabrina

2015-04-01

The MED-SUV project aims to implement a digital e-infrastructure for data access in order to promote the monitoring and study of key volcanic regions prone to volcanic hazards, and thus improve hazard assessment, according to the rationale of Supersite GEO initiative to Vesuvius- Campi Flegrei and Mt Etna, currently identified as Permanent Supersites. The present study focuses on the life cycle of MED-SUV data generated in the first period of the project and highlights the managing approach, as well as the crucial steps to be implemented for ensuring that data will be properly and ethically managed and can be used and accessed from both MED-SUV and the external community. The process is conceived outlining how research data being handled as the project progresses, describing what data are collected, processed or generated and how these data are going to be shared and made available through Open Access. Data cycle begins with their generation and ends with the deposit in the digital infrastructure, its key series of stages through which MED-SUV data passes are Collection, Data citation, Categorization of data, Approval procedure, Registration of datasets, Application of licensing models, and PID assignment. This involves a combination of procedures and practices taking into account the scientific core mission and the priorities of the project as well as the potential legal issues related to the management and protection of the Intellectual Property. We believe that the implementation of this process constitutes a significant encouragement in MED-SUV data sharing and as a consequence a better understanding on the volcanic processes, hazard assessment and a better integration with other Supersites projects.

Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

PubMed

Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

2011-11-01

The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in "Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa." Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs.

Cultivating Excellence: A Curriculum for Excellence in School Administration. V. School-Based Management.

ERIC Educational Resources Information Center

Lawson, John

This report is the fifth in a series on cultivating excellence in education for the purpose of training and retraining school leaders of the 1990s. The role of school administrators, and especially building principals; the characteristic administrative functions; the step-by-step procedures for implementation; and the advantages and possible…

And never the twain shall meet? Integrating revenue cycle and supply chain functions.

PubMed

Matjucha, Karen A; Chung, Bianca

2008-09-01

Four initial steps to implementing a profit and loss management model are: Identify the supplies clinicians are using. Empower stakeholders to remove items that are not commonly used. Reduce factors driving wasted product. Review the chargemaster to ensure that supplies used in selected procedures are represented. Strategically set prices that optimize maximum allowable reimbursement.

Biosafety practices associated with potential agents of biocrime and biowarfare.

PubMed

Burnett, LouAnn C

2006-12-01

Conducting research in a manner that guards against theft and intentional misuse of biological materials requires a process of hazard identification and risk assessment to most effectively identify and implement a risk management plan. Procedures describing physical security, personnel reliability, and material control and accountability define a security plan for this type of research.

Quality First in Education... Why Not? Using Quality and Productivity Methods To Improve Schools.

ERIC Educational Resources Information Center

Spanbauer, Stanley J.; Hillman, Jo Ann

A description is provided of the implementation at Fox Valley Technical College (FVTC), Wisconsin, of the Quality First Process Model, which was adapted from a model commonly used in manufacturing and service industries. The model uses private sector quality and productivity procedures and new management styles to serve students more effectively,…

Elder Abuse and Neglect: The Illinois Response.

ERIC Educational Resources Information Center

Illinois State Dept. on Aging, Springfield.

This document outlines the ideas of the Illinois Department of Aging on the implementation and management of the Elder Abuse and Neglect Intervention Program. These topics are addressed in order to provide a basis for discussion of key elements of the proposed program and serve as a guide in the development of rules, policies, and procedures for…

An Ada implementation of the network manager for the advanced information processing system

NASA Technical Reports Server (NTRS)

Nagle, Gail A.

1986-01-01

From an implementation standpoint, the Ada language provided many features which facilitated the data and procedure abstraction process. The language supported a design which was dynamically flexible (despite strong typing), modular, and self-documenting. Adequate training of programmers requires access to an efficient compiler which supports full Ada. When the performance issues for real time processing are finally addressed by more stringent requirements for tasking features and the development of efficient run-time environments for embedded systems, the full power of the language will be realized.

[The economic solution for integrating radiology and surgery: hybrid OR].

PubMed

Freitag, T; Langer, S

2012-10-01

Currently, interventional (angiographically-guided) therapies have become more and more important in cardiovascular medicine. Hybrid procedures in hybrid operating rooms (ORs) have now become major topics at national and international meetings. A few hospitals have already implemented the project "hybrid OR", in some institutions the system is still in the planning stage. The aim of our article is to present the hospital management point of view, and thus, to focus on the economic and logistic issues from planning through to implementation. Georg Thieme Verlag KG Stuttgart · New York.

Organisational Pattern Driven Recovery Mechanisms

NASA Astrophysics Data System (ADS)

Giacomo, Valentina Di; Presenza, Domenico; Riccucci, Carlo

The process of reaction to system failures and security attacks is strongly influenced by its infrastructural, procedural and organisational settings. Analysis of reaction procedures and practices from different domains (Air Traffic Management, Response to Computer Security Incident, Response to emergencies, recovery in Chemical Process Industry) highlight three key requirements for this activity: smooth collaboration and coordination among responders, accurate monitoring and management of resources and ability to adapt pre-established reaction plans to the actual context. The SERENITY Reaction Mechanisms (SRM) is the subsystem of the SERENITY Run-time Framework aimed to provide SERENITY aware AmI settings (i.e. socio-technical systems with highly distributed dynamic services) with functionalities to implement applications specific reaction strategies. The SRM uses SERENITY Organisational S&D Patterns as run-time models to drive these three key functionalities.

Towards local implementation of Dutch health policy guidelines: a concept-mapping approach.

PubMed

Kuunders, Theo J M; van Bon-Martens, Marja J H; van de Goor, Ien A M; Paulussen, Theo G W M; van Oers, Hans A M

2017-02-22

To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful implementation of the guideline were identified. Differences and similarities in perceptions of these characteristics between RHSs and developers were explored. Separate concept mapping procedures were executed in two RHSs, one with representatives from partner local health organizations and municipalities, the second with RHS members only. A third map was conducted with the developers of the guideline. All mapping procedures followed the same design of generating statements up to interpretation of results with participants. Concept mapping, as a practical implementation tool, will be discussed in the context of international research literature on guideline implementation in public health. Guideline developers consider implementation successful when substantive components (health issues) of the guidelines, content are visible in local policy practice. RHSs, local organizations and municipalities view the implementation process itself within and between organizations as more relevant, and state that usability of the guideline for municipal policy and commitment by officials and municipal managers are critical targets for successful implementation. Between the RHSs, differences in implementation targets were smaller than between RHSs and guideline developers. For successful implementation, RHSs tend to focus on process targets while developers focus more on the thematic contents of the guideline. Implications of these different orientations for implementation strategies are dealt with in the discussion. © The Author 2017. Published by Oxford University Press.

[Focus Notified Bodies. New requirements for designation and monitoring].

PubMed

Poos, U; Edelhäuser, R

2014-12-01

For medical devices with a higher risk, Notified Bodies assess whether the manufacturers and their products fulfill the requirements laid down in the European directives on medical devices. Notified Bodies are designated through a designation procedure by the designating authority, in Germany by ZLG. The requirements for the designation arise from the respective annexes of the directives on medical devices. Since these are only minimal criteria, different documents have been compiled on a European and national level to concretize these minimal criteria regarding the organization, quality management system, resources, and certification procedure. The rules of the ZLG are thereby the essential documents for designation in Germany. Moreover, according to Implementing Regulation (EU) no. 912/2013, the European commission and the other European designating authorities also have to be involved in the designation process. The aim of continuous monitoring of the Notified Bodies with assessments on the bodies' premises as well as with observed audits is to ensure the permanent fulfillment of the requirements. If nonconformities are found in a body's quality management system or in its implementation of the conformity assessment procedures, the body is obliged to provide ZLG with a corrective actions plan. In the case that the nonconformities are not resolved in time or critical nonconformities are found, ZLG may take actions, e.g., restrict the scope of designation, suspend, or - as last resort - withdraw the designation.

Recent Improvement Of The Institutional Radioactive Waste Management System In Slovenia

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

Sueiae, S.; Fabjan, M.; Hrastar, U.

2008-07-01

The task of managing institutional radioactive waste was assigned to the Slovenian National Agency for Radwaste Management by the Governmental Decree of May 1999. This task ranges from the collection of waste at users' premises to the storage in the Central Storage Facility in (CSF) and afterwards to the planned Low and Intermediate Level Waste (LILW) repository. By this Decree ARAO also became the operator of the CSF. The CSF has been in operation since 1986. Recent improvements of the institutional radioactive waste management system in Slovenia are presented in this paper. ARAO has been working on the reestablishment ofmore » institutional radioactive waste management since 1999. The Agency has managed to prepare the most important documents and carry out the basic activities required by the legislation to assure a safe and environmentally acceptable management of the institutional radioactive waste. With the aim to achieve a better organized operational system, ARAO took the advantage of the European Union Transition Facility (EU TF) financing support and applied for the project named 'Improvement of the management of institutional radioactive waste in Slovenia via the design and implementation of an Information Business System'. Through a public invitation for tenders one of the Slovenian largest software company gained the contract. Two international radwaste experts from Belgium were part of their project team. The optimization of the operational system has been carried out in 2007. The project was executed in ten months and it was divided into two phases. The first phase of the project was related with the detection of weaknesses and implementation of the necessary improvements in the current ARAO operational system. With the evaluation of the existing system, possible improvements were identified. In the second phase of the project the software system Information Business System (IBS) was developed and implemented by the group of IT experts. As a software development life-cycle methodology the Waterfall methodology was used. The reason for choosing this methodology lied in its simple approach: analyze the problem, design the solution, implement the code, test the code, integrate and deploy. ARAO's institutional radioactive waste management process was improved in the way that it is more efficient, better organized, allowing traceability and availability of all documents and operational procedures within the field of institutional radioactive waste. The tailored made IBS system links all activities of the institutional radioactive waste management process: collection, transportation, takeover, acceptance, storing, treatment, radiation protection, etc. into one management system. All existing and newly designed evidences, operational procedures and other documents can be searched and viewed via secured Internet access from different locations. (authors)« less

Airway management and vascular access simulation during a medical student rotation.

PubMed

Sakawi, Yasser; Vetter, Thomas R

2011-03-01

Medical students electing to spend a month in anaesthesiology during their third or fourth year often experience airway management and vascular access for the first time on an actual patient. An airway management and vascular access simulation course for medical students was developed and implemented at our institution. The purpose of this study was to assess the subjective comfort level after implementing this teaching tool in medical students. A brief didactic course on airway management and vascular access was provided to medical students on the first day of their anaesthesiology rotation. A survey was presented to the students immediately after a focused 1-hour lecture and prior to a simulation session. The pre-simulation survey was comprised of eight questions asking the medical students to rate their level of comfort with both types of procedures. The lecture was followed by a 1-hour simulation course on manikins. The medical students were asked to complete a post-simulation survey, which was comprised of the same initial eight questions. After participating in the didactic course and manikin simulation, the self-perceived comfort level of medical students with airway management (p < 0.0005), vascular access (p < 0.0005) and interpretation of the vascular pressure waveforms (p < 0.0005) demonstrated significant improvement. The results of this study suggest that providing medical students with a brief didactic session on airway and vascular access, including simulation on manikins, prior to the start of their encounter with actual surgical patients, can improve their comfort level in performing both procedures. © Blackwell Publishing Ltd 2011.

Dental solid and hazardous waste management and safety practices in developing countries: Nablus district, Palestine.

PubMed

Al-Khatib, Issam A; Monou, Maria; Mosleh, Salem A; Al-Subu, Mohammed M; Kassinos, Despo

2010-05-01

This study investigated the dental waste management practices and safety measures implemented by dentists in the Nablus district, Palestine. A comprehensive survey was conducted for 97 of the 134 dental clinics to assess the current situation. Focus was placed on hazardous waste produced by clinics and the handling, storage, treatment and disposal measures taken. Mercury, found in dental amalgam, is one of the most problematic hazardous waste. The findings revealed that there is no proper separation of dental waste by classification as demanded by the World Health Organization. Furthermore, medical waste is often mixed with general waste during production, collection and disposal. The final disposal of waste ends up in open dumping sites sometimes close to communities where the waste is burned. Correct management and safety procedures that could be effectively implemented in developing countries were examined. It was concluded that cooperation between dental associations, government-related ministries and authorities needs to be established, to enhance dental waste management and provide training and capacity building programs for all professionals in the medical waste management field.

Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

PubMed

Stab, Nicole; Hacker, Winfried

2018-05-01

The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.

Implementation of Hepatitis Information Management System in Iran.

PubMed

Reza, Safdari; Jebraeil, Farzi; Akbar, Nasiri Ali; Marjan, Ghazisaeedi; Reza, Taghavi Mohammad; Mehdi, Afshari; Mahlagha, Sargolzaee; Farhad, Taji

2015-11-17

Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes. Thus, this study addressed challenges of hepatitis information management and investigated the outcomes of establishing a hepatitis information management system to overcome such challenges. To this end, this research intended to study the implementation of an Electronic hepatitis information management system. This is an applied-developmental study with following specifications and procedures: preparation of study proposal and design, justification of the design's stakeholders, approval of the design by the Postgraduate Education Council of Faculty, determination of pilot hepatitis control center, software development, deciding on control, prevention, and treatment centers, and finally development of a network-based system for collecting and managing hepatitis information. Results indicated that the inconsistency and lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. This inhibited the possibility of considering a follow-up process. However, the implementation of this system and involvement of relevant units greatly solved these problems. Results show that the implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients' conditions. That mentioned system paves the way for the analysis of gathered information, managers' and specialists' access in different regions to the data for making appropriate and accurate decisions.

[Implementation of a rational standard of hygiene for preparation of operating rooms].

PubMed

Bauer, M; Scheithauer, S; Moerer, O; Pütz, H; Sliwa, B; Schmidt, C E; Russo, S G; Waeschle, R M

2015-10-01

The assurance of high standards of care is a major requirement in German hospitals while cost reduction and efficient use of resources are mandatory. These requirements are particularly evident in the high-risk and cost-intensive operating theatre field with multiple process steps. The cleaning of operating rooms (OR) between surgical procedures is of major relevance for patient safety and requires time and human resources. The hygiene procedure plan for OR cleaning between operations at the university hospital in Göttingen was revised and optimized according to the plan-do-check-act principle due to not clearly defined specifications of responsibilities, use of resources, prolonged process times and increased staff engagement. The current status was evaluated in 2012 as part of the first step "plan". The subsequent step "do" included an expert symposium with external consultants, interdisciplinary consensus conferences with an actualization of the former hygiene procedure plan and the implementation process. All staff members involved were integrated into this management change process. The penetration rate of the training and information measures as well as the acceptance and compliance with the new hygiene procedure plan were reviewed within step "check". The rates of positive swabs and air sampling as well as of postoperative wound infections were analyzed for quality control and no evidence for a reduced effectiveness of the new hygiene plan was found. After the successful implementation of these measures the next improvement cycle ("act") was performed in 2014 which led to a simplification of the hygiene plan by reduction of the number of defined cleaning and disinfection programs for preparation of the OR. The reorganization measures described led to a comprehensive commitment of the hygiene procedure plan by distinct specifications for responsibilities, for the course of action and for the use of resources. Furthermore, a simplification of the plan, a rational staff assignment and reduced process times were accomplished. Finally, potential conflicts due to an insufficient evidence-based knowledge of personnel was reduced. This present project description can be used by other hospitals as a guideline for similar changes in management processes.

Profile negotiation: An air/ground automation integration concept for managing arrival traffic

NASA Technical Reports Server (NTRS)

Williams, David H.; Arbuckle, P. Douglas; Green, Steven M.; Denbraven, Wim

1993-01-01

NASA Ames Research Center and NASA Langley Research Center conducted a joint simulation study to evaluate a profile negotiation process (PNP) between a time-based air traffic control ATC system and an airplane equipped with a four dimensional flight management system (4D FMS). Prototype procedures were developed to support the functional implementation of this process. The PNP was designed to provide an arrival trajectory solution that satisfies the separation requirements of ATC while remaining as close as possible to the airplane's preferred trajectory. The Transport Systems Research Vehicle cockpit simulator was linked in real-time to the Center/TRACON Automation System (CTAS) for the experiment. Approximately 30 hours of simulation testing were conducted over a three week period. Active airline pilot crews and active Center controller teams participated as test subjects. Results from the experiment indicate the potential for successful incorporation of airplane preferred arrival trajectories in the CTAS automation environment. Controllers were able to consistently and effectively negotiate nominally conflict-free trajectories with pilots flying a 4D-FMS-equipped airplane. The negotiated trajectories were substantially closer to the airplane's preference than would have otherwise been possible without the PNP. Airplane fuel savings relative to baseline CTAS were achieved in the test scenarios. The datalink procedures and clearances developed for this experiment, while providing the necessary functionality, were found to be operationally unacceptable to the pilots. Additional pilot control and understanding of the proposed airplane-preferred trajectory and a simplified clearance procedure were cited as necessary for operational implementation of the concept. From the controllers' perspective, the main concerns were the ability of the 4D airplane to accurately track the negotiated trajectory and the workload required to support the PNP as implemented in this study.

NASA Risk Management Handbook. Version 1.0

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Maggio, Gaspare; Stamatelatos, Michael; Youngblood, Robert; Guarro, Sergio; Rutledge, Peter; Sherrard, James; Smith, Curtis;

Examining the implementation of NICE guidance: cross-sectional survey of the use of NICE interventional procedures guidance by NHS Trusts.

