Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach.

PubMed

Si, Sheng-Li; You, Xiao-Yue; Liu, Hu-Chen; Huang, Jia

2017-08-19

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that "accidents/adverse events", "nosocomial infection", ''incidents/errors", "number of operations/procedures" are significant influential indicators. Also, the indicators of "length of stay", "bed occupancy" and "financial measures" play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions.

Is Self-Perceived Competency in Food Management a Reliable Indicator of Knowledge or Performance among Caucasian and Asian Students?

ERIC Educational Resources Information Center

Sim, Janet M.

1992-01-01

Reports a study of possible relationships among Caucasian and Asian college students' self-perceived competency, knowledge, performance, and ethnicity. Students enrolled in meal management classes completed questionnaires regarding food service management skills. Results indicated knowledge was a stronger determinant of self-perceived competency…

Performance measures for a dialysis setting.

PubMed

Gu, Xiuzhu; Itoh, Kenji

2018-03-01

This study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views. Two surveys were conducted using self-administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded. Eight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient-centred health care. These performance measures were almost compatible with those extracted in overall healthcare settings in a previous study. Internal reliability, content and construct validity of the performance measures for the dialysis setting were ensured to some extent. As a general trend, both dialysis managers and staff perceived performance measures as highly useful, especially for safety, mortality, operational efficiency and patient/employee satisfaction, but showed relatively low concerns for patient-centred health care and employee development. However, dialysis managers' usefulness perceptions were significantly higher than staff. Important guidelines for designing a holistic hospital/clinic management system were yielded. Performance measures must be balanced for outcomes and performance shaping factors (PSF); a common set of performance measures could be applied to all the healthcare settings, although performance indicators of each measure should be composed based on the application field and setting; in addition, sound causal relationships between PSF and outcome measures/indicators should be explored for further improvement. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness.

PubMed

Azami-Aghdash, Saber; Tabrizi, Jafar Sadegh; Sadeghi-Bazargani, Homayoun; Hajebrahimi, Sakineh; Naghavi-Behzad, Mohammad

2015-04-01

This study has been designed and conducted to develop domestic indicators for evaluating the performance of clinical governance in dimensions of risk management and clinical effectiveness. This study implemented a 5-stage process including conducting a comprehensive literature review, expert panel (∼ 1000 h per person per session, 11 experts), semi-structured interviews, a 2-round Delphi study (33 experts were in attendance) and a final expert panel (8 experts were in attendance). East Azerbaijan-Iran Province. Fifty-six specialists and experts in different fields of medical sciences. Importance and applicability of indicators. Using a thorough literature review, 361 indicators (129 risk management indicators in 4 dimensions and 232 clinical effectiveness indicators in 18 dimensions) were found. After conducting expert panels and interviews, the number of indicators decreased to 168 cases (65 risk management indicators in 4 dimensions and 103 clinical effectiveness indicators in 12 dimensions). Two rounds of Delphi identified four indicators that were omitted. The members of the final expert panel agreed on 113 indicators (43 risk management indicators in 4 dimensions and 70 clinical effectiveness indicators in 11 dimensions). In this study, indicators for assessing clinical governance in domains of risk management and clinical effectiveness were designed that can be used by policy-makers and other authorities for improving the quality of services and evaluating the performance of clinical governance. Those indicators can be used with slight modifications in other countries having healthcare systems similar to that of Iran. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach

PubMed Central

Si, Sheng-Li; You, Xiao-Yue; Huang, Jia

2017-01-01

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that “accidents/adverse events”, “nosocomial infection”, ‘‘incidents/errors”, “number of operations/procedures” are significant influential indicators. Also, the indicators of “length of stay”, “bed occupancy” and “financial measures” play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions. PMID:28825613

[Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

PubMed

Alonso, E; Rubio, A; March, J C; Danet, A

2011-01-01

The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Public services for distribution of drinking water and liquid sanitation in urban zones in Morocco Relevance of introduction the performance indicators for preservation water resources.

NASA Astrophysics Data System (ADS)

Habib, Akka; Abdelhamid, Bouzidi; Said, Housni

2018-05-01

Because of the absence of regulations and specific national norms, the unilaterally applied indicators for performance evaluation of water distribution management services are insufficient. This does not pave the way for a clear visibility of water resources. The indicators are also so heterogeneous that they are not in equilibrium with the applied management patterns. In fact: 1- The performance (yield and Linear loss index) of drinking water networks presents a discrepancy between operators and lack of homogeneity in terms of parameters put in its equation. Hence, It these indicators lose efficiency and reliability; 2- Liquid sanitation service has to go beyond the quantitative evaluation target in order to consider the qualitative aspects of water. To reach this aim, a reasonable enlargement of performance indicators is of paramount importance in order to better manage water resource which is becoming scarce and insufficient.

Designing a balanced scorecard for a tertiary care hospital in Pakistan: a modified Delphi group exercise.