PubMed

Lowson, Karin; Jenks, Michelle; Filby, Alexandra; Carr, Louise; Campbell, Bruce; Powell, John

2015-06-30

In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was therefore designed to examine the dissemination, decision-making, and monitoring processes for NICE interventional procedures (IP) guidance and to investigate the barriers and enablers to the implementation of such guidance. A cross-sectional survey questionnaire was developed and distributed to individuals responsible for managing the processes around NICE guidance in all 181 acute NHS hospitals in England, Scotland, Wales and Northern Ireland. A review of acute NHS hospital policies for implementing NICE guidance was also undertaken using information available in the public domain and from organisations' websites. The response rate to the survey was 75 % with 135 completed surveys received. Additionally, policies from 25 % of acute NHS hospitals were identified and analysed. NHS acute hospitals typically had detailed processes in place to implement NICE guidance, although organisations recognised barriers to implementation including organisational process barriers, clinical engagement and poor targeting with a large number of guidance issued. Examples of enablers to, and good practice for, implementation of guidance were found, most notably the value of shared learning experiences between NHS hospitals. Implications for NICE were also identified. These included making improvements to the layout of guidance, signposting on the website and making better use of their shared learning platform. Most organisations have robust processes in place to deal with implementing guidance. However, resource limitations and the scope of guidance received by organisations create barriers relating to organisational processes, clinician engagement and financing of new procedures. Guidance implementation can be facilitated through encouragement of shared learning by organisations such as NICE and open knowledge transfer between organisations.

Fluor Daniel Hanford Inc. integrated safety management system phase 1 verification final report

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

PARSONS, J.E.

1999-10-28

The purpose of this review is to verify the adequacy of documentation as submitted to the Approval Authority by Fluor Daniel Hanford, Inc. (FDH). This review is not only a review of the Integrated Safety Management System (ISMS) System Description documentation, but is also a review of the procedures, policies, and manuals of practice used to implement safety management in an environment of organizational restructuring. The FDH ISMS should support the Hanford Strategic Plan (DOE-RL 1996) to safely clean up and manage the site's legacy waste; deploy science and technology while incorporating the ISMS theme to ''Do work safely''; andmore » protect human health and the environment.« less

Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

PubMed

Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja

2018-03-16

The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources. The study is registered in the Clinical Trials.gov ( NCT02545257 ). Registration date September 9 2015.

34 CFR 300.150 - SEA implementation of procedural safeguards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false SEA implementation of procedural safeguards. 300.150... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Sea Responsibility for General Supervision and Implementation of Procedural Safeguards § 300.150 SEA implementation of procedural safeguards. The SEA (and any...

34 CFR 300.150 - SEA implementation of procedural safeguards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false SEA implementation of procedural safeguards. 300.150... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Sea Responsibility for General Supervision and Implementation of Procedural Safeguards § 300.150 SEA implementation of procedural safeguards. The SEA (and any...

34 CFR 300.150 - SEA implementation of procedural safeguards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true SEA implementation of procedural safeguards. 300.150... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Sea Responsibility for General Supervision and Implementation of Procedural Safeguards § 300.150 SEA implementation of procedural safeguards. The SEA (and any...

34 CFR 300.150 - SEA implementation of procedural safeguards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true SEA implementation of procedural safeguards. 300.150... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Sea Responsibility for General Supervision and Implementation of Procedural Safeguards § 300.150 SEA implementation of procedural safeguards. The SEA (and any...

34 CFR 300.150 - SEA implementation of procedural safeguards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false SEA implementation of procedural safeguards. 300.150... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Sea Responsibility for General Supervision and Implementation of Procedural Safeguards § 300.150 SEA implementation of procedural safeguards. The SEA (and any...

Implementing AORN recommended practices for medication safety.

PubMed

Hicks, Rodney W; Wanzer, Linda J; Denholm, Bonnie

2012-12-01

Medication errors in the perioperative setting can result in patient morbidity and mortality. The AORN "Recommended practices for medication safety" provide guidance to perioperative nurses in developing, implementing, and evaluating safe medication use practices. These practices include recognizing risk points in the medication use process, collaborating with pharmacy staff members, conducting preoperative assessments and postoperative evaluations (eg, medication reconciliation), and handling hazardous medications and pharmaceutical waste. Strategies for successful implementation of the recommended practices include promoting a basic understanding of the nurse's role in the medication use process and developing a medication management plan as well as policies and procedures that support medication safety and activities to measure compliance with safe practices. Published by Elsevier Inc.

Standard operating procedure changed pre-hospital critical care anaesthesiologists’ behaviour: a quality control study

PubMed Central

2013-01-01

Introduction The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists’ behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region prospectively registered pre-hospital advanced airway-management data according to the Utstein-style template. We collected pre-intervention data from February 1st 2011 to January 31st 2012, implemented the standard operating procedure on February 1st 2012 and collected post intervention data from February 1st 2012 until October 31st 2012. We included transported patients of all ages in need of controlled ventilation treated with pre-hospital endotracheal intubation or the insertion of a supraglottic airways device. The objective was to evaluate whether the development and implementation of a standard operating procedure for controlled ventilation during transport could change pre-hospital critical care anaesthesiologists’ behaviour and thereby increase the use of automated ventilators in these patients. Results The implementation of a standard operating procedure increased the overall prevalence of automated ventilator use in transported patients in need of controlled ventilation from 0.40 (0.34-0.47) to 0.74 (0.69-0.80) with a prevalence ratio of 1.85 (1.57-2.19) (p = 0.00). The prevalence of automated ventilator use in transported traumatic brain injury patients in need of controlled ventilation increased from 0.44 (0.26-0.62) to 0.85 (0.62-0.97) with a prevalence ratio of 1.94 (1.26-3.0) (p = 0.0039). The prevalence of automated ventilator use in patients transported after return of spontaneous circulation following pre-hospital cardiac arrest increased from 0.39 (0.26-0.48) to 0.69 (0.58-0.78) with a prevalence ratio of 1.79 (1.36-2.35) (p = 0.00). Conclusion We have shown that the implementation of a standard operating procedure for pre-hospital controlled ventilation can significantly change pre-hospital critical care anaesthesiologists’ behaviour. PMID:24308781

Global Forum: An International Perspective on Outpatient Surgical Procedures for Adult Hip and Knee Reconstruction.

PubMed

Argenson, Jean-Noël A; Husted, Henrik; Lombardi, Adolph; Booth, Robert E; Thienpont, Emmanuel

2016-07-06

Outpatient surgical procedures for adult hip and knee reconstruction are gaining interest on a worldwide basis and have been progressively increasing over the last few years. Preoperative screening needs to concentrate on both the patient's comorbidities and home environment to provide a proper alignment of expectations of the surgeon, the patient, and the patient's family. Preoperative multidisciplinary patient information covering all aspects of the upcoming treatment course is a mandatory step, focusing on pain management and early mobilization. Perioperative pain management includes both multimodal and preventive analgesia. Preemptive medications, minimization of narcotics, and combination of general and regional anesthesia are the techniques required in joint arthroplasty performed as an outpatient surgical procedure. A multimodal blood loss management program should be used with preoperative identification of anemia and attention directed toward minimizing blood loss, considering the use of tranexamic acid during the surgical procedure. Postoperative care extends from the initial recovery from anesthesia to the physical therapist's evaluation of the patient's ambulatory status. After the patient has met the criteria for discharge and has been discharged on the same day of the surgical procedure, a nurse should call the patient later at home to check on wound status, pain control, and muscle weakness, which will be further addressed by physiotherapy and education. Implementing outpatient arthroplasty requires monitoring safety, patient satisfaction, and economic impact. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

mREST Interface Specification

NASA Technical Reports Server (NTRS)

McCartney, Patrick; MacLean, John

2012-01-01

mREST is an implementation of the REST architecture specific to the management and sharing of data in a system of logical elements. The purpose of this document is to clearly define the mREST interface protocol. The interface protocol covers all of the interaction between mREST clients and mREST servers. System-level requirements are not specifically addressed. In an mREST system, there are typically some backend interfaces between a Logical System Element (LSE) and the associated hardware/software system. For example, a network camera LSE would have a backend interface to the camera itself. These interfaces are specific to each type of LSE and are not covered in this document. There are also frontend interfaces that may exist in certain mREST manager applications. For example, an electronic procedure execution application may have a specialized interface for configuring the procedures. This interface would be application specific and outside of this document scope. mREST is intended to be a generic protocol which can be used in a wide variety of applications. A few scenarios are discussed to provide additional clarity but, in general, application-specific implementations of mREST are not specifically addressed. In short, this document is intended to provide all of the information necessary for an application developer to create mREST interface agents. This includes both mREST clients (mREST manager applications) and mREST servers (logical system elements, or LSEs).

Medical Data Management in Time-Sharing: Findings of the DIRAC Project.

ERIC Educational Resources Information Center

Ludwig, Herbert; Vallee, Jacques

In terms of examples drawn from clinical and research data files, one of the objectives of this study is to illustrate several factors that have combined to delay the implementation of medical data bases. A primary factor has been inherent in the design of computer software. The languages currently on the market are procedural in nature: they…

29 CFR 1420.9 - FMCS deferral to parties' own private interest arbitration procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... regulations are a part of the Service's overall approach to implementing the health care amendments of 1974 in... to be flexible and to tailor its approach so as to accommodate the needs of the parties in the..., both unions and management, to take advantage of these and other options and to work with the Service...

29 CFR 1420.9 - FMCS deferral to parties' own private interest arbitration procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulations are a part of the Service's overall approach to implementing the health care amendments of 1974 in... to be flexible and to tailor its approach so as to accommodate the needs of the parties in the..., both unions and management, to take advantage of these and other options and to work with the Service...

Management and Treatment of Attention-Deficit/Hyperactivity Disorder on College Campuses.

PubMed

Amyx, Megan Lee; Hastings, Kylie Brooke; Reynolds, Elizabeth J; Weakley, Julie Ann; Dinkel, Shirley; Patzel, Brenda

2015-11-01

Attention-deficit/hyperactivity disorder (ADHD) on college campuses is a serious and often underdiagnosed condition. The current investigation analyzed current best practice guidelines for the management of ADHD in a mid-sized university in the Midwestern United States. Best practices were identified through a review of current evidence-based literature on ADHD management. A data collection tool was developed and used to organize data and determine adherence with best practice guidelines. Investigators revealed that policy and procedures followed best practice guidelines. Development and implementation of ADHD protocols on college campuses allows nurse practitioners to confidently provide safe, quality care to patients diagnosed with ADHD. Copyright 2015, SLACK Incorporated.

Classification and rates of adverse events in a Malawi male circumcision program: impact of quality improvement training.

PubMed

Kohler, Pamela K; Namate, Dorothy; Barnhart, Scott; Chimbwandira, Frank; Tippet-Barr, Beth A; Perdue, Tom; Chilongozi, David A; Tenthani, Lyson; Phiri, Oliver; Msungama, Wezi; Holmes, King K; Krieger, John N

2016-02-17

Assessing safety outcomes is critical to inform optimal scale-up of voluntary medical male circumcision (VMMC) programs. Clinical trials demonstrated adverse event (AE) rates from 1.5 to 8 %, but we have limited data on AEs from VMMC programs. A group problem-solving, quality improvement (QI) project involving retrospective chart audits, case-conference AE classification, and provider training was conducted at a VMMC clinic in Malawi. For each identified potential AE, the timing, assessment, treatment, and resolution was recorded, then a clinical team classified each event for type and severity. During group discussions, VMMC providers were queried regarding lessons learned and challenges in providing care. After baseline evaluation, clinicians and managers initiated a QI plan to improve AE assessment and management. A repeat audit 6 months later used similar methods to assess the proportions and severity of AEs after the QI intervention. Baseline audits of 3000 charts identified 418 possible AEs (13.9 %), including 152 (5.1 %) excluded after determination of provider misclassification. Of the 266 remaining AEs, the team concluded that 257 were procedure-related (8.6 AEs per 100 VMMC procedures), including 6 (0.2 %) classified as mild, 218 (7.3 %) moderate, and 33 (1.1 %) severe. Structural factors found to contribute to AE rates and misclassification included: provider management of post-operative inflammation was consistent with national guidelines for urethral discharge; available antibiotics were from the STI formulary; providers felt well-trained in surgical skills but insecure in post-operative assessment and care. After implementation of the QI plan, a repeat process evaluating 2540 cases identified 115 procedure-related AEs (4.5 AEs per 100 VMMC procedures), including 67 (2.6 %) classified as mild, 28 (1.1 %) moderate, and 20 (0.8 %) severe. Reports of AEs decreased by 48 % (from 8.6 to 4.5 per 100 VMMC procedures, p < 0.001). Reports of moderate-plus-severe (program-reportable) AEs decreased by 75 % (from 8.4 to 1.9 per 100 VMMC procedures, p < 0.001). AE rates from our VMMC program implementation site were within the range of clinical trial experiences. A group problem-solving QI intervention improved post-operative assessment, clinical management, and AE reporting. Our QI process significantly improved clinical outcomes and led to more accurate reporting of overall and program-reportable AEs.

Continued implementation and testing of a Neighborhood Office Center (NOC) and integration of the NOC with an administrative correspondence management information system

NASA Technical Reports Server (NTRS)

1978-01-01

The concept of decentralized (remote) neighborhood offices, linked together through a self-sustaining communications network for exchanging voice messages, video images, and digital data was quantitatively evaluated. Hardware and procedures for the integrated multifunctional system were developed. The configuration of the neighborhood office center (NOC) is explained, its production statistics given, and an experiment for NOC network integration via satellite is described. The hardware selected for the integration NOC/management information system is discussed, and the NASA teleconferencing network is evaluated.

Interactive Management and Updating of Spatial Data Bases

NASA Technical Reports Server (NTRS)

French, P.; Taylor, M.

1982-01-01

The decision making process, whether for power plant siting, load forecasting or energy resource planning, invariably involves a blend of analytical methods and judgement. Management decisions can be improved by the implementation of techniques which permit an increased comprehension of results from analytical models. Even where analytical procedures are not required, decisions can be aided by improving the methods used to examine spatially and temporally variant data. How the use of computer aided planning (CAP) programs and the selection of a predominant data structure, can improve the decision making process is discussed.

Sheep (Ovis aries) as a Model for Cardiovascular Surgery and Management before, during, and after Cardiopulmonary Bypass

PubMed Central

DiVincenti, Louis; Westcott, Robin; Lee, Candice

2014-01-01

Because of its similarity to humans in important respects, sheep (Ovis aries) are a common animal model for translational research in cardiovascular surgery. However, some unique aspects of sheep anatomy and physiology present challenges to its use in these complicated experiments. In this review, we discuss relevant anatomy and physiology of sheep and discuss management before, during, and after procedures requiring cardiopulmonary bypass to provide a concise source of information for veterinarians, technicians, and researchers developing and implementing protocols with this model. PMID:25255065

International interface design for Space Station Freedom - Challenges and solutions

NASA Technical Reports Server (NTRS)

Mayo, Richard E.; Bolton, Gordon R.; Laurini, Daniele

1988-01-01

The definition of interfaces for the International Space Station is discussed, with a focus on negotiations between NASA and ESA. The program organization and division of responsibilities for the Space Station are outlined; the basic features of physical and functional interfaces are described; and particular attention is given to the interface management and documentation procedures, architectural control elements, interface implementation and verification, and examples of Columbus interface solutions (including mechanical, ECLSS, thermal-control, electrical, data-management, standardized user, and software interfaces). Diagrams, drawings, graphs, and tables listing interface types are provided.

A Lean Six Sigma journey in radiology.

PubMed

Bucci, Ronald V; Musitano, Anne

2011-01-01

The department of radiology at Akron Children's Hospital embarked on a Lean Six Sigma mission as part of a hospital wide initiative to show increased customer satisfaction, reduce employee dissatisfaction and frustration, and decrease costs. Three processes that were addressed were reducing the MRI scheduling back-log, reconciling discrepancies in billing radiology procedures, and implementing a daily management system. Keys to success is that managers provide opportunities to openly communicate between department sections to break down barriers. Executive leaders must be engaged in Lean Six Sigma for the company to be successful.

Discussion series on PURPA related topics: load management

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

Sturgeon, J I

The Discussion Series on PURPA Related Topics is composed of five volumes: Metering, Billing, Information to Customers, Load Management Techniques and Master Metering. These reports are based on twenty-five Demonstration and Implementation projects sponsored and directed during the past five years by the US Department of Energy, Office of Utility Systems. Each of the topics bears directly on one or more of the federal standards contained in the Public Utilities Regulatory Policies Act of 1978 (PURPA). This volume, Load Management Techniques, relates primarily to the Time-of-Day rates standard, PURPA IB(d)3. The experiences related in this report deal, in part, withmore » the procedures and equipment which are affected when time-of-day rates are implemented. One goal of this report is to describe how people in a variety of settings have dealt with the many practical issues in load management. Another is to highlight the lessons and summarize the experiences of the Project participants. This report does not stand as a manual nor provide prescriptive guidelines on how to deal with the topic. Rather it offers an account for those charged with the responsibility of implementing PURPA requirements to learn from the insights and problems which occurred during the Rate Demonstration projects.« less

Operational Implementation of Space Debris Mitigation Procedures

NASA Astrophysics Data System (ADS)

Gicquel, Anne-Helene; Bonaventure, Francois

2013-08-01

During the spacecraft lifetime, Astrium supports its customers to manage collision risks alerts from the Joint Space Operations Center (JSpOC). This was previously done with hot-line support and a manual operational procedure. Today, it is automated and integrated in QUARTZ, the Astrium Flight Dynamics operational tool. The algorithms and process details for this new 5- step functionality are provided in this paper. To improve this functionality, some R&D activities such as the study of dilution phenomenon and low relative velocity encounters are going on. Regarding end of life disposal, recent operational experiences as well as studies results are presented.

NASA's post-Challenger safety program - Themes and thrusts

NASA Technical Reports Server (NTRS)

Rodney, G. A.

1988-01-01

The range of managerial, technical, and procedural initiatives implemented by NASA's post-Challenger safety program is reviewed. The recommendations made by the Rogers Commission, the NASA post-Challenger review of Shuttle design, the Congressional investigation of the accident, the National Research Council, the Aerospace Safety Advisory Panel, and NASA internal advisory panels and studies are summarized. NASA safety initiatives regarding improved organizational accountability for safety, upgraded analytical techniques and methodologies for risk assessment and management, procedural initiatives in problem reporting and corrective-action tracking, ground processing, maintenance documentation, and improved technologies are discussed. Safety issues relevant to the planned Space Station are examined.

Duties and functions of veterinary public health for the management of food safety: present needs and evaluation of efficiency.

PubMed

Trevisani, M; Rosmini, R

2008-09-01

Functions of veterinarians in the context of food safety assurance have changed very much in the last ten years as a consequence of new legislation. The aim of this review is to evaluate the management tools in veterinary public health that shall be used in response to the actual need and consider some possible key performance indicators. This review involved an examination of the legislation, guidelines and literature, which was then discussed to analyse the actual need, the strategies and the procedures with which the public veterinary service shall comply. The management of information gathered at different stages of the food chain, from both food production operators and veterinary inspectors operating in primary production, food processing and feed production should be exchanged and integrated in a database, not only to produce annual reports and plan national sampling plans, but also to verify and validate the effectiveness of procedures and strategies implemented by food safety operators to control risks. Further, the surveillance data from environmental agencies and human epidemiological units should be used for assessing risks and addressing management options.

Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

PubMed

1992-01-01

In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

The associations between organizational culture, organizational structure and quality management in European hospitals

PubMed Central

Wagner, C.; Mannion, R.; Hammer, A.; Groene, O.; Arah, O.A.; Dersarkissian, M.; Suñol, R.

2014-01-01

Objective To better understand associations between organizational culture (OC), organizational management structure (OS) and quality management in hospitals. Design A multi-method, multi-level, cross-sectional observational study. Setting and participants As part of the DUQuE project (Deepening our Understanding of Quality improvement in Europe), a random sample of 188 hospitals in 7 countries (France, Poland, Turkey, Portugal, Spain, Germany and Czech Republic) participated in a comprehensive questionnaire survey and a one-day on-site surveyor audit. Respondents for this study (n = 158) included professional quality managers and hospital trustees. Main outcome measures Extent of implementation of quality management systems, extent of compliance with existing management procedures and implementation of clinical quality activities. Results Among participating hospitals, 33% had a clan culture as their dominant culture type, 26% an open and developmental culture type, 16% a hierarchical culture type and 25% a rational culture type. The culture type had no statistically significant association with the outcome measures. Some structural characteristics were associated with the development of quality management systems. Conclusion The type of OC was not associated with the development of quality management in hospitals. Other factors (not culture type) are associated with the development of quality management. An OS that uses fewer protocols is associated with a less developed quality management system, whereas an OS which supports innovation in care is associated with a more developed quality management system. PMID:24671119

The associations between organizational culture, organizational structure and quality management in European hospitals.

PubMed

Wagner, C; Mannion, R; Hammer, A; Groene, O; Arah, O A; Dersarkissian, M; Suñol, R

2014-04-01

To better understand associations between organizational culture (OC), organizational management structure (OS) and quality management in hospitals. A multi-method, multi-level, cross-sectional observational study. As part of the DUQuE project (Deepening our Understanding of Quality improvement in Europe), a random sample of 188 hospitals in 7 countries (France, Poland, Turkey, Portugal, Spain, Germany and Czech Republic) participated in a comprehensive questionnaire survey and a one-day on-site surveyor audit. Respondents for this study (n = 158) included professional quality managers and hospital trustees. Extent of implementation of quality management systems, extent of compliance with existing management procedures and implementation of clinical quality activities. Among participating hospitals, 33% had a clan culture as their dominant culture type, 26% an open and developmental culture type, 16% a hierarchical culture type and 25% a rational culture type. The culture type had no statistically significant association with the outcome measures. Some structural characteristics were associated with the development of quality management systems. The type of OC was not associated with the development of quality management in hospitals. Other factors (not culture type) are associated with the development of quality management. An OS that uses fewer protocols is associated with a less developed quality management system, whereas an OS which supports innovation in care is associated with a more developed quality management system.

[Quality management in acute pain therapy: results from a survey of certified hospitals].

PubMed

Böhmer, A B; Poels, M; Simanski, C; Trojan, S; Messer, K; Wirtz, M D; Neugebauer, E A M; Wappler, F; Joppich, R

2012-08-01

Systems for and methods of quality management are increasingly being implemented in public health services. The aim of our study was to analyze the current state of the integrated quality management concept "quality management acute pain therapy" of the TÜV Rheinland® (TÜV) after a 5-year project period. General characteristics of the participating hospitals, number of departments certified by the TÜV and implementation of structures and processes according to the TÜV guidelines were evaluated by a mail questionnaire. Furthermore, positive and negative aspects concerning the effects of certification were evaluated by the hospitals' representatives of certification. A total of 36 questionnaires were returned. Since 2006 the number of certified hospitals (2011: n = 48) and surgical departments (2011: n = 202) has increased continuously. The number of certified medical departments is low (2011: n = 39); however, in the last 3 years, it has increased by about 200-300% annually. Standard operative procedures for pain therapy and measurement of pain intensity at regular intervals were implemented in all certified clinics (100%). Although 41% take part in the benchmarking project QUIPS (Quality Improvement in Postoperative Pain Therapy), 24% do not systematically check the quality of the outcome of pain management. Acceptance of the new pain therapy concepts among nursing staff was rated positively (ratio positive:negative 16:1); however, acceptance among physicians was rated negatively (1:15). Certification by the TÜV leads to sustainable implementation of quality management principles. Future efforts should focus on better integration of physicians in acute pain therapy and the development of an integrated tool to measure patients' outcome.

Implementing sustainable drainage systems for urban surface water management within the regulatory framework in England and Wales.

PubMed

Ellis, J Bryan; Lundy, Lian

2016-12-01

The UK 2007 floods resulted in damages estimated to exceed over £4 billion. This triggered a national review of strategic flood risk management (Pitt, 2008) with its recommendations informing and implemented by the Flood and Water Management, Act (FWMA, 2010). Estimating that up to two-thirds of properties flooded in the 2007 event as a direct result of overloaded sewer systems, the FWMA set out an ambitious overhaul of flood risk management approaches including identifying bodies responsible for the management of local flood risk (local municipalities) and the development of over-arching Lead Local Flood Authorities (LLFAs) at a regional level. LLFAs duties include developing local flood risk management strategies and, aligned with this, many LLFAs and local municipalities produced sustainable drainage system (SUDS) guidance notes. In parallel, changes to the national planning policy framework (NPPF) in England give priority to the use of SUDS in new major developments, as does the related Town and Country Planning Order (2015). However, whilst all three pieces of legislation refer to the preferential use of SUDs, these requirements remain "economically proportionate" and thus the inclusion of SUDS within development controls remain desirable - but not mandatory - obligations. Within this dynamic policy context, reignited most recently by the December 2015 floods, this paper examines some of the challenges to the implementation of SUDS in England and Wales posed by the new regulatory frameworks. In particular, it examines how emerging organisational procedures and processes are likely to impact on future SUDS implementation, and highlights the need for further cross-sectoral working to ensure opportunities for cross-sectoral benefits- such as that accrued by reducing stormwater flows within combined sewer systems for water companies, property developers and environmental protection - are not lost. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implementation of Hepatitis Information Management System in Iran

PubMed Central

Reza, Safdari; Jebraeil, Farzi; Akbar, Nasiri Ali; Marjan, Ghazisaeedi; Reza, Taghavi Mohammad; Mehdi, Afshari; Mahlagha, Sargolzaee; Farhad, Taji

2016-01-01

Introduction: Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes. Thus, this study addressed challenges of hepatitis information management and investigated the outcomes of establishing a hepatitis information management system to overcome such challenges. To this end, this research intended to study the implementation of an Electronic hepatitis information management system. Methodology: This is an applied-developmental study with following specifications and procedures: preparation of study proposal and design, justification of the design’s stakeholders, approval of the design by the Postgraduate Education Council of Faculty, determination of pilot hepatitis control center, software development, deciding on control, prevention, and treatment centers, and finally development of a network-based system for collecting and managing hepatitis information. Findings: Results indicated that the inconsistency and lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. This inhibited the possibility of considering a follow-up process. However, the implementation of this system and involvement of relevant units greatly solved these problems. Conclusion: Results show that the implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions. That mentioned system paves the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions. PMID:26755478

GCS plan for software aspects of certification

NASA Technical Reports Server (NTRS)

Shagnea, Anita M.; Lowman, Douglas S.; Withers, B. Edward

1990-01-01

As part of the Guidance and Control Software (GCS) research project being sponsored by NASA to evaluate the failure processes of software, standard industry software development procedures are being employed. To ensure that these procedures are authentic, the guidelines outlined in the Radio Technical Commission for Aeronautics (RTCA/DO-178A document entitled, software considerations in airborne systems and equipment certification, were adopted. A major aspect of these guidelines is proper documentation. As such, this report, the plan for software aspects of certification, was produced in accordance with DO-178A. An overview is given of the GCS research project, including the goals of the project, project organization, and project schedules. It also specifies the plans for all aspects of the project which relate to the certification of the GCS implementations developed under a NASA contract. These plans include decisions made regarding the software specification, accuracy requirements, configuration management, implementation development and verification, and the development of the GCS simulator.

Man-rated flight software for the F-8 DFBW program

NASA Technical Reports Server (NTRS)

Bairnsfather, R. R.

1975-01-01

The design, implementation, and verification of the flight control software used in the F-8 DFBW program are discussed. Since the DFBW utilizes an Apollo computer and hardware, the procedures, controls, and basic management techniques employed are based on those developed for the Apollo software system. Program Assembly Control, simulator configuration control, erasable-memory load generation, change procedures and anomaly reporting are discussed. The primary verification tools--the all-digital simulator, the hybrid simulator, and the Iron Bird simulator--are described, as well as the program test plans and their implementation on the various simulators. Failure-effects analysis and the creation of special failure-generating software for testing purposes are described. The quality of the end product is evidenced by the F-8 DFBW flight test program in which 42 flights, totaling 58 hours of flight time, were successfully made without any DFCS inflight software, or hardware, failures.

Contractor and government - Teamwork and commitment

NASA Technical Reports Server (NTRS)

Griffin, G. D.

1985-01-01

Procedures being implemented at NASA to improve cooperation with contractors and increase productivity are reviewed from the NASA point of view. The goals of the U.S. space program for the coming 25 years are listed, and the importance of the commercial utilization of space in these plans is stressed. Consideration is given to the ongoing American Productivity Center White-Collar Productivity-Improvement Project, the implementation of the recommendations of the 1984 NASA/Contractor Conferences in present and future contracts, and the use of incentive contracts to create situations in which both NASA and the contractor benefit from increased productivity. Future plans call for increased industry responsibility in managing and operating the STS; steamlining of Shuttle operations; advanced design-to-cost procedures, increased commonality, better NASA-contractor communications, and more use of CAD/CAM and robotics for the Space Station; and accommodation of greatly expanded private investment and exploitation of space.

Procedural Challenges In International Collaborative Research

PubMed Central

Loo, Kek Khee

2009-01-01

There is tremendous promise for a rewarding experience in an international research project due to the collaboration, mutual learning and cultural bridging that intrinsically occur. However, knowledge of the procedural requirements for international research is not widely disseminated to investigators who may not have been involved in the administration of a federal grant with a foreign component. The purpose of this article is to highlight the major challenges in administrative, procedural and equipment management aspects of grant implementation when federal funding is involved in international collaborative research. It is hoped that awareness of these difficulties and demystification of the process for future investigators can minimize the potential encumbrances in a rewarding journey towards realizing the scientific goals in an international collaborative research project. PMID:19574522

A collaborative interdisciplinary approach to electronic fetal monitoring: report of a statewide initiative.

PubMed

Miller, Lisa A; Miller, David A

2013-01-01

Intrapartum electronic fetal monitoring (EFM) is one of the most common procedures in obstetrics. Current consensus statements provide clinicians with a common language for EFM as well as provide a basis for a simplified approach to interpretation and management. This article presents a summary of the content and implementation of a statewide initiative in interdisciplinary EFM education and training designed to give clinicians of all backgrounds a shared mental model in EFM. Challenges to implementation at individual institutions may include physician and nursing engagement as well as time and cost constraints.

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

Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.

The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less

Fall Prevention for Older Adults Receiving Home Healthcare.

PubMed

Bamgbade, Sarah; Dearmon, Valorie

2016-02-01

Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

The role of risk perception in making flood risk management more effective

NASA Astrophysics Data System (ADS)

Buchecker, M.; Salvini, G.; Di Baldassarre, G.; Semenzin, E.; Maidl, E.; Marcomini, A.

2013-11-01

Over the last few decades, Europe has suffered from a number of severe flood events and, as a result, there has been a growing interest in probing alternative approaches to managing flood risk via prevention measures. A literature review reveals that, although in the last decades risk evaluation has been recognized as key element of risk management, and risk assessment methodologies (including risk analysis and evaluation) have been improved by including social, economic, cultural, historical and political conditions, the theoretical schemes are not yet applied in practice. One main reason for this shortcoming is that risk perception literature is mainly of universal and theoretical nature and cannot provide the necessary details to implement a comprehensive risk evaluation. This paper therefore aims to explore a procedure that allows the inclusion of stakeholders' perceptions of prevention measures in risk assessment. It proposes to adopt methods of risk communication (both one-way and two-way communication) in risk assessment with the final aim of making flood risk management more effective. The proposed procedure not only focuses on the effect of discursive risk communication on risk perception, and on achieving a shared assessment of the prevention alternatives, but also considers the effects of the communication process on perceived uncertainties, accepted risk levels, and trust in the managing institutions. The effectiveness of this combined procedure has been studied and illustrated using the example of the participatory flood prevention assessment process on the Sihl River in Zurich, Switzerland. The main findings of the case study suggest that the proposed procedure performed well, but that it needs some adaptations for it to be applicable in different contexts and to allow a (semi-) quantitative estimation of risk perception to be used as an indicator of adaptive capacity.

A multinational, multidisciplinary consensus for the diagnosis and management of spinal cord compression among patients with mucopolysaccharidosis VI.

PubMed

Solanki, Guirish A; Alden, Tord D; Burton, Barbara K; Giugliani, Roberto; Horovitz, Dafne D G; Jones, Simon A; Lampe, Christina; Martin, Kenneth W; Ryan, Maura E; Schaefer, Matthias K; Siddiqui, Aisha; White, Klane K; Harmatz, Paul

2012-09-01

Cervical cord compression is a sequela of mucopolysaccharidosis VI, a rare lysosomal storage disorder, and has devastating consequences. An international panel of orthopedic surgeons, neurosurgeons, anesthesiologists, neuroradiologists, metabolic pediatricians, and geneticists pooled their clinical expertise to codify recommendations for diagnosing, monitoring, and managing cervical cord compression; for surgical intervention criteria; and for best airway management practices during imaging or anesthesia. The recommendations offer ideal best practices but also attempt to recognize the worldwide spectrum of resource availability. Functional assessments and clinical neurological examinations remain the cornerstone for identification of early signs of myelopathy, but magnetic resonance imaging is the gold standard for identification of cervical cord compression. Difficult airways of MPS VI patients complicate the anesthetic and, thus, the surgical management of cervical cord compression. All patients with MPS VI require expert airway management during any surgical procedure. Neurophysiological monitoring of the MPS VI patient during complex spine or head and neck surgery is considered standard practice but should also be considered for other procedures performed with the patient under general anesthesia, depending on the length and type of the procedure. Surgical interventions may include cervical decompression, stabilization, or both. Specific techniques vary widely among surgeons. The onset, presentation, and rate of progression of cervical cord compression vary among patients with MPS VI. The availability of medical resources, the expertise and experience of members of the treatment team, and the standard treatment practices vary among centers of expertise. Referral to specialized, experienced MPS treatment centers should be considered for high-risk patients and those requiring complex procedures. Therefore, the key to optimal patient care is to implement best practices through meaningful communication among treatment team members at each center and among MPS VI specialists worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.

[The German program for disease management guidelines. Results and perspectives].

PubMed

Ollenschläger, Günter; Kopp, Ina

2007-05-15

The Program for National Disease Management Guidelines (German DM-CPG Program) is a joint initiative of the German Medical Association (umbrella organization of the German Chambers of Physicians), the Association of the Scientific Medical Societies (AWMF), and of the National Association of Statutory Health Insurance Physicians (NASHIP). The program aims at developing, implementing and continuously updating best-practice recommendations for countrywide and regional disease management programs in Germany. Since 2003 twelve national guidelines (topics: asthma, chronic obstructive pulmonary disease, HI (Chronic heart failure), CVD (Chronic coronary heart disease) back pain, depression, several aspects of diabetes) have been produced by use of a standardized procedure in accordance with internationally consented methodologies. For countrywide dissemination and implementation the program uses a wide range of specialist journals, continuous medical education and quality management programs. So far, 36 out of 150 national scientific medical associations, four allied health profession organizations, and twelve national consumer organizations have been participating in the DM-CPG Program. Studies to evaluate the program's effects on health-care providers' behavior and patients' outcomes are under way.

Environmental management and monitoring for education building development

NASA Astrophysics Data System (ADS)

Masri, R. M.

2018-05-01

The purpose of research were (1) a conceptual, functional model designed and implementation for environmental management and monitoring for education building development, (2) standard operational procedure made for management and monitoring for education building development, (3) assessed physic-chemical, biological, social-economic environmental components so that fulfilling sustainable development, (4) environmental management and monitoring program made for decreasing negative and increasing positive impact in education building development activities. Descriptive method is used for the research. Cibiru UPI Campus, Bandung, West Java, Indonesia was study location. The research was conducted on July 2016 to January 2017. Spatial and activities analysis were used to assess physic-chemical, biological, social-economic environmental components. Environmental management and monitoring for education building development could be decreasing water, air, soil pollution and environmental degradation in education building development activities.