PubMed

Rabbani, Fauziah; Jafri, Syed M Wasim; Abbas, Farhat; Shah, Mairaj; Azam, Syed Iqbal; Shaikh, Babar Tasneem; Brommels, Mats; Tomson, Goran

2010-01-01

Balanced Scorecards (BSC) are being implemented in high income health settings linking organizational strategies with performance data. At this private university hospital in Pakistan an elaborate information system exists. This study aimed to make best use of available data for better performance management. Applying the modified Delphi technique an expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size. Indicators from existing documents were evaluated for their importance, scientific soundness, appropriateness to hospital's strategic plan, feasibility and modifiability. Panel members individually rated each indicator on a scale of 1-9 for the above criteria. Median scores were assigned. Of an initial set of 50 indicators, 20 were finally selected to be assigned to the four BSC quadrants. These were financial (n = 4), customer or patient (n = 4), internal business or quality of care (n = 7) and innovation/learning or employee perspectives (n = 5). A need for stringent definitions, international benchmarking and standardized measurement methods was identified. BSC compels individual clinicians and managers to jointly work towards improving performance. This scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings. Copyright 2010 John Wiley & Sons, Ltd.

Quantitative assessments of municipal waste management systems: using different indicators to compare and rank programs in New York State.

PubMed

Greene, Krista L; Tonjes, David J

2014-04-01

The primary objective of waste management technologies and policies in the United States is to reduce the harmful environmental impacts of waste, particularly those relating to energy consumption and climate change. Performance indicators are frequently used to evaluate the environmental quality of municipal waste systems, as well as to compare and rank programs relative to each other in terms of environmental performance. However, there currently is no consensus on the best indicator for performing these environmental evaluations. The purpose of this study is to examine the common performance indicators used to assess the environmental benefits of municipal waste systems to determine if there is agreement between them regarding which system performs best environmentally. Focus is placed on how indicator selection influences comparisons between municipal waste management programs and subsequent system rankings. The waste systems of ten municipalities in the state of New York, USA, were evaluated using each common performance indicator and Spearman correlations were calculated to see if there was a significant association between system rank orderings. Analyses showed that rank orders of waste systems differ substantially when different indicators are used. Therefore, comparative system assessments based on indicators should be considered carefully, especially those intended to gauge environmental quality. Insight was also gained into specific factors which may lead to one system achieving higher rankings than another. However, despite the insufficiencies of indicators for comparative quality assessments, they do provide important information for waste managers and they can assist in evaluating internal programmatic performance and progress. To enhance these types of assessments, a framework for scoring indicators based on criteria that evaluate their utility and value for system evaluations was developed. This framework was used to construct an improved model for waste system performance assessments. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard.

PubMed

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-08-01

management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

Status quo and current trends of operating room management in Germany.

PubMed

Baumgart, André; Schüpfer, Guido; Welker, Andreas; Bender, Hans-Joachim; Schleppers, Alexander

2010-04-01

Ongoing healthcare reforms in Germany have required strenuous efforts to adapt hospital and operating room organizations to the needs of patients, new technological developments, and social and economic demands. This review addresses the major developments in German operating room management research and current practice. The introduction of the diagnosis-related group system in 2003 has changed the incentive structure of German hospitals to redesign their operating room units. The role of operating room managers has been gradually changing in hospitals in response to the change in the reimbursement system. Operating room managers are today specifically qualified and increasingly externally hired staff. They are more and more empowered with authority to plan and control operating rooms as profit centers. For measuring performance, common perioperative performance indicators are still scarcely implemented in German hospitals. In 2008, a concerted time glossary was established to enable consistent monitoring of operating room performance with generally accepted process indicators. These key performance indicators are a consistent way to make a procedure or case - and also the effectiveness of the operating room management - more transparent. In the presence of increasing financial pressure, a hospital's executives need to empower an independent operating room management function to achieve the hospital's economic goals. Operating room managers need to adopt evidence-based methods also from other scientific fields, for example management science and information technology, to further sustain operating room performance.

Structural and psychological empowerment climates, performance, and the moderating role of shared felt accountability: a managerial perspective.

PubMed

Wallace, J Craig; Johnson, Paul D; Mathe, Kimberly; Paul, Jeff

2011-07-01

The authors proposed and tested a model in which data were collected from managers (n = 539) at 116 corporate-owned quick service restaurants to assess the structural and psychological empowerment process as moderated by shared-felt accountability on indices of performance from a managerial perspective. The authors found that empowering leadership climate positively relates to psychological empowerment climate. In turn, psychological empowerment climate relates to performance only under conditions of high-felt accountability; it does not relate to performance under conditions of low-felt accountability. Overall, the present results indicate that the quick-service restaurant managers, who feel more empowered, operate restaurants that perform better than managers who feel less empowered, but only when those empowered managers also feel a high sense of accountability.

Strategic planning by independent community pharmacies.

PubMed

Harrison, Donald L

2005-01-01

(1) To assess the degree and level of use of the strategic planning process (none, partly, fully) by independent community pharmacy owners/managers and (2) to evaluate the relationships between independent community pharmacy owners/managers' level of strategic planning and indicators of pharmacy performance; including new and refill prescriptions filled, gross margin, rated patient care performance, rated dispensing performance, rated non-pharmacy performance, and rated financial performance. Cross-sectional study. United States. Nationwide random sample of 1,250 owners/managers of independent community pharmacies. Mailed survey. Quality of strategic planning conducted; pharmacy performance measures. Only 141 of 527 (26.8%) usable responses indicated use of some (77 pharmacies, 54.6%) or all (64 pharmacies, 45.4%) of the seven steps typical of strategic planning. Significant associations were observed between the level of strategic planning use and all pharmacy performance variables assessed, including indicators such as greater numbers of new and refill prescriptions dispensed, gross margins, patient care performance, dispensing performance, non-pharmacy performance, and financial performance. Greater ratings of pharmacy performance were significantly associated with the level of strategic planning use. Respondents who fully used strategic planning had significantly higher indicators than partial users; respondents who partly used the process had significantly higher ratings than respondents who did not conduct strategic planning.

Measuring, managing and maximizing performance of mineral processing plants

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

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

1995-12-31

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

[Consolidation of international guidelines for the management of canine populations in urban areas and proposal of performance indicators].

PubMed

Garcia, Rita de Cassia Maria; Calderón, Néstor; Ferreira, Fernando

2012-08-01

The objective of this study is to propose a generic program for the management of urban canine populations with suggestion of performance indicators. The following international guidelines on canine population management were revised and consolidated: World Health Organization, World Organisation for Animal Health, World Society for the Protection of Animals, International Companion Animal Management Coalition, and the Food and Agriculture Organization. Management programs should cover: situation diagnosis, including estimates of population size; social participation with involvement of various sectors in the planning and execution of strategies; educational actions to promote humane values, animal welfare, community health, and responsible ownership (through purchase or adoption); environmental and waste management to eliminate sources of food and shelter; registration and identification of animals; animal health care, reproductive control; prevention and control of zoonoses; control of animal commerce; management of animal behavior and adequate solutions for abandoned animals; and laws regulating responsible ownership, prevention of abandonment and zoonoses. To monitor these actions, four groups of indicators are suggested: animal population indicators, human/animal interaction indicators, public service indicators, and zoonosis indicators. The management of stray canine populations requires political, sanitary, ethologic, ecologic, and humanitarian strategies that are socially acceptable and environmentally sustainable. Such measures must also include the control of zoonoses such as rabies and leishmaniasis, considering the concept of "one health," which benefits both the animals and people in the community.

A theoretical framework for holistic hospital management in the Japanese healthcare context.

PubMed

Liu, Hu-Chen

2013-11-01

This paper develops a conceptual framework for performance measurement as a pilot study on holistic hospital management in the Japanese healthcare context. We primarily used two data sources as well as expert statements obtained through interviews: a systematic review of literature and a questionnaire survey to healthcare experts. The systematic survey searched PubMed and PubMed Central, and 24 relevant papers were elicited. The expert questionnaire asked respondents to rate the degree of "usefulness" for each of 66 indicators on a three-point scale. Applying the theoretical framework, a minimum set of performance indicators was selected for holistic hospital management, which well fit the healthcare context in Japan. This indicator set comprised 35 individual indicators and several factors measured through questionnaire surveys. The indicators were confirmed by expert judgments from viewpoints of face, content and construct validities as well as their usefulness. A theoretical framework of performance measurement was established from primary healthcare stakeholders' perspectives. Performance indicators were largely divided into healthcare outcomes and performance shaping factors. Indicators in the former category may be applied for the detection of operational problems, while their latent causes can be effectively addressed by the latter category in terms of process, structure and culture/climate within the organization. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Quality indicators for the detection and management of chronic kidney disease in primary care in Canada derived from a modified Delphi panel approach.

PubMed

Tu, Karen; Bevan, Lindsay; Hunter, Katie; Rogers, Jess; Young, Jacqueline; Nesrallah, Gihad

2017-01-01

The detection and management of chronic kidney disease lies within primary care; however, performance measures applicable in the Canadian context are lacking. We sought to develop a set of primary care quality indicators for chronic kidney disease in the Canadian setting and to assess the current state of the disease's detection and management in primary care. We used a modified Delphi panel approach, involving 20 panel members from across Canada (10 family physicians, 7 nephrologists, 1 patient, 1 primary care nurse and 1 pharmacist). Indicators identified from peer-reviewed and grey literature sources were subjected to 3 rounds of voting to develop a set of quality indicators for the detection and management of chronic kidney disease in the primary care setting. The final indicators were applied to primary care electronic medical records in the Electronic Medical Record Administrative data Linked Database (EMRALD) to assess the current state of primary care detection and management of chronic kidney disease in Ontario. Seventeen indicators made up the final list, with 1 under the category Prevalence, Incidence and Mortality; 4 under Screening, Diagnosis and Risk Factors; 11 under Management; and 1 under Referral to a Specialist. In a sample of 139 993 adult patients not on dialysis, 6848 (4.9%) had stage 3 or higher chronic kidney disease, with the average age of patients being 76.1 years (standard deviation [SD] 11.0); 62.9% of patients were female. Diagnosis and screening for chronic kidney disease were poorly performed. Only 27.1% of patients with stage 3 or higher disease had their diagnosis documented in their cumulative patient profile. Albumin-creatinine ratio testing was only performed for 16.3% of patients with a low estimated glomerular filtration rate (eGFR) and for 28.5% of patients with risk factors for chronic kidney disease. Family physicians performed relatively better with the management of chronic kidney disease, with 90.4% of patients with stage 3 or higher disease having an eGFR performed in the previous 18 months and 83.1% having a blood pressure recorded in the previous 9 months. We propose a set of measurable indicators to evaluate the quality of the management of chronic kidney disease in primary care. These indicators may be used to identify opportunities to improve current practice in Canada.