The National Space Science Data Center: An operational perspective

NASA Technical Reports Server (NTRS)

Blitstein, Ronald; Green, James L.

1991-01-01

The National Space Science Data Center (NSSDC) manages over 110,000 data tapes with over 4,000 data sets. The size of the digital archive is approximately 6,000 GBytes and is expected to grow to more than 28,000 GBytes by 1995. The NSSDC is involved in several initiatives to better serve the scientific community and improve the management of current and future data holdings. These initiatives address the need to manage data to ensure ready access by the user and manage the media to ensure continuing accessibility and integrity of the data. An operational view of the NSSDC, outlining current policies and procedures that have been implemented to ensure the effective use of available resources to support service and mission goals, and maintain compliance with prescribed data management directives is presented.

The National Space Science Data Center: An operational perspective

NASA Technical Reports Server (NTRS)

Blitstein, Ronald; Green, James L.

1992-01-01

The National Space Science Data Center (NSSDC) manages over 110,000 data tapes with over 4,000 data sets. The size of the digital archive is approximately 6,000 GBytes and is expected to grow to more than 28,000 GBytes by 1995. The NSSDC is involved in several initiatives to better serve the scientific community and improve the management of current and future data holdings. These initiatives address the need to manage data to ensure ready access by the user and manage the media to ensure continuing accessibility and integrity of the data. This paper will present an operational view of the NSSDC, outlining current policies and procedures that were implemented to ensure the effective use of available resources to support service and mission goals, and maintain compliance with prescribed data management directives.

Applicability of NASA contract quality management and failure mode effect analysis procedures to the USGS Outer Continental Shelf oil and gas lease management program

NASA Technical Reports Server (NTRS)

Dyer, M. K.; Little, D. G.; Hoard, E. G.; Taylor, A. C.; Campbell, R.

1972-01-01

An approach that might be used for determining the applicability of NASA management techniques to benefit almost any type of down-to-earth enterprise is presented. A study was made to determine the following: (1) the practicality of adopting NASA contractual quality management techniques to the U.S. Geological Survey Outer Continental Shelf lease management function; (2) the applicability of failure mode effects analysis to the drilling, production, and delivery systems in use offshore; (3) the impact on industrial offshore operations and onshore management operations required to apply recommended NASA techniques; and (4) the probable changes required in laws or regulations in order to implement recommendations. Several management activities that have been applied to space programs are identified, and their institution for improved management of offshore and onshore oil and gas operations is recommended.

Piloted simulation of an air-ground profile negotiation process in a time-based Air Traffic Control environment

NASA Technical Reports Server (NTRS)

Williams, David H.; Green, Steven M.

1993-01-01

Historically, development of airborne flight management systems (FMS) and ground-based air traffic control (ATC) systems has tended to focus on different objectives with little consideration for operational integration. A joint program, between NASA's Ames Research Center (Ames) and Langley Research Center (Langley), is underway to investigate the issues of, and develop systems for, the integration of ATC and airborne automation systems. A simulation study was conducted to evaluate a profile negotiation process (PNP) between the Center/TRACON Automation System (CTAS) and an aircraft equipped with a four-dimensional flight management system (4D FMS). Prototype procedures were developed to support the functional implementation of this process. The PNP was designed to provide an arrival trajectory solution which satisfies the separation requirements of ATC while remaining as close as possible to the aircraft's preferred trajectory. Results from the experiment indicate the potential for successful incorporation of aircraft-preferred arrival trajectories in the CTAS automation environment. Fuel savings on the order of 2 percent to 8 percent, compared to fuel required for the baseline CTAS arrival speed strategy, were achieved in the test scenarios. The data link procedures and clearances developed for this experiment, while providing the necessary functionality, were found to be operationally unacceptable to the pilots. In particular, additional pilot control and understanding of the proposed aircraft-preferred trajectory, and a simplified clearance procedure were cited as necessary for operational implementation of the concept.

Safe procedure development to manage hazardous drugs in the workplace.

PubMed

Gaspar Carreño, Marisa; Achau Muñoz, Rubén; Torrico Martín, Fátima; Agún Gonzalez, Juan José; Sanchez Santos, Jose Cristobal; Cercos Lletí, Ana Cristina; Ramos Orozco, Pedro

2017-03-01

To develop a safety working procedure for the employees in the Intermutual Hospital de Levante (HIL) in those areas of activity that deal with the handling of hazardous drugs (MP). The procedure was developed in six phases: 1) hazard definition; 2) definition and identification of processes and development of general correct work practices about hazardous drugs' selection and special handling; 3) detection, selection and set of specific recommendations to handle with hazardous drugs during the processes of preparation and administration included in the hospital GFT; 4) categorization of risk during the preparation/administration and development of an identification system; 5) information and training of professionals; 6) implementation of the identification measures and prevention guidelines. Six processes were detected handling HD. During those processes, thirty HD were identified included in the hospital GFT and a safer alternative was found for 6 of them. The HD were classified into 4 risk categories based on those measures to be taken during the preparation and administration of each of them. The development and implementation of specific safety-work processes dealing with medication handling, allows hospital managers to accomplish effectively with their legal obligations about the area of prevention and provides healthcare professional staff with the adequate techniques and safety equipment to avoid possible dangers and risks of some drugs. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

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

Green,T.

This Wildland Fire Management Plan (FMP) for Brookhaven National Lab (BNL) updates the 2003 plan incorporating changes necessary to comply with DOE Order 450.1 and DOE P 450.4, Federal Wildland Fire Management Policy and Program Review; Wildland and Prescribed Fire Management Policy and implementation Procedures Reference Guide. This current plan incorporates changes since the original draft of the FMP that result from new policies on the national level. This update also removes references and dependence on the U.S. Fish & Wildlife Service and Department of the Interior, fully transitioning Wildland Fire Management responsibilities to BNL. The Department of Energy policymore » for managing wildland fires requires that all areas, managed by the DOE and/or its various contractors, that can sustain fire must have a FMP that details fire management guidelines for operational procedures associated with wild fire, operational, and prescribed fires. Fire management plans provide guidance on fire preparedness, fire prevention, wildfire suppression, and the use of controlled, 'prescribed' fires and mechanical means to control the amount of available combustible material. Values reflected in the BNL Wildland FMP include protecting life and public safety; Lab properties, structures and improvements; cultural and historical sites; neighboring private and public properties; and endangered, threatened, and species of concern. Other values supported by the plan include the enhancement of fire-dependent ecosystems at BNL. This FMP will be reviewed periodically to ensure the fire program advances and evolves with the missions of the DOE and BNL. This Fire Management Plan is presented in a format that coverers all aspects specified by DOE guidance documents which are based on the national template for fire management plans adopted under the National Fire Plan. The DOE is one of the signatory agencies on the National Fire Plan. This FMP is to be used and implemented for the entire BNL site including the Upton Reserve and has been reviewed by, The Nature Conservancy, New York State Department of Environmental Conservation Forest Rangers, and DOE, as well as appropriate BNL emergency services personnel. The BNL Fire Department is the lead on wildfire suppression. However, the BNL Natural Resource Manager will be assigned to all wildland fires as technical resource advisor.« less

Experimental application of Business Process Management technology to manage clinical pathways: a pediatric kidney transplantation follow up case.

PubMed

Andellini, Martina; Fernandez Riesgo, Sandra; Morolli, Federica; Ritrovato, Matteo; Cosoli, Piero; Petruzzellis, Silverio; Rosso, Nicola

2017-11-03

To test the application of Business Process Management technology to manage clinical pathways, using a pediatric kidney transplantation as case study, and to identify the benefits obtained from using this technology. Using a Business Process Management platform, we implemented a specific application to manage the clinical pathway of pediatric patients, and monitored the activities of the coordinator in charge of the case management during a 6-month period (from June 2015 to November 2015) using two methodologies: the traditional procedure and the one under study. The application helped physicians and nurses to optimize the amount of time and resources devoted to management purposes. In particular, time reduction was close to 60%. In addition, the reduction of data duplication, the integrated event management and the efficient data collection improved the quality of the service. The use of Business Process Management technology, usually related to well-defined processes with high management costs, is an established procedure in multiple environments; its use in healthcare, however, is innovative. The use of already accepted clinical pathways is known to improve outcomes. The combination of these two techniques, well established in their respective areas of application, could represent a revolution in clinical pathway management. The study has demonstrated that the use of this technology in a clinical environment, using a proper architecture and identifying a well-defined process, leads to real benefits in terms of resources optimization and quality improvement.

Methods for Monitoring Fish Communities of Buffalo National River and Ozark National Scenic Riverways in the Ozark Plateaus of Arkansas and Missouri: Version 1.0

USGS Publications Warehouse

Petersen, James C.; Justus, B.G.; Dodd, H.R.; Bowles, D.E.; Morrison, L.W.; Williams, M.H.; Rowell, G.A.

2008-01-01

Buffalo National River located in north-central Arkansas, and Ozark National Scenic Riverways, located in southeastern Missouri, are the two largest units of the National Park Service in the Ozark Plateaus physiographic province. The purpose of this report is to provide a protocol that will be used by the National Park Service to sample fish communities and collect related water-quality, habitat, and stream discharge data of Buffalo National River and Ozark National Scenic Riverways to meet inventory and long-term monitoring objectives. The protocol includes (1) a protocol narrative, (2) several standard operating procedures, and (3) supplemental information helpful for implementation of the protocol. The protocol narrative provides background information about the protocol such as the rationale of why a particular resource or resource issue was selected for monitoring, information concerning the resource or resource issue of interest, a description of how monitoring results will inform management decisions, and a discussion of the linkages between this and other monitoring projects. The standard operating procedures cover preparation, training, reach selection, water-quality sampling, fish community sampling, physical habitat collection, measuring stream discharge, equipment maintenance and storage, data management and analysis, reporting, and protocol revision procedures. Much of the information in the standard operating procedures was gathered from existing protocols of the U.S. Geological Survey National Water Quality Assessment program or other sources. Supplemental information that would be helpful for implementing the protocol is included. This information includes information on fish species known or suspected to occur in the parks, sample sites, sample design, fish species traits, index of biotic integrity metrics, sampling equipment, and field forms.

Special Area Management Plan (SAMP) Upper Yellowstone River, Montana: Environmental Assessment, FONSI, and Selected Alternative

DTIC Science & Technology

2011-04-01

Mitigation Procedure NEPA National Environmental Policy Act NHPA National Historic Preservation Act NRCS Natural Resources Conservation Service NWP...United States Geological Service, Biological Research Division USFWS US Fish and Wildlife Service YNP Yellowstone National Park 4 5 Finding of No...Significant Impact In accordance with the National Environmental Policy Act and its implementing regulations, the attached environmental assessment (EA

Using microsoft excel applications in the graduate intern program at Goddard Space Flight Center. M.S. Thesis

NASA Technical Reports Server (NTRS)

Antoine, Lisa

1992-01-01

An outline of the Project Operations Branch at Goddard Space Flight Center is presented that describes the management of the division and each subgroup's responsibility. The paper further describes the development of software tools for the Macintosh personal computer, and their impending implementation. A detailed step by step procedure is given for using these software tools.

Development of a Prototype Decision Support System to Manage the Air Force Alternative Care Program

DTIC Science & Technology

1990-09-01

development model was selected to structure the development process. Since it is necessary to ensure...uncertainty. Furthermore, the SDLC model provides a specific framework "by which an application is conceived, developed , and implemented" (Davis and Olson...associated with the automation of the manual ACP procedures. The SDLC Model has three stages: (1) definition, (2) development , and (3) installation

Optimization of Landscape Services under Uncoordinated Management by Multiple Landowners

PubMed Central

Porto, Miguel; Correia, Otília; Beja, Pedro

2014-01-01

Landscapes are often patchworks of private properties, where composition and configuration patterns result from cumulative effects of the actions of multiple landowners. Securing the delivery of services in such multi-ownership landscapes is challenging, because it is difficult to assure tight compliance to spatially explicit management rules at the level of individual properties, which may hinder the conservation of critical landscape features. To deal with these constraints, a multi-objective simulation-optimization procedure was developed to select non-spatial management regimes that best meet landscape-level objectives, while accounting for uncoordinated and uncertain response of individual landowners to management rules. Optimization approximates the non-dominated Pareto frontier, combining a multi-objective genetic algorithm and a simulator that forecasts trends in landscape pattern as a function of management rules implemented annually by individual landowners. The procedure was demonstrated with a case study for the optimum scheduling of fuel treatments in cork oak forest landscapes, involving six objectives related to reducing management costs (1), reducing fire risk (3), and protecting biodiversity associated with mid- and late-successional understories (2). There was a trade-off between cost, fire risk and biodiversity objectives, that could be minimized by selecting management regimes involving ca. 60% of landowners clearing the understory at short intervals (around 5 years), and the remaining managing at long intervals (ca. 75 years) or not managing. The optimal management regimes produces a mosaic landscape dominated by stands with herbaceous and low shrub understories, but also with a satisfactory representation of old understories, that was favorable in terms of both fire risk and biodiversity. The simulation-optimization procedure presented can be extended to incorporate a wide range of landscape dynamic processes, management rules and quantifiable objectives. It may thus be adapted to other socio-ecological systems, particularly where specific patterns of landscape heterogeneity are to be maintained despite imperfect management by multiple landowners. PMID:24465833

Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services

PubMed Central

Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

2011-01-01

Background The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President’s Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. Methods and Findings This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Conclusions Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in “Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa.” Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs. Please see later in the article for the Editors' Summary PMID:22140363

A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping

PubMed Central

2011-01-01

Background The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Methods Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. Results A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. Conclusions EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light. PMID:21899754

A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping.

PubMed

Green, Amy E; Aarons, Gregory A

2011-09-07

The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

Coding for effective denial management.

PubMed

Miller, Jackie; Lineberry, Joe

2004-01-01

Nearly everyone will agree that accurate and consistent coding of diagnoses and procedures is the cornerstone for operating a compliant practice. The CPT or HCPCS procedure code tells the payor what service was performed and also (in most cases) determines the amount of payment. The ICD-9-CM diagnosis code, on the other hand, tells the payor why the service was performed. If the diagnosis code does not meet the payor's criteria for medical necessity, all payment for the service will be denied. Implementation of an effective denial management program can help "stop the bleeding." Denial management is a comprehensive process that works in two ways. First, it evaluates the cause of denials and takes steps to prevent them. Second, denial management creates specific procedures for refiling or appealing claims that are initially denied. Accurate, consistent and compliant coding is key to both of these functions. The process of proactively managing claim denials also reveals a practice's administrative strengths and weaknesses, enabling radiology business managers to streamline processes, eliminate duplicated efforts and shift a larger proportion of the staff's focus from paperwork to servicing patients--all of which are sure to enhance operations and improve practice management and office morale. Accurate coding requires a program of ongoing training and education in both CPT and ICD-9-CM coding. Radiology business managers must make education a top priority for their coding staff. Front office staff, technologists and radiologists should also be familiar with the types of information needed for accurate coding. A good staff training program will also cover the proper use of Advance Beneficiary Notices (ABNs). Registration and coding staff should understand how to determine whether the patient's clinical history meets criteria for Medicare coverage, and how to administer an ABN if the exam is likely to be denied. Staff should also understand the restrictions on use of ABNs and the compliance risks associated with improper use. Finally, training programs should include routine audits to monitor coders for competence and precision. Constantly changing codes and guidelines mean that a coder's skills can quickly become obsolete if not reinforced by ongoing training and monitoring. Comprehensive reporting and routine analysis of claim denials is without a doubt one of the greatest assets to a practice that is suffering from excessive claim denials and should be considered an investment capable of providing both short and long term ROIs. Some radiologists may lack the funding or human resources needed to implement truly effective coding programs for their staff members. In these circumstances, radiology business managers should consider outsourcing their coding.

ICT and mobile health to improve clinical process delivery. a research project for therapy management process innovation.

PubMed

Locatelli, Paolo; Montefusco, Vittorio; Sini, Elena; Restifo, Nicola; Facchini, Roberta; Torresani, Michele

2013-01-01

The volume and the complexity of clinical and administrative information make Information and Communication Technologies (ICTs) essential for running and innovating healthcare. This paper tells about a project aimed to design, develop and implement a set of organizational models, acknowledged procedures and ICT tools (Mobile & Wireless solutions and Automatic Identification and Data Capture technologies) to improve actual support, safety, reliability and traceability of a specific therapy management (stem cells). The value of the project is to design a solution based on mobile and identification technology in tight collaboration with physicians and actors involved in the process to ensure usability and effectivenes in process management.

Objectives and metrics for wildlife monitoring

USGS Publications Warehouse

Sauer, J.R.; Knutson, M.G.

2008-01-01

Monitoring surveys allow managers to document system status and provide the quantitative basis for management decision-making, and large amounts of effort and funding are devoted to monitoring. Still, monitoring surveys often fall short of providing required information; inadequacies exist in survey designs, analyses procedures, or in the ability to integrate the information into an appropriate evaluation of management actions. We describe current uses of monitoring data, provide our perspective on the value and limitations of current approaches to monitoring, and set the stage for 3 papers that discuss current goals and implementation of monitoring programs. These papers were derived from presentations at a symposium at The Wildlife Society's 13th Annual Conference in Anchorage, Alaska, USA. [2006

78 FR 6218 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Reef Fish Fishery of the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

...NMFS issues this final rule to implement management measures described in Amendment 38 to the Fishery Management Plan for the Reef Fish Resources of the Gulf of Mexico (FMP) prepared by the Gulf of Mexico (Gulf) Fishery Management Council (Council). This final rule modifies post-season accountability measures (AMs) that affect the recreational harvest of shallow-water grouper species (SWG), changes the trigger for recreational sector AMs for gag and red grouper, and revises the Gulf reef fish framework procedure. The intent of this final rule is to achieve optimum yield (OY) while ensuring the Gulf reef fish fishery resources are utilized efficiently.