Management of children exposed to Mycobacterium tuberculosis: a public health evaluation in West Java, Indonesia.

PubMed

Rutherford, Merrin E; Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C

2013-12-01

To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. THE GAPS BETWEEN OBSERVED AND TARGET PERFORMANCE INDICATORS WERE: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

PubMed Central

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-01-01

Introduction: management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. Methods: the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. Results: the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. Conclusion: the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process. PMID:26483593

Reference Model for Performance Management in Service-Oriented Virtual Organization Breeding Environments

NASA Astrophysics Data System (ADS)

Paszkiewicz, Zbigniew; Picard, Willy

Performance management (PM) is a key function of virtual organization (VO) management. A large set of PM indicators has been proposed and evaluated within the context of virtual breeding environments (VBEs). However, it is currently difficult to describe and select suitable PM indicators because of the lack of a common vocabulary and taxonomies of PM indicators. Therefore, there is a need for a framework unifying concepts in the domain of VO PM. In this paper, a reference model for VO PM is presented in the context of service-oriented VBEs. In the proposed reference model, both a set of terms that could be used to describe key performance indicators, and a set of taxonomies reflecting various aspects of PM are proposed. The proposed reference model is a first attempt and a work in progress that should not be supposed exhaustive.

Assessments of managed care organizations in the Greater Baton Rouge area by physicians and physicians' office managers.

PubMed

Cassidy, W M; Dyson, T; Grenier, C E

2001-03-01

Health care quality assessment under managed care organizations is usually derived from two sources: (1) consumer satisfaction surveys, and (2) The Health Plan Employer Data Information Set reports. There is little published data regarding physicians' critiques. This study surveyed physicians and office managers as to the quality of healthcare under 10 managed care organizations in the Greater Baton Rouge area. Performance indicators in the physician questionnaire focused on personal satisfaction, perception of patient satisfaction, and mental health coverage. The office managers' checklist included payment and certification issues, telephone time spent gaining certification, level of knowledge among plan enrollees of their benefits, appeal process, and adequacy of reimbursement. Means were calculated for each performance indicator and managed care organizations were ranked. Tukey-Kramer's post-hoc multiple comparisons test was used to confirm rank order validity. Significant differences were found among companies. Significant rank-order agreement by both physicians and office managers was evident. The usefulness of such surveys and performing them annually is discussed.

Measuring, managing and maximizing refinery performance

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

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

1996-01-01

Implementing continuous quality improvement is a confluence of total quality management, people empowerment, performance indicators and information engineering. Supporting information technologies allow a refiner to narrow the gap between management objectives and the process control level. Dynamic performance monitoring benefits come from production cost savings, improved communications and enhanced decision making. A refinery workgroup information flow model helps automate continuous improvement of processes, performance and the organization. The paper discusses the rethinking of refinery operations, dynamic performance monitoring, continuous process improvement, the knowledge coordinator and repository manager, an integrated plant operations workflow, and successful implementation.

Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

PubMed

Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

2016-06-01

This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

Health, safety and environmental unit performance assessment model under uncertainty (case study: steel industry).

PubMed

Shamaii, Azin; Omidvari, Manouchehr; Lotfi, Farhad Hosseinzadeh

2017-01-01

Performance assessment is a critical objective of management systems. As a result of the non-deterministic and qualitative nature of performance indicators, assessments are likely to be influenced by evaluators' personal judgments. Furthermore, in developing countries, performance assessments by the Health, Safety and Environment (HSE) department are based solely on the number of accidents. A questionnaire is used to conduct the study in one of the largest steel production companies in Iran. With respect to health, safety, and environment, the results revealed that control of disease, fire hazards, and air pollution are of paramount importance, with coefficients of 0.057, 0.062, and 0.054, respectively. Furthermore, health and environment indicators were found to be the most common causes of poor performance. Finally, it was shown that HSE management systems can affect the majority of performance safety indicators in the short run, whereas health and environment indicators require longer periods of time. The objective of this study is to present an HSE-MS unit performance assessment model in steel industries. Moreover, we seek to answer the following question: what are the factors that affect HSE unit system in the steel industry? Also, for each factor, the extent of impact on the performance of the HSE management system in the organization is determined.

Performance analysis of Supply Chain Management with Supply Chain Operation reference model

NASA Astrophysics Data System (ADS)

Hasibuan, Abdurrozzaq; Arfah, Mahrani; Parinduri, Luthfi; Hernawati, Tri; Suliawati; Harahap, Bonar; Rahmah Sibuea, Siti; Krianto Sulaiman, Oris; purwadi, Adi

2018-04-01

This research was conducted at PT. Shamrock Manufacturing Corpora, the company is required to think creatively to implement competition strategy by producing goods/services that are more qualified, cheaper. Therefore, it is necessary to measure the performance of Supply Chain Management in order to improve the competitiveness. Therefore, the company is required to optimize its production output to meet the export quality standard. This research begins with the creation of initial dimensions based on Supply Chain Management process, ie Plan, Source, Make, Delivery, and Return with hierarchy based on Supply Chain Reference Operation that is Reliability, Responsiveness, Agility, Cost, and Asset. Key Performance Indicator identification becomes a benchmark in performance measurement whereas Snorm De Boer normalization serves to equalize Key Performance Indicator value. Analiytical Hierarchy Process is done to assist in determining priority criteria. Measurement of Supply Chain Management performance at PT. Shamrock Manufacturing Corpora produces SC. Responsiveness (0.649) has higher weight (priority) than other alternatives. The result of performance analysis using Supply Chain Reference Operation model of Supply Chain Management performance at PT. Shamrock Manufacturing Corpora looks good because its monitoring system between 50-100 is good.

Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators.

PubMed

Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard

2016-04-01

The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.

Assessing the effect of increased managed care on hospitals.

PubMed

Mowll, C A

1998-01-01

This study uses a new relative risk methodology developed by the author to assess and compare certain performance indicators to determine a hospital's relative degree of financial vulnerability, based on its location, to the effects of increased managed care market penetration. The study also compares nine financial measures to determine whether hospital in states with a high degree of managed-care market penetration experience lower levels of profitability, liquidity, debt service, and overall viability than hospitals in low managed care states. A Managed Care Relative Financial Risk Assessment methodology composed of nine measures of hospital financial and utilization performance is used to develop a high managed care state Composite Index and to determine the Relative Financial Risk and the Overall Risk Ratio for hospitals in a particular state. Additionally, financial performance of hospitals in the five highest managed care states is compared to hospitals in the five lowest states. While data from Colorado and Massachusetts indicates that hospital profitability diminishes as the level of managed care market penetration increases, the overall study results indicate that hospitals in high managed care states demonstrate a better cash position and higher profitability than hospitals in low managed care states. Hospitals in high managed care states are, however, more heavily indebted in relation to equity and have a weaker debt service coverage capacity. Moreover, the overall financial health and viability of hospitals in high managed care states is superior to that of hospitals in low managed care states.

Management of children exposed to Mycobacterium tuberculosis: a public health evaluation in West Java, Indonesia

PubMed Central

Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C

2013-01-01

Abstract Objective To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. Methods A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. Findings The gaps between observed and target performance indicators were: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. Conclusion The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing. PMID:24347732

76 FR 59069 - Revision to the Section 8 Management Assessment Program Lease-Up Indicator

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

...-AC76 Revision to the Section 8 Management Assessment Program Lease-Up Indicator AGENCY: Office of the... process by which HUD measures and verifies performance under the SEMAP lease-up indicator. Specifically... (PHA) leasing indicator will be based on a calendar year cycle, rather than a fiscal year cycle, which...

Environmental performance policy indicators for the public sector: the case of the defence sector.

PubMed

Ramos, Tomás B; Alves, Inês; Subtil, Rui; Joanaz de Melo, João

2007-03-01

The development of environmental performance policy indicators for public services, and in particular for the defence sector, is an emerging issue. Despite a number of recent initiatives there has been little work done in this area, since the other sectors usually focused on are agriculture, transport, industry, tourism and energy. This type of tool can be an important component for environmental performance evaluation at policy level, when integrated in the general performance assessment system of public missions and activities. The main objective of this research was to develop environmental performance policy indicators for the public sector, specifically applied to the defence sector. Previous research included an assessment of the environmental profile, through the evaluation of how environmental management practices have been adopted in this sector and an assessment of environmental aspects and impacts. This paper builds upon that previous research, developing an indicator framework--SEPI--supported by the selection and construction of environmental performance indicators. Another aim is to discuss how the current environmental indicator framework can be integrated into overall performance management. The Portuguese defence sector is presented and the usefulness of this methodology demonstrated. Feasibility and relevancy criteria are applied to evaluate the set of indicators proposed, allowing indicators to be scored and indicators for the policy level to be obtained.

The Fishery Performance Indicators: A Management Tool for Triple Bottom Line Outcomes

PubMed Central

Anderson, James L.; Anderson, Christopher M.; Chu, Jingjie; Meredith, Jennifer; Asche, Frank; Sylvia, Gil; Smith, Martin D.; Anggraeni, Dessy; Arthur, Robert; Guttormsen, Atle; McCluney, Jessica K.; Ward, Tim; Akpalu, Wisdom; Eggert, Håkan; Flores, Jimely; Freeman, Matthew A.; Holland, Daniel S.; Knapp, Gunnar; Kobayashi, Mimako; Larkin, Sherry; MacLauchlin, Kari; Schnier, Kurt; Soboil, Mark; Tveteras, Sigbjorn; Uchida, Hirotsugu; Valderrama, Diego