Prevalence and Implementation of IAQ Programs in U.S. Schools

PubMed Central

Moglia, Dena; Smith, Alisa; MacIntosh, David L.; Somers, Jennifer L.

2006-01-01

In this study, we determined the extent to which U.S. schools are implementing indoor air quality (IAQ) programs. We administered a questionnaire on IAQ programs and practices to a representative sample of schools. Participants were asked to provide information on the use, administration, implementation, challenges, and benefits of the IAQ program in their school. We developed an IAQ Practice Index to determine the level of activity directed toward IAQ in schools. The index was computed based on responses to specific survey questions and was normalized to a range of 0 to 100. Each question was weighted qualitatively according to its contribution to strong IAQ management practices. Forty-two percent of schools in the United States have an IAQ management program, and there has been sustained growth from 1998 through 2002 in the number of schools that have such programs. Nearly half of those schools use the U.S. Environmental Protection Agency’s IAQ Tools for Schools program. The IAQ Practice Index scores varied widely for schools with an IAQ management program, suggesting that having a program is not equivalent to implementing effective IAQ policies and procedures. Respondents indicated that their IAQ programs led to improved workplace satisfaction, fewer asthma attacks, fewer visits to the school nurse, and lower absenteeism. When actively supported by the school administration, an IAQ program appears to be a valuable factor in improving the learning environment for U.S. schoolchildren. PMID:16393672

Prevalence and implementation of IAQ programs in U.S. schools.

PubMed

Moglia, Dena; Smith, Alisa; MacIntosh, David L; Somers, Jennifer L

2006-01-01

In this study, we determined the extent to which U.S. schools are implementing indoor air quality (IAQ) programs. We administered a questionnaire on IAQ programs and practices to a representative sample of schools. Participants were asked to provide information on the use, administration, implementation, challenges, and benefits of the IAQ program in their school. We developed an IAQ Practice Index to determine the level of activity directed toward IAQ in schools. The index was computed based on responses to specific survey questions and was normalized to a range of 0 to 100. Each question was weighted qualitatively according to its contribution to strong IAQ management practices. Forty-two percent of schools in the United States have an IAQ management program, and there has been sustained growth from 1998 through 2002 in the number of schools that have such programs. Nearly half of those schools use the U.S. Environmental Protection Agency's IAQ Tools for Schools program. The IAQ Practice Index scores varied widely for schools with an IAQ management program, suggesting that having a program is not equivalent to implementing effective IAQ policies and procedures. Respondents indicated that their IAQ programs led to improved workplace satisfaction, fewer asthma attacks, fewer visits to the school nurse, and lower absenteeism. When actively supported by the school administration, an IAQ program appears to be a valuable factor in improving the learning environment for U.S. schoolchildren.

Blood Sampling in Newborns: A Systematic Review of YouTube Videos.

PubMed

Bueno, Mariana; Nishi, Érika Tihemi; Costa, Taine; Freire, Laís Machado; Harrison, Denise

Objective of this study was to conduct a systematic review of YouTube videos showing neonatal blood sampling, and to evaluate pain management and comforting interventions used. Selected videos were consumer- or professional-produced videos showing human newborns undergoing heel lancing or venipuncture for blood sampling, videos showing the entire blood sampling procedure (from the first attempt or puncture to the time of application of a cotton ball or bandage), publication date prior to October 2014, Portuguese titles, available audio. Search terms included "neonate," "newborn," "neonatal screening," and "blood collection." Two reviewers independently screened the videos and extracted the following data. A total of 13 140 videos were retrieved, of which 1354 were further evaluated, and 68 were included. Videos were mostly consumer produced (97%). Heel lancing was performed in 62 (91%). Forty-nine infants (72%) were held by an adult during the procedure. Median pain score immediately after puncture was 4 (interquartile range [IQR] = 0-5), and median length of cry throughout the procedure was 61 seconds (IQR = 88). Breastfeeding (3%) and swaddling (1.5%) were rarely implemented. Posted YouTube videos in Portuguese of newborns undergoing blood collection demonstrate minimal use of pain treatment, and maximal distress during procedures. Knowledge translation strategies are needed to implement effective measures for neonatal pain relief and comfort.

76 FR 69333 - Derivatives Clearing Organization General Provisions and Core Principles

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

...The Commodity Futures Trading Commission (Commission) is adopting final regulations to implement certain provisions of Title VII and Title VIII of the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) governing derivatives clearing organization (DCO) activities. More specifically, the regulations establish the regulatory standards for compliance with DCO Core Principles A (Compliance), B (Financial Resources), C (Participant and Product Eligibility), D (Risk Management), E (Settlement Procedures), F (Treatment of Funds), G (Default Rules and Procedures), H (Rule Enforcement), I (System Safeguards), J (Reporting), K (Recordkeeping), L (Public Information), M (Information Sharing), N (Antitrust Considerations), and R (Legal Risk) set forth in Section 5b of the Commodity Exchange Act (CEA). The Commission also is updating and adding related definitions; adopting implementing rules for DCO chief compliance officers (CCOs); revising procedures for DCO applications including the required use of a new Form DCO; adopting procedural rules applicable to the transfer of a DCO registration; and adding requirements for approval of DCO rules establishing a portfolio margining program for customer accounts carried by a futures commission merchant (FCM) that is also registered as a securities broker-dealer (FCM/BD). In addition, the Commission is adopting certain technical amendments to parts 21 and 39, and is adopting certain delegation provisions under part 140.

[Maturity Levels of Quality and Risk Management at the University Hospital Schleswig-Holstein].

PubMed

Jussli-Melchers, Jill; Hilbert, Carsten; Jahnke, Iris; Wehkamp, Kai; Rogge, Annette; Freitag-Wolf, Sandra; Kahla-Witzsch, Heike A; Scholz, Jens; Petzina, Rainer

2018-05-16

Quality and risk management in hospitals are not only required by law but also for an optimal patient-centered and process-optimized patient care. To evaluate the maturity levels of quality and risk management at the University Hospital Schleswig-Holstein (UKSH), a structured analytical tool was developed for easy and efficient application. Four criteria concerning quality management - quality assurance (QS), critical incident reporting system (CIRS), complaint management (BM) and process management (PM) - were evaluated with a structured questionnaire. Self-assessment and external assessment were performed to classify the maturity levels at the UKSH (location Kiel and Lübeck). Every quality item was graded into four categories from "A" (fully implemented) to "D" (not implemented at all). First of all, an external assessment was initiated by the head of the department of quality and risk management. Thereafter, a self-assessment was performed by 46 clinical units of the UKSH. Discrepancies were resolved in a collegial dialogue. Based on these data, overall maturity levels were obtained for every clinical unit. The overall maturity level "A" was reached by three out of 46 (6.5%) clinical units. No unit was graded with maturity level "D". 50% out of all units reached level "B" and 43.5% level "C". The distribution of the four different quality criteria revealed a good implementation of complaint management (maturity levels "A" and "B" in 78.3%), whereas the levels for CIRS were "C" and "D" in 73.9%. Quality assurance and process management showed quite similar distributions for the levels of maturity "B" and "C" (87% QS; 91% PM). The structured analytical tool revealed maturity levels of 46 clinical units of the UKSH and defined the maturity levels of four relevant quality criteria (QS, CIRS, BM, PM). As a consequence, extensive procedures were implemented to raise the standard of quality and risk management. In future, maturity levels will be reevaluated every two years. This qualitative maturity level model enables in a simple and efficient way precise statements concerning presence, manifestation and development of quality and risk management. © Georg Thieme Verlag KG Stuttgart · New York.

A survey on hematology-oncology pediatric AIEOP centers: prophylaxis, empirical therapy and nursing prevention procedures of infectious complications

PubMed Central

Livadiotti, Susanna; Milano, Giuseppe Maria; Serra, Annalisa; Folgori, Laura; Jenkner, Alessandro; Castagnola, Elio; Cesaro, Simone; Rossi, Mario R.; Barone, Angelica; Zanazzo, Giulio; Nesi, Francesca; Licciardello, Maria; De Santis, Raffaella; Ziino, Ottavio; Cellini, Monica; Porta, Fulvio; Caselli, Desiree; Pontrelli, Giuseppe

2012-01-01

A nationwide questionnaire-based survey was designed to evaluate the management and prophylaxis of febrile neutropenia in pediatric patients admitted to hematology-oncology and hematopoietic stem cell transplant units. Of the 34 participating centers, 40 and 63%, respectively, continue to prescribe antibacterial and antimycotic prophylaxis in low-risk subjects and 78 and 94% in transplant patients. Approximately half of the centers prescribe a combination antibiotic regimen as first-line therapy in low-risk patients and up to 81% in high-risk patients. When initial empirical therapy fails after seven days, 63% of the centers add empirical antimycotic therapy in low-and 81% in high-risk patients. Overall management varies significantly across centers. Preventive nursing procedures are in accordance with international guidelines. This survey is the first to focus on prescribing practices in children with cancer and could help to implement practice guidelines. PMID:21993676

Procedures for woody vegetation surveys in the Kazgail rural council area, Kordofan, Sudan

USGS Publications Warehouse

Falconer, Allan; Cross, Matthew D.; Orr, Donald G.

1990-01-01

Efforts to reforest parts of the Kordofan Province of Sudan are receiving support from international development agencies. These efforts include planning and implementing reforestation activities that require the collection of natural resources and socioeconomic data, and the preparation of base maps. A combination of remote sensing, geographic information system and global positioning systems procedures are used in this study to meet these requirements.Remote sensing techniques were used to provide base maps and to guide the compilation of vegetation resources maps. These techniques provided a rapid and efficient method for documenting available resources. Pocket‐sized global positioning system units were used to establish the location of field data collected for mapping and resource analysis. A microcomputer data management system tabulated and displayed the field data. The resulting system for data analysis, management, and planning has been adopted for the mapping and inventory of the Gum Belt of Sudan.

Engineering-Geological Data Model - The First Step to Build National Polish Standard for Multilevel Information Management

NASA Astrophysics Data System (ADS)

Ryżyński, Grzegorz; Nałęcz, Tomasz

2016-10-01

The efficient geological data management in Poland is necessary to support multilevel decision processes for government and local authorities in case of spatial planning, mineral resources and groundwater supply and the rational use of subsurface. Vast amount of geological information gathered in the digital archives and databases of Polish Geological Survey (PGS) is a basic resource for multi-scale national subsurface management. Data integration is the key factor to allow development of GIS and web tools for decision makers, however the main barrier for efficient geological information management is the heterogeneity of data in the resources of the Polish Geological Survey. Engineering-geological database is the first PGS thematic domain applied in the whole data integration plan. The solutions developed within this area will facilitate creation of procedures and standards for multilevel data management in PGS. Twenty years of experience in delivering digital engineering-geological mapping in 1:10 000 scale and archival geotechnical reports acquisition and digitisation allowed gathering of more than 300 thousands engineering-geological boreholes database as well as set of 10 thematic spatial layers (including foundation conditions map, depth to the first groundwater level, bedrock level, geohazards). Historically, the desktop approach was the source form of the geological-engineering data storage, resulting in multiple non-correlated interbase datasets. The need for creation of domain data model emerged and an object-oriented modelling (UML) scheme has been developed. The aim of the aforementioned development was to merge all datasets in one centralised Oracle server and prepare the unified spatial data structure for efficient web presentation and applications development. The presented approach will be the milestone toward creation of the Polish national standard for engineering-geological information management. The paper presents the approach and methodology of data unification, thematic vocabularies harmonisation, assumptions and results of data modelling as well as process of the integration of domain model with enterprise architecture implemented in PGS. Currently, there is no geological data standard in Poland. Lack of guidelines for borehole and spatial data management results in an increasing data dispersion as well as in growing barrier for multilevel data management and implementation of efficient decision support tools. Building the national geological data standard makes geotechnical information accessible to multiple institutions, universities, administration and research organisations and gather their data in the same, unified digital form according to the presented data model. Such approach is compliant with current digital trends and the idea of Spatial Data Infrastructure. Efficient geological data management is essential to support the sustainable development and the economic growth, as they allow implementation of geological information to assist the idea of Smart Cites, deliver information for Building Information Management (BIM) and support modern spatial planning. The engineering-geological domain data model presented in the paper is a scalable solution. Future implementation of developed procedures on other domains of PGS geological data is possible.

Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

2009-01-01

Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following functions: (1) detect anomalies, (2) diagnose causes, (3) predict future anomalies/failures, and (4) provide the user with an integrated awareness about the condition of every element in the system and guide user decisions.

Operational Improvements From the Automatic Dependant Surveillance Broadcast In-Trail Procedure in the Pacific Organized Track System

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Jones, Kenneth M.; Allen, Bonnie D.

2012-01-01

The Federal Aviation Administration's Surveillance and Broadcast Services Program has supported implementation of the Automatic Dependant Surveillance Broadcast (ADS-B) In-Trail Procedure (ITP) on commercial revenue flights. ADS-B ITP is intended to be used in non-radar airspace that is employing procedural separation. Through the use of onboard tools, pilots are able to make a new type of altitude change request to an Air Traffic Service Provider (ATSP). The FAA, in partnership with United Airlines, is conducting flight trials of the ITP in revenue service in the Pacific. To support the expansion of flight trials to the rest of the US managed Pacific Airspace Region, a computerized batch study was conducted to investigate the operational impacts and potential benefits that can be gained through the use of the ITP in the Pacific Organized Track System (PACOTS). This study, which simulated the Oakland managed portion of the PACOTS, suggests that potential benefits in the PACOTS are significant with a considerable increase in time spent at optimum altitude and associated fuel savings.

[Accreditation of forensic laboratories].

PubMed

Sołtyszewski, Ireneusz

2010-01-01

According to the framework decision of the European Union Council, genetic laboratories which perform tests for the benefit of the law enforcement agencies and the administration of justice are required to obtain a certificate of accreditation testifying to compliance with the PN EN ISO/IEC 17025:2005 standard. The certificate is the official confirmation of the competence to perform research, an acknowledgement of credibility, impartiality and professional independence. It is also the proof of establishment, implementation and maintenance of an appropriate management system. The article presents the legal basis for accreditation, the procedure of obtaining the certificate of accreditation and selected elements of the management system.

[The maintenance of automatic analysers and associated documentation].

PubMed

Adjidé, V; Fournier, P; Vassault, A

2010-12-01

The maintenance of automatic analysers and associated documentation taking part in the requirements of the ISO 15189 Standard and the French regulation as well have to be defined in the laboratory policy. The management of the periodic maintenance and documentation shall be implemented and fulfilled. The organisation of corrective maintenance has to be managed to avoid interruption of the task of the laboratory. The different recommendations concern the identification of materials including automatic analysers, the environmental conditions to take into account, the documentation provided by the manufacturer and documents prepared by the laboratory including procedures for maintenance.

[Quality control in anesthesiology].

PubMed

Muñoz-Ramón, J M

1995-03-01

The process of quality control and auditing of anesthesiology allows us to evaluate care given by a service and solve problems that are detected. Quality control is a basic element of care giving and is only secondarily an area of academic research; it is therefore a meaningless effort if the information does not serve to improve departmental procedures. Quality assurance procedures assume certain infrastructural requirements and an initial period of implementation and adjustment. The main objectives of quality control are the reduction of morbidity and mortality due to anesthesia, assurance of the availability and proper management of resources and, finally, the well-being and safety of the patient.

Management Approach for NASA's Earth Venture-1 (EV-1) Airborne Science Investigations

NASA Technical Reports Server (NTRS)

Guillory, Anthony R.; Denkins, Todd C.; Allen, B. Danette

2013-01-01

The Earth System Science Pathfinder (ESSP) Program Office (PO) is responsible for programmatic management of National Aeronautics and Space Administration's (NASA) Science Mission Directorate's (SMD) Earth Venture (EV) missions. EV is composed of both orbital and suborbital Earth science missions. The first of the Earth Venture missions is EV-1, which are Principal Investigator-led, temporally-sustained, suborbital (airborne) science investigations costcapped at $30M each over five years. Traditional orbital procedures, processes and standards used to manage previous ESSP missions, while effective, are disproportionally comprehensive for suborbital missions. Conversely, existing airborne practices are primarily intended for smaller, temporally shorter investigations, and traditionally managed directly by a program scientist as opposed to a program office such as ESSP. In 2010, ESSP crafted a management approach for the successful implementation of the EV-1 missions within the constructs of current governance models. NASA Research and Technology Program and Project Management Requirements form the foundation of the approach for EV-1. Additionally, requirements from other existing NASA Procedural Requirements (NPRs), systems engineering guidance and management handbooks were adapted to manage programmatic, technical, schedule, cost elements and risk. As the EV-1 missions are nearly at the end of their successful execution and project lifecycle and the submission deadline of the next mission proposals near, the ESSP PO is taking the lessons learned and updated the programmatic management approach for all future Earth Venture Suborbital (EVS) missions for an even more flexible and streamlined management approach.

Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies

PubMed Central

Bissonnette, Luc; Bergeron, Michel G.

2012-01-01

Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients. PMID:25562799

Parents' Use of Nonpharmacologic Methods to Manage Procedural Pain in Infants.

PubMed

Pölkki, Tarja; Korhonen, Anne; Laukkala, Helena

2018-01-01

To describe parents' use of nonpharmacologic methods to manage infant procedural pain in the NICU and determine the demographic factors related to such use. A cross-sectional and descriptive study design. Level III and Level II NICUs (seven units) of four University Hospitals in Finland. Parents (N = 178) whose infants were treated in Finnish NICUs. Parents were asked to respond to a structured questionnaire during their infants' hospitalizations. We analyzed the data using the nonparametric Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test. Most parents reported that they used physical methods, such as touching, holding, and positioning, nearly always/always (86%, 76%, and 55%, respectively). However, less commonly used strategies included recorded music (2%), breastfeeding (2%), and non-nutritive sucking with oral sucrose (6%). Many characteristics of the infants, such as their gestational ages and their conditions, were significantly related to the implementation of nonpharmacologic methods. There is a clear need to extend parents' use of nonpharmacologic methods to manage their infants' procedural pain in the NICU. Because many methods were not considered as pain-relieving strategies, it is important to increase knowledge about the effectiveness of these interventions among parents and nurses. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Innovations for the future of pharmacovigilance.