2015-01-01

Pursuit of the triple bottom line of economic, community and ecological sustainability has increased the complexity of fishery management; fisheries assessments require new types of data and analysis to guide science-based policy in addition to traditional biological information and modeling. We introduce the Fishery Performance Indicators (FPIs), a broadly applicable and flexible tool for assessing performance in individual fisheries, and for establishing cross-sectional links between enabling conditions, management strategies and triple bottom line outcomes. Conceptually separating measures of performance, the FPIs use 68 individual outcome metrics—coded on a 1 to 5 scale based on expert assessment to facilitate application to data poor fisheries and sectors—that can be partitioned into sector-based or triple-bottom-line sustainability-based interpretative indicators. Variation among outcomes is explained with 54 similarly structured metrics of inputs, management approaches and enabling conditions. Using 61 initial fishery case studies drawn from industrial and developing countries around the world, we demonstrate the inferential importance of tracking economic and community outcomes, in addition to resource status. PMID:25946194

‘Wasteaware’ benchmark indicators for integrated sustainable waste management in cities

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

Wilson, David C., E-mail: waste@davidcwilson.com; Rodic, Ljiljana; Cowing, Michael J.

Highlights: • Solid waste management (SWM) is a key utility service, but data is often lacking. • Measuring their SWM performance helps a city establish priorities for action. • The Wasteaware benchmark indicators: measure both technical and governance aspects. • Have been developed over 5 years and tested in more than 50 cities on 6 continents. • Enable consistent comparison between cities and countries and monitoring progress. - Abstract: This paper addresses a major problem in international solid waste management, which is twofold: a lack of data, and a lack of consistent data to allow comparison between cities. The papermore » presents an indicator set for integrated sustainable waste management (ISWM) in cities both North and South, to allow benchmarking of a city’s performance, comparing cities and monitoring developments over time. It builds on pioneering work for UN-Habitat’s solid waste management in the World’s cities. The comprehensive analytical framework of a city’s solid waste management system is divided into two overlapping ‘triangles’ – one comprising the three physical components, i.e. collection, recycling, and disposal, and the other comprising three governance aspects, i.e. inclusivity; financial sustainability; and sound institutions and proactive policies. The indicator set includes essential quantitative indicators as well as qualitative composite indicators. This updated and revised ‘Wasteaware’ set of ISWM benchmark indicators is the cumulative result of testing various prototypes in more than 50 cities around the world. This experience confirms the utility of indicators in allowing comprehensive performance measurement and comparison of both ‘hard’ physical components and ‘soft’ governance aspects; and in prioritising ‘next steps’ in developing a city’s solid waste management system, by identifying both local strengths that can be built on and weak points to be addressed. The Wasteaware ISWM indicators are applicable to a broad range of cities with very different levels of income and solid waste management practices. Their wide application as a standard methodology will help to fill the historical data gap.« less

Using Key Performance Indicators to Do More with Less in Your Practice

PubMed Central

Taylor, Brian

2016-01-01

Key performance indicators (KPIs) are important to managing any sustainable business. This tutorial provides audiologists, especially those with little formal business education, with a working definition of KPIs. A major theme of this article is that a relatively small group of about a dozen KPIs are an essential part of managing a successful audiology practice. The most useful KPIs for managing retail-oriented and medically oriented practices will be provided. Best practice benchmarks and how to use them to hire, coach, and train your staff also is covered. PMID:28028323

Using Key Performance Indicators to Do More with Less in Your Practice.

PubMed

Taylor, Brian

2016-11-01

Key performance indicators (KPIs) are important to managing any sustainable business. This tutorial provides audiologists, especially those with little formal business education, with a working definition of KPIs. A major theme of this article is that a relatively small group of about a dozen KPIs are an essential part of managing a successful audiology practice. The most useful KPIs for managing retail-oriented and medically oriented practices will be provided. Best practice benchmarks and how to use them to hire, coach, and train your staff also is covered.

NASA's Evolutionary Xenon Thruster (NEXT) Prototype Model 1R (PM1R) Ion Thruster and Propellant Management System Wear Test Results

NASA Technical Reports Server (NTRS)

VanNoord, Jonathan L.; Soulas, George C.; Sovey, James S.

2010-01-01

The results of the NEXT wear test are presented. This test was conducted with a 36-cm ion engine (designated PM1R) and an engineering model propellant management system. The thruster operated with beam extraction for a total of 1680 hr and processed 30.5 kg of xenon during the wear test, which included performance testing and some operation with an engineering model power processing unit. A total of 1312 hr was accumulated at full power, 277 hr at low power, and the remainder was at intermediate throttle levels. Overall ion engine performance, which includes thrust, thruster input power, specific impulse, and thrust efficiency, was steady with no indications of performance degradation. The propellant management system performed without incident during the wear test. The ion engine and propellant management system were also inspected following the test with no indication of anomalous hardware degradation from operation.

Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations.