PubMed

Almenoff, June S

2007-01-01

Post-marketing pharmacovigilance involves the review and management of safety information from many sources. Among these sources, spontaneous adverse event reporting systems are among the most challenging and resource-intensive to manage. Traditionally, efforts to monitor spontaneous adverse event reporting systems have focused on review of individual case reports. The science of pharmacovigilance could be enhanced with the availability of systems-based tools that facilitate analysis of aggregate data for purposes of signal detection, signal evaluation and knowledge management. GlaxoSmithKline (GSK) recently implemented Online Signal Management (OSM) as a data-driven framework for managing the pharmacovigilance of marketed products. This pioneering work builds upon the strong history GSK has of innovation in this area. OSM is a software application co-developed by GSK and Lincoln Technologies that integrates traditional pharmacovigilance methods with modern quantitative statistical methods and data visualisation tools. OSM enables the rapid identification of trends from the individual adverse event reports received by GSK. OSM also provides knowledge-management tools to ensure the successful tracking of emerging safety issues. GSK has developed standard procedures and 'best practices' around the use of OSM to ensure the systematic evaluation of complex safety datasets. In summary, the implementation of OSM provides new tools and efficient processes to advance the science of pharmacovigilance.

Implementation of quality management in early stages of research and development projects at a university.

PubMed

Fiehe, Sandra; Wagner, Georg; Schlanstein, Peter; Rosefort, Christiane; Kopp, Rüdger; Bensberg, Ralf; Knipp, Peter; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Arens, Jutta

2014-04-01

The ultimate objective of university research and development projects is usually to create knowledge, but also to successfully transfer results to industry for subsequent marketing. We hypothesized that the university technology transfer requires efficient measures to improve this important step. Besides good scientific practice, foresighted and industry-specific adapted documentation of research processes in terms of a quality management system might improve the technology transfer. In order to bridge the gap between research institute and cooperating industry, a model project has been accompanied by a project specific amount of quality management. However, such a system had to remain manageable and must not constrain the researchers' creativity. Moreover, topics and research team are strongly interdisciplinary, which entails difficulties regarding communication because of different perspectives and terminology. In parallel to the technical work of the model project, an adaptable quality management system with a quality manual, defined procedures, and forms and documents accompanying the research, development and validation was implemented. After process acquisition and analysis the appropriate amount of management for the model project was identified by a self-developed rating system considering project characteristics like size, innovation, stakeholders, interdisciplinarity, etc. Employees were trained according to their needs. The management was supported and the technical documentation was optimized. Finally, the quality management system has been transferred successfully to further projects.

Use of continuous transdermal alcohol monitoring during a contingency management procedure to reduce excessive alcohol use.

PubMed

Dougherty, Donald M; Hill-Kapturczak, Nathalie; Liang, Yuanyuan; Karns, Tara E; Cates, Sharon E; Lake, Sarah L; Mullen, Jillian; Roache, John D

2014-09-01

Research on contingency management to treat excessive alcohol use is limited due to feasibility issues with monitoring adherence. This study examined the effectiveness of using transdermal alcohol monitoring as a continuous measure of alcohol use to implement financial contingencies to reduce heavy drinking. Twenty-six male and female drinkers (from 21 to 39 years old) were recruited from the community. Participants were randomly assigned to one of the two treatment sequences. Sequence 1 received 4 weeks of no financial contingency (i.e., $0) drinking followed by 4 weeks each of $25 and then $50 contingency management; Sequence 2 received 4 weeks of $25 contingency management followed by 4 weeks each of no contingency (i.e., $0) and then $50 contingency management. During the $25 and $50 contingency management conditions, participants were paid each week when the Secure Continuous Remote Alcohol Monitor (SCRAM-II™) identified no heavy drinking days. Participants in both contingency management conditions had fewer drinking episodes and reduced frequencies of heavy drinking compared to the $0 condition. Participants randomized to Sequence 2 (receiving $25 contingency before the $0 condition) exhibited less frequent drinking and less heavy drinking in the $0 condition compared to participants from Sequence 1. Transdermal alcohol monitoring can be used to implement contingency management programs to reduce excessive alcohol consumption. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Use of Continuous Transdermal Alcohol Monitoring during a Contingency Management Procedure to Reduce Excessive Alcohol Use

PubMed Central

Dougherty, Donald M.; Hill-Kapturczak, Nathalie; Liang, Yuanyuan; Karns, Tara E.; Cates, Sharon E.; Lake, Sarah L.; Mullen, Jillian; Roache, John D.

2014-01-01

Background Research on contingency management to treat excessive alcohol use is limited due to feasibility issues with monitoring adherence. This study examined the effectiveness of using transdermal alcohol monitoring as a continuous measure of alcohol use to implement financial contingencies to reduce heavy drinking. Methods Twenty-six male and female drinkers (from 21–39 years old) were recruited from the community. Participants were randomly assigned to one of two treatment sequences. Sequence 1 received 4 weeks of no financial contingency (i.e., $0) drinking followed by 4 weeks each of $25 and then $50 contingency management; Sequence 2 received 4 weeks of $25 contingency management followed by 4 weeks each of no contingency (i.e., $0) and then $50 contingency management. During the $25 and $50 contingency management conditions, participants were paid each week when the Secure Continuous Remote Alcohol Monitor (SCRAM-II™) identified no heavy drinking days. Results Participants in both contingency management conditions had fewer drinking episodes and reduced frequencies of heavy drinking compared to the $0 condition. Participants randomized to Sequence 2 (receiving $25 contingency before the $0 condition) exhibited less frequent drinking and less heavy drinking in the $0 condition compared to participants from Sequence 1. Conclusions Transdermal alcohol monitoring can be used to implement contingency management programs to reduce excessive alcohol consumption. PMID:25064019

Department of the Interior metadata implementation guide—Framework for developing the metadata component for data resource management

USGS Publications Warehouse

Obuch, Raymond C.; Carlino, Jennifer; Zhang, Lin; Blythe, Jonathan; Dietrich, Christopher; Hawkinson, Christine

2018-04-12

The Department of the Interior (DOI) is a Federal agency with over 90,000 employees across 10 bureaus and 8 agency offices. Its primary mission is to protect and manage the Nation’s natural resources and cultural heritage; provide scientific and other information about those resources; and honor its trust responsibilities or special commitments to American Indians, Alaska Natives, and affiliated island communities. Data and information are critical in day-to-day operational decision making and scientific research. DOI is committed to creating, documenting, managing, and sharing high-quality data and metadata in and across its various programs that support its mission. Documenting data through metadata is essential in realizing the value of data as an enterprise asset. The completeness, consistency, and timeliness of metadata affect users’ ability to search for and discover the most relevant data for the intended purpose; and facilitates the interoperability and usability of these data among DOI bureaus and offices. Fully documented metadata describe data usability, quality, accuracy, provenance, and meaning.Across DOI, there are different maturity levels and phases of information and metadata management implementations. The Department has organized a committee consisting of bureau-level points-of-contacts to collaborate on the development of more consistent, standardized, and more effective metadata management practices and guidance to support this shared mission and the information needs of the Department. DOI’s metadata implementation plans establish key roles and responsibilities associated with metadata management processes, procedures, and a series of actions defined in three major metadata implementation phases including: (1) Getting started—Planning Phase, (2) Implementing and Maintaining Operational Metadata Management Phase, and (3) the Next Steps towards Improving Metadata Management Phase. DOI’s phased approach for metadata management addresses some of the major data and metadata management challenges that exist across the diverse missions of the bureaus and offices. All employees who create, modify, or use data are involved with data and metadata management. Identifying, establishing, and formalizing the roles and responsibilities associated with metadata management are key to institutionalizing a framework of best practices, methodologies, processes, and common approaches throughout all levels of the organization; these are the foundation for effective data resource management. For executives and managers, metadata management strengthens their overarching views of data assets, holdings, and data interoperability; and clarifies how metadata management can help accelerate the compliance of multiple policy mandates. For employees, data stewards, and data professionals, formalized metadata management will help with the consistency of definitions, and approaches addressing data discoverability, data quality,  and data lineage. In addition to data professionals and others  associated with information technology; data stewards and program subject matter experts take on important metadata management roles and responsibilities as data flow through their respective business and science-related workflows.  The responsibilities of establishing, practicing, and  governing the actions associated with their specific metadata management roles are critical to successful metadata implementation.

Evaluation of effectiveness of information systems implementation in organization (by example of ERP-systems)

NASA Astrophysics Data System (ADS)

Demyanova, O. V.; Andreeva, E. V.; Sibgatullina, D. R.; Kireeva-Karimova, A. M.; Gafurova, A. Y.; Zakirova, Ch S.

2018-05-01

ERP in a modern enterprise information system allowed optimizing internal business processes, reducing production costs and increasing the attractiveness of enterprises for investors. It is an important component of success in the competition and an important condition for attracting investments in the key sector of the state. A vivid example of these systems are enterprise information systems using the methodology of ERP (Enterprise Resource Planning - enterprise resource planning). ERP is an integrated set of methods, processes, technologies and tools. It is based on: supply chain management; advanced planning and scheduling; sales automation; tool responsible for configuring; final resource planning; intelligence business; OLAP technology; block e- Commerce; management of product data. The main purpose of ERP systems is the automation of interrelated processes of planning, accounting and management in key areas of the company. ERP systems are automated systems that effectively address complex problems, including optimal allocation of business resources, ensuring quick and efficient delivery of goods and services to the consumer. Knowledge embedded in ERP systems provided enterprise-wide automation to introduce the activities of all functional departments of the company as a single complex system. At the level of quality estimates, most managers understand that the implementations of ERP systems is a necessary and useful procedure. Assessment of the effectiveness of the information systems implementation is relevant.

Leveraging workflow control patterns in the domain of clinical practice guidelines.

PubMed

Kaiser, Katharina; Marcos, Mar

2016-02-10

Clinical practice guidelines (CPGs) include recommendations describing appropriate care for the management of patients with a specific clinical condition. A number of representation languages have been developed to support executable CPGs, with associated authoring/editing tools. Even with tool assistance, authoring of CPG models is a labor-intensive task. We aim at facilitating the early stages of CPG modeling task. In this context, we propose to support the authoring of CPG models based on a set of suitable procedural patterns described in an implementation-independent notation that can be then semi-automatically transformed into one of the alternative executable CPG languages. We have started with the workflow control patterns which have been identified in the fields of workflow systems and business process management. We have analyzed the suitability of these patterns by means of a qualitative analysis of CPG texts. Following our analysis we have implemented a selection of workflow patterns in the Asbru and PROforma CPG languages. As implementation-independent notation for the description of patterns we have chosen BPMN 2.0. Finally, we have developed XSLT transformations to convert the BPMN 2.0 version of the patterns into the Asbru and PROforma languages. We showed that although a significant number of workflow control patterns are suitable to describe CPG procedural knowledge, not all of them are applicable in the context of CPGs due to their focus on single-patient care. Moreover, CPGs may require additional patterns not included in the set of workflow control patterns. We also showed that nearly all the CPG-suitable patterns can be conveniently implemented in the Asbru and PROforma languages. Finally, we demonstrated that individual patterns can be semi-automatically transformed from a process specification in BPMN 2.0 to executable implementations in these languages. We propose a pattern and transformation-based approach for the development of CPG models. Such an approach can form the basis of a valid framework for the authoring of CPG models. The identification of adequate patterns and the implementation of transformations to convert patterns from a process specification into different executable implementations are the first necessary steps for our approach.

Implementation of Recommendations from the One System Comparative Evaluation of the Hanford Tank Farms and Waste Treatment Plant Safety Bases

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

Garrett, Richard L.; Niemi, Belinda J.; Paik, Ingle K.

2013-11-07

A Comparative Evaluation was conducted for One System Integrated Project Team to compare the safety bases for the Hanford Waste Treatment and Immobilization Plant Project (WTP) and Tank Operations Contract (TOC) (i.e., Tank Farms) by an Expert Review Team. The evaluation had an overarching purpose to facilitate effective integration between WTP and TOC safety bases. It was to provide One System management with an objective evaluation of identified differences in safety basis process requirements, guidance, direction, procedures, and products (including safety controls, key safety basis inputs and assumptions, and consequence calculation methodologies) between WTP and TOC. The evaluation identified 25more » recommendations (Opportunities for Integration). The resolution of these recommendations resulted in 16 implementation plans. The completion of these implementation plans will help ensure consistent safety bases for WTP and TOC along with consistent safety basis processes. procedures, and analyses. and should increase the likelihood of a successful startup of the WTP. This early integration will result in long-term cost savings and significant operational improvements. In addition, the implementation plans lead to the development of eight new safety analysis methodologies that can be used at other U.S. Department of Energy (US DOE) complex sites where URS Corporation is involved.« less

U.S. Army Central did not Implement Controls to Effectively Manage the Shared Cost of Administrative Support Functions in Iraq

DTIC Science & Technology

2016-02-17

diverse organization, working together as one professional team, recognized as leaders in our field. For more information about whistleblower protection...Administrative Support Services SOP Standard Operating Procedures SoS Subscription of Services Whistleblower Protection U.S. Department of Defense The... Whistleblower Protection Enhancement Act of 2012 requires the Inspector General to designate a Whistleblower Protection Ombudsman to educate agency

User Interface on the World Wide Web: How to Implement a Multi-Level Program Online

NASA Technical Reports Server (NTRS)

Cranford, Jonathan W.

1995-01-01

The objective of this Langley Aerospace Research Summer Scholars (LARSS) research project was to write a user interface that utilizes current World Wide Web (WWW) technologies for an existing computer program written in C, entitled LaRCRisk. The project entailed researching data presentation and script execution on the WWW and than writing input/output procedures for the database management portion of LaRCRisk.

A system for the management of requests at an image data bank. M.S. Thesis

NASA Technical Reports Server (NTRS)

Debarrosaguirre, J. L. (Principal Investigator)

1984-01-01

An automated system was implemented to supersede existing manual procedures in fulfilling user requests made to a remote sensing data bank, concerning specifically LANDSAT imagery. The system controls the several production steps from request entry to the shipment of each final product. Special solutions and techniques were employed due to the severe limitations, in both hardware and software of the host minicomputer system.

Life Cycle Assessment for Chemical Agent Resistant Coating.

DTIC Science & Technology

1996-09-01

994) document to develop HVs from 1 to 2.5. The final equivalency factor for a chemical was based on the formula: Equivalency Factor = (toxicity HV...applicable to the development of processes/procedures and their implementation, likely would fit better with a true LCA- based design exercise for a product...Johnny Springer, Jr., National Risk Management Research Laboratory, Office of Research and Development , U.S. Environmental Protection Agency

Applying industrial engineering practices to radiology.

PubMed

Rosen, Len

2004-01-01

Seven hospitals in Oregon and Washington have successfully adopted the Toyota Production System (TPS). Developed by Taiichi Ohno, TPS focuses on finding efficiencies and cost savings in manufacturing processes. A similar effort has occurred in Canada, where Toronto's Hospital for Sick Children has developed a database for its diagnostic imaging department built on the principles of TPS applied to patient encounters. Developed over the last 5 years, the database currently manages all interventional patient procedures for quality assurance, inventory, equipment, and labor. By applying industrial engineering methodology to manufacturing processes, it is possible to manage these constraints, eliminate the obstacles to achieving streamlined processes, and keep the cost of delivering products and services under control. Industrial engineering methodology has encouraged all stakeholders in manufacturing plants to become participants in dealing with constraints. It has empowered those on the shop floor as well as management to become partners in the change process. Using a manufacturing process model to organize patient procedures enables imaging department and imaging centers to generate reports that can help them understand utilization of labor, materials, equipment, and rooms. Administrators can determine the cost of individual procedures as well as the total and average cost of specific procedure types. When Toronto's Hospital for Sick Children first implemented industrial engineering methodology to medical imaging interventional radiology patient encounters, it focused on materials management. Early in the process, the return on investment became apparent as the department improved its management of more than 500,000 dollars of inventory. The calculated accumulated savings over 4 years for 10,000 interventional procedures alone amounted to more than 140,000 dollars. The medical imaging department in this hospital is only now beginning to apply what it has learned to other factors contributing to case cost. It has started to analyze its service contracts with equipment vendors. The department also is accumulating data to measure room, equipment, and labor utilization. The hospital now has a true picture of the real cost associated with each patient encounter in medical imaging. It can now begin to manage case costs, perform better capacity planning, create more effective relationships with its material suppliers, and optimize scheduling of patients and staff.

How treating the patient with diabetes can enhance your practice: recommendations for practice management.

PubMed

Levin, Roger P

2003-10-01

The ability of dental practices to remain productive and profitable over time depends on their capacity to serve patients comprehensively. The increasing diversity in the patient population demands that practices customize services to ensure exceptional care for all patients. This diversity is particularly prevalent in patient subpopulations with unique medical conditions and treatment needs, such as patients with diabetes. Proper and effective management of patients with diabetes requires that the practice evaluate all aspects of patient interaction. Systems need to be customized so that all procedures and patient communication scripts are implemented consistently to meet the distinct needs of patients with diabetes. A significant return on investment in customized systems can be realized if the practice implements effective marketing strategies to both attract this population of patients and brand the practice as a unique and specialized service provider.

New food safety law: effectiveness on the ground.

PubMed

Drew, Christa A; Clydesdale, Fergus M

2015-01-01

The demand for safety in the US food supply from production to consumption necessitates a scientific, risk-based strategy for the management of microbiological, chemical, and physical hazards in food. The key to successful management is an increase in systematic collaboration and communication and in enforceable procedures with all domestic and international stakeholders. The enactment of the Food Safety Modernization Act (FSMA) aims to prevent or reduce large-scale food-borne illness outbreaks through stricter facility registration and records standards, mandatory prevention-based controls, increased facility inspections in the United States and internationally, mandatory recall authority, import controls, and increased consumer communication. The bill provisions are expected to cost $1.4 billion over the next four years. Effective implementation of the FSMA's 50 rules, reports, studies, and guidance documents in addition to an increased inspection burden requires further funding appropriations. Additional full-time inspectors and unprecedented foreign compliance is necessary for the full and effective implementation of the FSMA.

[A method of education at a distance for nurses' aides in the community area of Guatemala].

PubMed

García Pastor de Domínguez, E; Robles de Sandoval, A; Martínez Chopen, O

1988-01-01

The authors describe in detail a self-tutorial system that has been used for some ten years in Guatemala to train auxiliary nursing personnel. This model addressed both training and service objectives, and it proved to be consistent with a health policy of integrating teaching and service which the country was implementing at the time. The system involved a national effort to develop self-tutorial units and materials on basic subjects such as nursing procedures, mother and child health, first aid, management, guided therapy, community development and health education. Materials were divided into three categories: for self-tutorial instruction, for recording, supervision and evaluation, and for coordination and feedback within the system. Lastly, greater detail is given on the functions and tasks performed at the different levels of staff involved in managing the system, and the mechanisms which were implemented in the country's health areas are described.

The Challenges of Field Testing the Traffic Management Advisor (TMA) in an Operational Air Traffic Control Facility

NASA Technical Reports Server (NTRS)

Hoang, Ty; Swenson, Harry N.

1997-01-01

The Traffic Management Advisor (TMA), the sequence and schedule tool of the Center/TRACON Automation System (CTAS), was evaluated at the Fort Worth Center (ZFW) in the summer of 1996. This paper describes the challenges encountered during the various phases of the TMA field evaluation, which included system (hardware and software) installation, personnel training, and data collection. Operational procedures were developed and applied to the evaluation process that would ensure air safety. The five weeks of field evaluation imposed minimal impact on the hosting facility and provided valuable engineering and human factors data. The collection of data was very much an opportunistic affair, due to dynamic traffic conditions. One measure of the success of the TMA evaluation is that, rather than remove TMA after the evaluation until it could be fully implemented, the prototype TMA is in continual use at ZFW as the fully operational version is readied for implementation.

A Model-Driven Architecture Approach for Modeling, Specifying and Deploying Policies in Autonomous and Autonomic Systems

NASA Technical Reports Server (NTRS)

Pena, Joaquin; Hinchey, Michael G.; Sterritt, Roy; Ruiz-Cortes, Antonio; Resinas, Manuel

2006-01-01

Autonomic Computing (AC), self-management based on high level guidance from humans, is increasingly gaining momentum as the way forward in designing reliable systems that hide complexity and conquer IT management costs. Effectively, AC may be viewed as Policy-Based Self-Management. The Model Driven Architecture (MDA) approach focuses on building models that can be transformed into code in an automatic manner. In this paper, we look at ways to implement Policy-Based Self-Management by means of models that can be converted to code using transformations that follow the MDA philosophy. We propose a set of UML-based models to specify autonomic and autonomous features along with the necessary procedures, based on modification and composition of models, to deploy a policy as an executing system.

Information Architecture for Quality Management Support in Hospitals.

PubMed

Rocha, Álvaro; Freixo, Jorge

2015-10-01

Quality Management occupies a strategic role in organizations, and the adoption of computer tools within an aligned information architecture facilitates the challenge of making more with less, promoting the development of a competitive edge and sustainability. A formal Information Architecture (IA) lends organizations an enhanced knowledge but, above all, favours management. This simplifies the reinvention of processes, the reformulation of procedures, bridging and the cooperation amongst the multiple actors of an organization. In the present investigation work we planned the IA for the Quality Management System (QMS) of a Hospital, which allowed us to develop and implement the QUALITUS (QUALITUS, name of the computer application developed to support Quality Management in a Hospital Unit) computer application. This solution translated itself in significant gains for the Hospital Unit under study, accelerating the quality management process and reducing the tasks, the number of documents, the information to be filled in and information errors, amongst others.

Managed care and critical pathway development: the joint replacement experience.

PubMed

Benham, A J

1999-01-01

This article examines the economic, social, ethical, and political issues affecting total joint replacement patients in a managed care environment. Using general systems theory as a framework, it examines the interrelated historical events that have shaped the development of both joint replacement procedures and managed care, and discusses the extent to which these two phenomena have been mutually influential. Specifically, the article examines the initial development, implementation, and continuing evolution of clinical pathways as an easily identified and relatively discrete manifestation of managed care for the joint replacement population. While the overall impact of managed care is beyond the scope of this presentation, it is hoped that a focus on the practical application of clinical pathways to joint replacement will allow some general principles to emerge that may be useful for both patients and practitioners operating in other aspects of the managed care environment.

A structural multidisciplinary approach to depression management in nursing-home residents: a multicentre, stepped-wedge cluster-randomised trial.

PubMed

Leontjevas, Ruslan; Gerritsen, Debby L; Smalbrugge, Martin; Teerenstra, Steven; Vernooij-Dassen, Myrra J F J; Koopmans, Raymond T C M

2013-06-29

Depression in nursing-home residents is often under-recognised. We aimed to establish the effectiveness of a structural approach to its management. Between May 15, 2009, and April 30, 2011, we undertook a multicentre, stepped-wedge cluster-randomised trial in four provinces of the Netherlands. A network of nursing homes was invited to enrol one dementia and one somatic unit per nursing home. In enrolled units, nursing-home staff recruited residents, who were eligible as long as we had received written informed consent. Units were randomly allocated to one of five groups with computer-generated random numbers. A multidisciplinary care programme, Act in Case of Depression (AiD), was implemented at different timepoints in each group: at baseline, no groups were implenting the programme (usual care); the first group implemented it shortly after baseline; and other groups sequentially began implementation after assessments at intervals of roughly 4 months. Residents did not know when the intervention was being implemented or what the programme elements were; research staff were masked to intervention implementation, depression treatment, and results of previous assessments; and data analysts were masked to intervention implementation. The primary endpoint was depression prevalence in units, which was the proportion of residents per unit with a score of more than seven on the proxy-based Cornell scale for depression in dementia. Analyses were by intention to treat. This trial is registered with the Netherlands National Trial Register, number NTR1477. 16 dementia units (403 residents) and 17 somatic units (390 residents) were enrolled in the course of the study. In somatic units, AiD reduced prevalence of depression (adjusted effect size -7·3%, 95% CI -13·7 to -0·9). The effect was not significant in dementia units (0·6, -5·6 to 6·8) and differed significantly from that in somatic units (p=0·031). Adherence to depression assessment procedures was lower in dementia units (69% [SD 19%]) than in somatic units (82% [15%]; p=0·045). Adherence to treatment pathways did not differ between dementia units (43% [SD 33%]) and somatic units (38% [40%]; p=0·745). A structural approach to management of depression in nursing homes that includes assessment procedures can reduce depression prevalence in somatic units. Improvements are needed in depression screening in dementia units and in implementation of nursing-home treatment protocols generally. The Netherlands Organization for Health Research and Development. Copyright © 2013 Elsevier Ltd. All rights reserved.

SU-D-209-03: Radiation Dose Reduction Using Real-Time Image Processing in Interventional Radiology

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

Kanal, K; Moirano, J; Zamora, D

Purpose: To characterize changes in radiation dose after introducing a new real-time image processing technology in interventional radiology systems. Methods: Interventional radiology (IR) procedures are increasingly complex, at times requiring substantial time and radiation dose. The risk of inducing tissue reactions as well as long-term stochastic effects such as radiation-induced cancer is not trivial. To reduce this risk, IR systems are increasingly equipped with dose reduction technologies.Recently, ClarityIQ (Philips Healthcare) technology was installed in our existing neuroradiology IR (NIR) and vascular IR (VIR) suites respectively. ClarityIQ includes real-time image processing that reduces noise/artifacts, enhances images, and sharpens edges while alsomore » reducing radiation dose rates. We reviewed 412 NIR (175 pre- and 237 post-ClarityIQ) procedures and 329 VIR (156 preand 173 post-ClarityIQ) procedures performed at our institution pre- and post-ClarityIQ implementation. NIR procedures were primarily classified as interventional or diagnostic. VIR procedures included drain port, drain placement, tube change, mesenteric, and implanted venous procedures. Air Kerma (AK in units of mGy) was documented for all the cases using a commercial radiation exposure management system. Results: When considering all NIR procedures, median AK decreased from 1194 mGy to 561 mGy. When considering all VIR procedures, median AK decreased from 49 to 14 mGy. Both NIR and VIR exhibited a decrease in AK exceeding 50% after ClarityIQ implementation, a statistically significant (p<0.05) difference. Of the 5 most common VIR procedures, all median AK values decreased, but significance (p<0.05) was only reached in venous access (N=53), angio mesenteric (N=41), and drain placement procedures (N=31). Conclusion: ClarityIQ can reduce dose significantly for both NIR and VIR procedures. Image quality was not assessed in conjunction with the dose reduction.« less

Implementing a Pro-forma for Multidisciplinary Management of an Enterocutaneous Fistula: A Case Study.

PubMed

Samad, Sohel; Anele, Chukwuemeka; Akhtar, Mansoor; Doughan, Samer

2015-06-01

Optimal management of patients with an entercocutaneous fistula (ECF) requires utilization of the sepsis, nutrition, anatomy, and surgical procedure (SNAP) protocol. The protocol includes early detection and treatment of sepsis, optimizing patient nutrition through oral and parenteral routes, identifying the fistula anatomy, optimal fistula management, and proceeding to corrective surgery when appropriate. The protocol requires multidisciplinary team (MDT) coordination among surgeons, nurses, dietitians, stoma nurses, and physiotherapists. This case study describes a 70-year-old man who developed an ECF subsequent to a laparotomy for a small bowel obstruction. Following a period of ileus, 16 days post laparotomy the patient developed a high-output (2,000 mL per day) fistula. The patient also became pyrexial with raised inflammatory markers, requiring antibiotic treatment. Following development of his ECF, he was managed using the SNAP protocol for the duration of his admission; however, in implementing this protocol with this patient, clinicians noted fluid charts were inadequate to allow effective management of the variables. Thus, a new pro-forma was created that encompassed fluid balance, nutritional status, and pertinent blood test results, as well as perifistular skin condition, medication, and documentation of management plans from the MDT team. The pro-forma was recorded daily in the patient notes. Following implementation of the pro-forma and the SNAP protocol, the patient recovered well clinically over a period of 4 weeks with a decrease in his fistula output to 300-500 mL per day, and he was discharged with plans for further corrective surgery to resect the fistula and for bowel re-anastomoses. Although fluid charts are readily available, they do not include all pertinent variables for optimal management of patients with an ECF. Further research is needed to validate the pro-forma and evaluate its effect on patient outcomes.

Prerequisite programs at schools: diagnosis and economic evaluation.

PubMed

Lockis, Victor R; Cruz, Adriano G; Walter, Eduardo H M; Faria, Jose A F; Granato, Daniel; Sant'Ana, Anderson S

2011-02-01

In this study, 20 Brazilian public schools have been assessed regarding good manufacturing practices and standard sanitation operating procedures implementation. We used a checklist comprised of 10 parts (facilities and installations, water supply, equipments and tools, pest control, waste management, personal hygiene, sanitation, storage, documentation, and training), making a total of 69 questions. The implementing modification cost to the found nonconformities was also determined so that it could work with technical data as a based decision-making prioritization. The average nonconformity percentage at schools concerning to prerequisite program was 36%, from which 66% of them own inadequate installations, 65% waste management, 44% regarding documentation, and 35% water supply and sanitation. The initial estimated cost for changing has been U.S.$24,438 and monthly investments of 1.55% on the currently needed invested values. This would result in U.S.$0.015 increase on each served meal cost over the investment replacement within a year. Thus, we have concluded that such modifications are economically feasible and will be considered on technical requirements when prerequisite program implementation priorities are established.

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

NASA Astrophysics Data System (ADS)

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

2015-02-01

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

A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania

PubMed Central

Fillinger, Ulrike; Kannady, Khadija; William, George; Vanek, Michael J; Dongus, Stefan; Nyika, Dickson; Geissbühler, Yvonne; Chaki, Prosper P; Govella, Nico J; Mathenge, Evan M; Singer, Burton H; Mshinda, Hassan; Lindsay, Steven W; Tanner, Marcel; Mtasiwa, Deo; de Castro, Marcia C; Killeen, Gerry F

2008-01-01

Background As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. Methods A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. Results The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6–37.6%; p = 0.04). Conclusion This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience. PMID:18218148

78 FR 24347 - Approval and Promulgation of Implementation Plans; Oregon: Open Burning and Enforcement Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... Promulgation of Implementation Plans; Oregon: Open Burning and Enforcement Procedures AGENCY: Environmental..., 2008 that relate to open burning rules, enforcement procedures, civil penalties, and procedures in.... These revisions relate to open burning rules, enforcement procedures, civil penalties, and procedures in...

[Methods in health services research. The example of the evaluation of the German disease management programmes].

PubMed

Morfeld, M; Wirtz, M

2006-02-01

According to the established definition of Pfaff, health services research analyses patients' path through the institutions of the health care system. The focus is on development, evaluation and implementation of innovative measures of health care. By increasing its quality health services research strives for an improvement of efficacy and efficiency of the health care system. In order to allow for an appropriate evaluation it is essential to differentiate between structure, process and outcome quality referring to (1) the health care system in its entirety, (2) specific health care units as well as (3) processes of communication in different settings. Health services research comprises a large array of scientific disciplines like public health, medicine, social sciences and social care. For the purpose of managing its tasks adequately a special combination of instruments and methodological procedures is needed. Thus, diverse techniques of evaluation research as well as special requirements for study designs and assessment procedures are of vital importance. The example of the German disease management programmes illustrates the methodical requirements for a scientific evaluation.

Evolution of a Patient Information Management System in a Local Area Network Environment at Loyola University of Chicago Medical Center

PubMed Central

Price, Ronald N; Chandrasekhar, Arcot J; Tamirisa, Balaji

1990-01-01

The Department of Medicine at Loyola University Medical Center (LUMC) of Chicago has implemented a local area network (LAN) based Patient Information Management System (PIMS) as part of its integrated departmental database management system. PIMS consists of related database applications encompassing demographic information, current medications, problem lists, clinical data, prior events, and on-line procedure results. Integration into the existing departmental database system permits PIMS to capture and manipulate data in other departmental applications. Standardization of clinical data is accomplished through three data tables that verify diagnosis codes, procedures codes and a standardized set of clinical data elements. The modularity of the system, coupled with standardized data formats, allowed the development of a Patient Information Protocol System (PIPS). PIPS, a userdefinable protocol processor, provides physicians with individualized data entry or review screens customized for their specific research protocols or practice habits. Physician feedback indicates that the PIMS/PIPS combination enhances their ability to collect and review specific patient information by filtering large amount of clinical data.

Medical informatics in medical research - the Severe Malaria in African Children (SMAC) Network's experience.

PubMed

Olola, C H O; Missinou, M A; Issifou, S; Anane-Sarpong, E; Abubakar, I; Gandi, J N; Chagomerana, M; Pinder, M; Agbenyega, T; Kremsner, P G; Newton, C R J C; Wypij, D; Taylor, T E

2006-01-01

Computers are widely used for data management in clinical trials in the developed countries, unlike in developing countries. Dependable systems are vital for data management, and medical decision making in clinical research. Monitoring and evaluation of data management is critical. In this paper we describe database structures and procedures of systems used to implement, coordinate, and sustain data management in Africa. We outline major lessons, challenges and successes achieved, and recommendations to improve medical informatics application in biomedical research in sub-Saharan Africa. A consortium of experienced research units at five sites in Africa in studying children with disease formed a new clinical trials network, Severe Malaria in African Children. In December 2000, the network introduced an observational study involving these hospital-based sites. After prototyping, relational database management systems were implemented for data entry and verification, data submission and quality assurance monitoring. Between 2000 and 2005, 25,858 patients were enrolled. Failure to meet data submission deadline and data entry errors correlated positively (correlation coefficient, r = 0.82), with more errors occurring when data was submitted late. Data submission lateness correlated inversely with hospital admissions (r = -0.62). Developing and sustaining dependable DBMS, ongoing modifications to optimize data management is crucial for clinical studies. Monitoring and communication systems are vital in multi-center networks for good data management. Data timeliness is associated with data quality and hospital admissions.

Establishing a proactive safety and health risk management system in the fire service.

PubMed

Poplin, Gerald S; Pollack, Keshia M; Griffin, Stephanie; Day-Nash, Virginia; Peate, Wayne F; Nied, Ed; Gulotta, John; Burgess, Jefferey L

2015-04-19

Formalized risk management (RM) is an internationally accepted process for reducing hazards in the workplace, with defined steps including hazard scoping, risk assessment, and implementation of controls, all within an iterative process. While required for all industry in the European Union and widely used elsewhere, the United States maintains a compliance-based regulatory structure, rather than one based on systematic, risk-based methodologies. Firefighting is a hazardous profession, with high injury, illness, and fatality rates compared with other occupations, and implementation of RM programs has the potential to greatly improve firefighter safety and health; however, no descriptions of RM implementation are in the peer-reviewed literature for the North American fire service. In this paper we describe the steps used to design and implement the RM process in a moderately-sized fire department, with particular focus on prioritizing and managing injury hazards during patient transport, fireground, and physical exercise procedures. Hazard scoping and formalized risk assessments are described, in addition to the identification of participatory-led injury control strategies. Process evaluation methods were conducted to primarily assess the feasibility of voluntarily instituting the RM approach within the fire service setting. The RM process was well accepted by the fire department and led to development of 45 hazard specific-interventions. Qualitative data documenting the implementation of the RM process revealed that participants emphasized the: value of the RM process, especially the participatory bottom-up approach; usefulness of the RM process for breaking down tasks to identify potential risks; and potential of RM for reducing firefighter injury. As implemented, this risk-based approach used to identify and manage occupational hazards and risks was successful and is deemed feasible for U.S. (and other) fire services. While several barriers and challenges do exist in the implementation of any intervention such as this, recommendations for adopting the process are provided. Additional work will be performed to determine the effectiveness of select controls strategies that were implemented; however participants throughout the organizational structure perceived the RM process to be of high utility while researchers also found the process improved the awareness and engagement in actively enhancing worker safety and health.