PubMed

Mohammadfam, Iraj; Kamalinia, Mojtaba; Momeni, Mansour; Golmohammadi, Rostam; Hamidi, Yadollah; Soltanian, Alireza

2017-06-01

Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified and three noncertified companies. Findings indicate that the performance of certified companies with respect to occupational health and safety management practices is significantly better than that of noncertified companies. Occupational Health and Safety Assessment Series 18001-certified companies have a better level of occupational health and safety; this supports the argument that Occupational Health and Safety Management Systems play an important strategic role in health and safety in the workplace.

Intelligent Performance Analysis with a Natural Language Interface

NASA Astrophysics Data System (ADS)

Juuso, Esko K.

2017-09-01

Performance improvement is taken as the primary goal in the asset management. Advanced data analysis is needed to efficiently integrate condition monitoring data into the operation and maintenance. Intelligent stress and condition indices have been developed for control and condition monitoring by combining generalized norms with efficient nonlinear scaling. These nonlinear scaling methodologies can also be used to handle performance measures used for management since management oriented indicators can be presented in the same scale as intelligent condition and stress indices. Performance indicators are responses of the process, machine or system to the stress contributions analyzed from process and condition monitoring data. Scaled values are directly used in intelligent temporal analysis to calculate fluctuations and trends. All these methodologies can be used in prognostics and fatigue prediction. The meanings of the variables are beneficial in extracting expert knowledge and representing information in natural language. The idea of dividing the problems into the variable specific meanings and the directions of interactions provides various improvements for performance monitoring and decision making. The integrated temporal analysis and uncertainty processing facilitates the efficient use of domain expertise. Measurements can be monitored with generalized statistical process control (GSPC) based on the same scaling functions.

Performance-based management and quality of work: an empirical assessment.

PubMed

Falzon, Pierre; Nascimento, Adelaide; Gaudart, Corinne; Piney, Cécile; Dujarier, Marie-Anne; Germe, Jean-François

2012-01-01

In France, in the private sector as in the public sector, performance-based management tends to become a norm. Performance-based management is supposed to improve service quality, productivity and efficiency, transparency of allotted means and achieved results, and to better focus the activity of employees and of the whole organization. This text reports a study conducted for the French Ministry of Budget by a team of researchers in ergonomics, sociology and management science, in order to assess the impact of performance-based management on employees, on teams and on work organization. About 100 interviews were conducted with employees of all categories and 6 working groups were set up in order to discuss and validate or amend our first analyses. Results concern several aspects: workload and work intensification, indicators and performance management and the transformation of jobs induced by performance management.

'Wasteaware' benchmark indicators for integrated sustainable waste management in cities.

PubMed

Wilson, David C; Rodic, Ljiljana; Cowing, Michael J; Velis, Costas A; Whiteman, Andrew D; Scheinberg, Anne; Vilches, Recaredo; Masterson, Darragh; Stretz, Joachim; Oelz, Barbara

2015-01-01

This paper addresses a major problem in international solid waste management, which is twofold: a lack of data, and a lack of consistent data to allow comparison between cities. The paper presents an indicator set for integrated sustainable waste management (ISWM) in cities both North and South, to allow benchmarking of a city's performance, comparing cities and monitoring developments over time. It builds on pioneering work for UN-Habitat's solid waste management in the World's cities. The comprehensive analytical framework of a city's solid waste management system is divided into two overlapping 'triangles' - one comprising the three physical components, i.e. collection, recycling, and disposal, and the other comprising three governance aspects, i.e. inclusivity; financial sustainability; and sound institutions and proactive policies. The indicator set includes essential quantitative indicators as well as qualitative composite indicators. This updated and revised 'Wasteaware' set of ISWM benchmark indicators is the cumulative result of testing various prototypes in more than 50 cities around the world. This experience confirms the utility of indicators in allowing comprehensive performance measurement and comparison of both 'hard' physical components and 'soft' governance aspects; and in prioritising 'next steps' in developing a city's solid waste management system, by identifying both local strengths that can be built on and weak points to be addressed. The Wasteaware ISWM indicators are applicable to a broad range of cities with very different levels of income and solid waste management practices. Their wide application as a standard methodology will help to fill the historical data gap. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does performance management affect nurses' well-being?

PubMed

Decramer, Adelien; Audenaert, Mieke; Van Waeyenberg, Thomas; Claeys, Tine; Claes, Claudia; Vandevelde, Stijn; van Loon, Jos; Crucke, Saskia

2015-04-01

This article focuses on employee performance-management practices in the healthcare sector. We specifically aim to contribute to a better understanding of the impact of employee performance-management practices on affective well-being of nurses in hospitals. Theory suggests that the features of employee-performance management (planning and evaluation of individual performances) predict affective well-being (in this study: job satisfaction and affective commitment). Performance-management planning and evaluation and affective well-being were drawn from a survey of nurses at a Flemish hospital. Separate estimations were performed for different aspects of affective well-being. Performance planning has a negative effect on job satisfaction of nurses. Both vertical alignment and satisfaction with the employee performance-management system increase the affective well-being of nurses; however, the impact of vertical alignment differs for different aspects of affective well-being (i.e. job satisfaction and affective commitment). Performance-management planning and evaluation of nurses are associated with attitudinal outcomes. The results indicate that employee performance-management features have different impacts on different aspects of well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Job performance in work organizations: the effects of management by group goals and job interdependence].