International Variability in Gastrointestinal Decontamination With Acute Poisonings.

PubMed

Mintegi, Santiago; Dalziel, Stuart R; Azkunaga, Beatriz; Prego, Javier; Arana-Arri, Eunate; Acedo, Yordana; Martinez-Indart, Lorea; Benito, Javier; Kuppermann, Nathan

2017-08-01

Identifying international differences in the management of acute pediatric poisonings may help improve the quality of care. The objective of this study was to assess the international variation and appropriateness of gastrointestinal decontamination (GID) procedures performed in children and adolescents who present with acute poisonings to emergency departments. This was an international, multicenter, cross-sectional prospective study including children <18 years with poisoning exposures presenting to 105 emergency departments in 20 countries from 8 global regions belonging to the Pediatric Emergency Research Networks. Data collection started between January and September 2013 and continued for 1 year. The appropriateness of GID procedures performed was analyzed using the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists' recommendations. Multivariate logistic regression was performed to identify independent risk factors for performing GID procedures. We included 1688 patients, 338 of whom (20.0%, 95% confidence interval 18.1%-22.0%) underwent the following GID procedures: activated charcoal (166, 49.1%), activated charcoal and gastric lavage (122, 36.1%), gastric lavage (47, 13.9%), and ipecac (3, 0.9%). In 155 (45.8%, 40.5%-51.2%), the GID procedure was considered appropriate, with significant differences between regions. Independent risk factors for GID procedures included age, toxin category, mechanism of poisoning, absence of symptoms, and the region where the intoxication occurred ( P < .001). Globally, there are substantial differences in the use and appropriateness of GID procedures in the management of pediatric poisonings. International best practices need to be better implemented. Copyright © 2017 by the American Academy of Pediatrics.

GestationaL Obesity Weight management: Implementation of National Guidelines (GLOWING): a pilot cluster randomised controlled trial of a guideline implementation intervention for the management of maternal obesity by midwives.

PubMed

Heslehurst, Nicola; Rankin, Judith; McParlin, Catherine; Sniehotta, Falko F; Howel, Denise; Rice, Stephen; McColl, Elaine

2018-01-01

Weight management in pregnancy guidelines exist, although dissemination alone is an ineffective means of implementation. Midwives identify the need for support to overcome complex barriers to practice. An evaluation of an intervention to support midwives' guideline implementation would require a large-scale cluster randomised controlled trial. A pilot study is necessary to explore the feasibility of delivery and evaluation prior to a definitive trial. The GestationaL Obesity Weight management: Implementation of National Guidelines (GLOWING) trial aims to test whether it is feasible and acceptable to deliver a behaviour change intervention to support midwives' implementation of weight management guidelines. GLOWING is a multi-centre parallel group pilot cluster randomised controlled trial comparing the delivery of a behaviour change intervention for midwives versus usual practice. Four NHS Trusts (clusters) will be randomised to intervention and control arms, stratified by size of maternity services. The intervention uses social cognitive theory and consists of face-to-face midwifery training plus information resources for routine practice. The main outcomes are whether the intervention and trial procedures are feasible and acceptable to participants and the feasibility of recruitment and data collection for a definitive trial. Target recruitment involves all eligible midwives in the intervention arm recruited to receive the intervention, 30 midwives and pregnant women per arm for baseline and outcome questionnaire data collection and 20 midwives and women to provide qualitative data. All quantitative and qualitative analyses will be descriptive with the purpose of informing the development of the definitive trial. This pilot study has been developed to support community midwives' implementation of guidelines. Community midwives have been selected as they usually carry out the booking appointment which includes measuring and discussing maternal body mass index. A cluster design is the gold standard in implementation research as there would be a high risk of contamination if randomisation was at individual midwife level: community midwives usually work in locality-based teams, interact on a daily basis, and share care of pregnant women. The results of the pilot trial will be used to further develop and refine GLOWING prior to a definitive trial to evaluate effectiveness and cost-effectiveness. ISRCTN46869894; retrospectively registered 25th May 2016.

Necessary organizational changes according to Burke-Litwin model in the head nurses system of management in healthcare and social welfare institutions - the Slovenia experience.

PubMed

Filej, Bojana; Skela-Savic, Brigita; Vicic, Visnja H; Hudorovic, Narcis

2009-05-01

To discover which changes should be implemented in the system of head nursing management in Slovenian healthcare institutions and social welfare institutions. The questionnaire was distributed to 155 head nurses of Slovenian hospitals, primary healthcare centres and social welfare institutions. The Burke-Litwin organizational change model has been used to look at which changes have to be implemented in the management system of head nurses. In hospitals head nurses have greater independent competence for planning professional training of nursing employees (p<.022) and are also more independent when it comes to selecting employees when it comes to new job openings (M=4.20, S.D.=.83, p<.004). According to the Burke-Litwin organizational change model, the elements to which changes should be introduced include "external environment" for primary healthcare centres and social welfare institutions, and "system (policies and procedures)" for primary healthcare centres. According to results of our study, changes are needed in leadership and management of nursing in primary healthcare centres. In social welfare institutions changes are only required in leadership. Organizational changes are not necessary for any element of the Burke-Litwin model for hospitals.

Periprocedural considerations of transcatheter aortic valve implantation for anesthesiologists

PubMed Central

Afshar, Ata Hassani; Pourafkari, Leili; Nader, Nader D

2016-01-01

Transcatheter aortic valve replacement (TAVR) is rapidly gaining popularity as a viable option in the management of patients with symptomatic aortic stenosis (AS) and high risk for open surgical intervention. TAVR soon expanding its indications from "high-risk" group of patients to those with "intermediate-risk". As an anesthesiologist; understanding the procedure and the challenges inherent to it is of utmost importance, in order to implement optimal care for this generally frail population undergoing a rather novel procedure. Cardiac anesthesiologists generally play a pivotal role in the perioperative care of the patients, and therefore they should be fully familiar with the circumstances occurring surrounding the procedure. Along with increasing experience and technical developments for TAVR, the procedure time becomes shorter. Due to this improvement in the procedure time, more and more anesthesiologists feel comfortable in using monitored anesthesia care with moderate sedation for patients undergoing TAVR. A number of complications could arise during the procedure needing rapid diagnoses and occasionally conversion to general anesthesia. This review focuses on the periprocedural anesthetic considerations for TAVR. PMID:27489596

Malpractice risk and cost are significantly reduced after tort reform.

PubMed

Stewart, Ronald M; Geoghegan, Kathy; Myers, John G; Sirinek, Kenneth R; Corneille, Michael G; Mueller, Deborah; Dent, Daniel L; Wolf, Steven E; Pruitt, Basil A

2011-04-01

Rising medical malpractice premiums have reached a crisis point in many areas of the United States. In 2003 the Texas legislature passed a comprehensive package of tort reform laws that included a cap at $250,000 on noneconomic damages in most medical malpractice cases. We hypothesized that tort reform laws significantly reduce the risk of malpractice lawsuit in an academic medical center. We compared malpractice prevalence, incidence, and liability costs before and after comprehensive state tort reform measures were implemented. Two prospectively maintained institutional databases were used to calculate and characterize malpractice risk: a surgical operation database and a risk management and malpractice database. Risk groups were divided into pretort reform (1992 to 2004) and post-tort reform groups (2004 to the present). Operative procedures were included for elective, urgent, and emergency general surgery procedures. During the study period, 98,513 general surgical procedures were performed. A total of 28 lawsuits (25 pre-reform, 3 postreform) were filed, naming general surgery faculty or residents. The prevalence of lawsuits filed/100,000 procedures performed is as follows: before reform, 40 lawsuits/100,000 procedures, and after reform, 8 lawsuits/100,000 procedures (p < 0.01, relative risk 0.21 [95% CI 0.063 to 0.62]). Virtually all of the liability and defense cost was in the pretort reform period: $595,000/year versus $515/year in the postreform group (p < 0.01). Implementation of comprehensive tort reform in Texas was associated with a significant decrease in the prevalence and cost of surgical malpractice lawsuits at one academic medical center. Copyright © 2011. Published by Elsevier Inc.

Guide for mass prophylaxis of hospital employees in preparation for a bioterrorist attack.

PubMed

Lee, Jeremy John; Johnson, Shannon John; Sohmer, Michael J

2009-03-15

The key elements required for the health-system pharmacist to prepare and implement a hospital-based mass prophylaxis distribution effort for hospital employees are described. A bioterrorist attack may involve multiple jurisdictions which would necessitate a regional response. Pharmacists should collaborate not only with colleagues in their immediate areas, but also with pharmacists and emergency-management planners in neighboring counties and jurisdictions. Pharmacists must also develop antibiotic drug selection protocols and define the quantity needed to maintain hospital operations after a bioterrorist attack. Once the desired antibiotics have been selected and the number of employees has been determined, along with the length of prophylaxis therapy, it should be determined how much money will be needed to purchase and store enough medications to meet the need. Next, provisions must be made to acquire and store the antibiotic cache, with attention paid to cache rotation and packaging and repackaging recommendations. A detailed procedure for the deployment of an antibiotic cache must be developed. This procedure should include job descriptions and job action sheets for deployment team members and plans for receiving and dispensing antibiotics from the Strategic National Stockpile. Once the employee prophylaxis procedure is developed, staff must be educated about it, and exercises should be conducted to identify possible weaknesses in the procedure. Health-system pharmacists should play an active role in designing and implementing an antibiotic prophylaxis plan for employees for a potential bioterrorist attack. Understanding and following procedures provided in the tool kit are critical to their successful readiness.

Enhanced Tobacco Control Initiative at Johns Hopkins Health System: Employee Fairness Perception.

PubMed

Durrani, Shabnum; Lucik, Meg; Safeer, Richard

2018-02-01

Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.

Baobab Laboratory Information Management System: Development of an Open-Source Laboratory Information Management System for Biobanking

PubMed Central

Bendou, Hocine; Sizani, Lunga; Reid, Tim; Swanepoel, Carmen; Ademuyiwa, Toluwaleke; Merino-Martinez, Roxana; Meuller, Heimo; Abayomi, Akin

2017-01-01

A laboratory information management system (LIMS) is central to the informatics infrastructure that underlies biobanking activities. To date, a wide range of commercial and open-source LIMSs are available and the decision to opt for one LIMS over another is often influenced by the needs of the biobank clients and researchers, as well as available financial resources. The Baobab LIMS was developed by customizing the Bika LIMS software (www.bikalims.org) to meet the requirements of biobanking best practices. The need to implement biobank standard operation procedures as well as stimulate the use of standards for biobank data representation motivated the implementation of Baobab LIMS, an open-source LIMS for Biobanking. Baobab LIMS comprises modules for biospecimen kit assembly, shipping of biospecimen kits, storage management, analysis requests, reporting, and invoicing. The Baobab LIMS is based on the Plone web-content management framework. All the system requirements for Plone are applicable to Baobab LIMS, including the need for a server with at least 8 GB RAM and 120 GB hard disk space. Baobab LIMS is a server–client-based system, whereby the end user is able to access the system securely through the internet on a standard web browser, thereby eliminating the need for standalone installations on all machines. PMID:28375759

Baobab Laboratory Information Management System: Development of an Open-Source Laboratory Information Management System for Biobanking.

PubMed

Bendou, Hocine; Sizani, Lunga; Reid, Tim; Swanepoel, Carmen; Ademuyiwa, Toluwaleke; Merino-Martinez, Roxana; Meuller, Heimo; Abayomi, Akin; Christoffels, Alan

2017-04-01

A laboratory information management system (LIMS) is central to the informatics infrastructure that underlies biobanking activities. To date, a wide range of commercial and open-source LIMSs are available and the decision to opt for one LIMS over another is often influenced by the needs of the biobank clients and researchers, as well as available financial resources. The Baobab LIMS was developed by customizing the Bika LIMS software ( www.bikalims.org ) to meet the requirements of biobanking best practices. The need to implement biobank standard operation procedures as well as stimulate the use of standards for biobank data representation motivated the implementation of Baobab LIMS, an open-source LIMS for Biobanking. Baobab LIMS comprises modules for biospecimen kit assembly, shipping of biospecimen kits, storage management, analysis requests, reporting, and invoicing. The Baobab LIMS is based on the Plone web-content management framework. All the system requirements for Plone are applicable to Baobab LIMS, including the need for a server with at least 8 GB RAM and 120 GB hard disk space. Baobab LIMS is a server-client-based system, whereby the end user is able to access the system securely through the internet on a standard web browser, thereby eliminating the need for standalone installations on all machines.

Lessons learned in the deployment of a HIV counseling and testing management information system on a new project.

PubMed

Makinde, Olusesan A; Ezomike, Chioma F; Lehmann, Harold P; Ibanga, Iko J

2011-11-28

To share our experience on how we used simple but detailed processes and deployed a management information system on a new HIV counseling and testing (HCT) project in Nigeria. The procedures used in this study were adopted for their strength in identifying areas of continuous improvement as the project was implemented. We used an iterative brainstorming technique among 30 participants (volunteer counselors and project management staff) as well as iterative quality audits to identify several limitations to the success of the project and to propose solutions. We then implemented the solutions and reevaluated for performance. Findings from the evaluations were then reintroduced into the brainstorming and planning sessions. Several limitations were identified with the most prominent being the poor documentation of records at the site and the lack of a document transfer trail for audit purposes. Communication, cohesion and team focus are necessary to achieve success on any new project. Institutionalizing routine HIV behavioral surveillance using data collected at HCT will help in streamlining interventions that will be evidence-based. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Health, Environment and Social Management in Enterprises programme in the Republic of Macedonia.

PubMed

Karadzinska-Bislimovska, Jovanka; Baranski, Boguslaw; Risteska-Kuc, Snezana

2004-01-01

Macedonia is the first country in the region to launch implementation of the WHO Health, Environment and Social Management in Enterprises (HESME) Programme, following the WHO Ministerial Conference on Environment and Health held in London in 1999. The aim of this paper is to describe the efforts made to implement this programme. Methods are based on integrated management with joint involvement of crucial partners at all levels of activities suggested by the WHO. Commitment to inter-sectorial and interagency collaboration at national level, adoption of a final version of a National HESME Plan, with basic principles, criteria and concrete activities, establishment of a National coordination center for the HESME Project, development of training curricula and specific educational tools for occupational health personnel, preparation of questionnaires and procedures for a national survey to detect high occupational risks, specific occupational hazards and health promotion needs of the working population, and finally setting up quantitative and qualitative indicators for national or provincial workplace health profiles. Building up the concept of cooperation, partnership and common work in HESME activities is a challenge for the new public health view in Europe.

Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

PubMed Central

Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi

2010-01-01

Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449

Reilly pulls it together with care

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

Kiesche, E.S.

1992-12-09

Reilly Industries (Indianapolis) has changed strategic planning procedures to incorporate Responsible Care into its business plans. Each of the company's business units budgets for Responsible Care and reports quarterly on progress in implementing the codes, says Jacqueline Fernette, corporate communications coordinator and Responsible Care coordinator. The company's goal is to achieve full implementation by the end of 1997. In Reilly's 1993 budget, 20% of capital is directed at Responsible Care, says president Robert McNeeley. We hold unit managers responsible for planning Responsible Care within their businesses and reporting on them on a quarterly basis, says McNeeley. The firm makes pyridine,more » coal tar, potash and related chemicals, and specialized esters, and posts annual in the $250 million-$300 million range. Reilly has seven plants and 900 employees. Incorporating Responsible Care into the strategic business plan required a fair amount of administrative work to make sure that all business unit managers understood the concepts and were working in comparable terms, says McNeeley. We needed to bring the managers up to speed in six codes, so there was a training aspect to it.« less

Knowledge, attitudes and practices of dental hygienists regarding caries management by risk assessment.

PubMed

Urban, Ruth A; Rowe, Dorothy J

2015-02-01

The purpose of this study was to survey dental hygienists to determine their knowledge, attitudes and practices regarding the implementation of caries risk assessment, particularly caries management by risk assessment (CAMBRA), in private dental practices. A 17 item survey was developed to evaluate dental hygienists' knowledge, attitudes and practices related to CAMBRA and perceived barriers to CAMBRA implementation in private dental practice. Surveys were mailed to a randomized sample of 1,000 dental hygienists licensed to practice in California. Responses were tabulated for each respondent, and the response frequency for each survey item was calculated. Respondents' comments to the open-ended question were compiled, according to themes. The response rate was 18%. Only 66% of the respondents were familiar with the term CAMBRA, although 89% agreed with its underlying principles of risk assessment. CAMBRA protocol had been implemented in 40% of the respondents' employment sites. Respondents disagreed that time (45%) and cost of products (68%) were barriers to implementation. Many did not know their employers' knowledge or attitudes about CAMBRA and its implementation, as evidenced by a "don't know" response range of 29 to 48% for the 4 relevant statements. Respondents' comments included both successes and barriers implementing CAMBRA. CAMBRA protocol has not been widely implemented in private practice, although the current data do not indicate insurmountable barriers. Broader dissemination may be feasible if dental hygienists would obtain more comprehensive knowledge of evidence-based risk assessment protocols and would assume a leadership role in implementing CAMBRA protocols and procedures in private dental practices. Copyright © 2015 The American Dental Hygienists’ Association.