PubMed

Ikeda, Hiroshi; Furukawa, Hisataka

2015-04-01

cThis study examined the interactive effect of management by group goals and job interdependence on employee's activities in terms of task and contextual performance. A survey was conducted among 140 Japanese employees. Results indicated that management by group goals was related only to contextual performance. Job interdependence, however, had a direct effect on both task and contextual performance. Moreover, moderated regression analyses revealed that for work groups requiring higher interdependence among employees, management by group goals had a positive relation to contextual performance but not to task performance. When interdependence was not necessarily required, however, management by group goals had no relation to contextual performance and even negatively impacted task performance, respectively. These results show that management by group goals affects task and contextual performance, and that this effect is moderated by job interdependence. This provides a theoretical extension as well as a practical application to the setting and management of group goals.

Impact of Management Style on Performance Indicators of Academic Staff

ERIC Educational Resources Information Center

Irtwange, S. V.; Orsaah, S.

2009-01-01

The objective of this study is to assess the impact of management style on academic staff performance with University of Agriculture, Makurdi as a case study. The management style of the vice chancellor of the University of Agriculture, Makurdi between the periods, September 3, 1996 to September 3, 2001 was determined using the Ohio State…

Satisfaction monitoring for quality control in campground management

Treesearch

Wilbur F. LaPage; Malcolm I. Bevins

1981-01-01

A 4-year study of camper satisfaction indicates that satisfaction monitoring is a useful tool for campground managers to assess their performance and achieve a high level of quality control in their service to the public. An indication of camper satisfaction with campground management is gained from a report card on which a small sample of visitors rates 14 elements of...

Performance, Process, and Costs: Managing Service Quality with the Balanced Scorecard.

ERIC Educational Resources Information Center

Poll, Roswitha

2001-01-01

Describes a cooperative project among three German libraries that used the Balanced Scorecard as a concept for an integrated quality management system. Considers performance indicators across four perspectives that will help academic libraries establish an integrated controlling system and to collect and evaluate performance as well as cost data…

Opening the black box in nursing work and management practice: the role of ward managers.

PubMed

Townsend, Keith; Wilkinson, Adrian; Kellner, Ashlea

2015-03-01

This paper aims to identify and explore key obstacles preventing ward managers from effectively performing the human resource management (HRM) responsibilities required in their role. In the context of increasing costs and the decentralisation of responsibility to ward level, the relevance of the ward manager role within the 'black box' between human resource management and firm performance is becoming increasingly pertinent. This paper presents an intensive case study including 37 interviews across all levels of a hospital where senior management attempted to shift to a high performance model of human resource management. The findings indicated that ward managers played a critical role in maintaining and improving employee performance, although they were restricted from effectively performing their responsibilities due to budget pressure and limited managerial skill development. Our findings support the contention that hospitals would benefit from focusing on the critical role of the ward manager as the central locus of influence in high performance human resource management (HPHRM) systems. Investment into high performance human resource management is discouraged if the hospital cannot adequately enable ward managers who are responsible for implementation. Introduction of managerial skills training to potential and existing ward managers is critical. © 2013 John Wiley & Sons Ltd.

Role delineation study for the American Society for Pain Management Nursing.

PubMed

Willens, Joyce S; DePascale, Christine; Penny, James

2010-06-01

A role delineation study, or job analysis, is a necessary step in the development of a quality credentialing program. The process requires a logical approach and systematic methods to have an examination that is legally defensible. There are three main phases: initial development and evaluation, validation study, and development of test specifications. In the first phase, the content expert panel discussed performance domains that exist in pain management nursing. The six domains developed were: 1) assessment, monitoring, and evaluation of pain; 2) pharmacologic pain management; 3) nonpharmacologic pain management; 4) therapeutic communication and counseling; 5) patient and family teaching; and 6) collaborative and organizational activities. The panel then produced a list of 70 task statements to develop an online survey which was sent to independent reviewers with expertise in pain management nursing. After the panel reviewed the results of the pilot test, it was decided to clarify a few items that did not perform as expected. After the questionnaire was finalized it was distributed to 1,500 pain management nurses. The final yield was 585 usable returns, for a response rate of 39%. Thirty-three percent of the respondents reported a bachelor's degree in nursing as the highest degree awarded. Over 80% indicated that they were certified in pain management. Over 35% reported working in a staff position, 14% as a nurse practitioner, and 13% as a clinical nurse specialist. Part of the questionnaire asked the participants to rate performance expectation, consequence or the likelihood that the newly certified pain management nurse could cause harm, and the frequency of how often that nurse performs in each of the performance domains. The performance expectation was rated from 0 (the newly certified pain management nurse was not at all expected to perform the domain task) to 2 (after 6 months the newly certified pain management nurse would be expected to perform the domain task). The consequences of the degree would be the inability of the newly certified pain management nurse to perform duties or tasks in each domain was rated from 0 (no harm) to 4 (extreme harm). The first domain received the highest average frequency rating. The pharmacologic domain received the highest mean rating on consequence. The reliability of all scales was 0.95 or higher, which indicated that the questionnaire consistently measured what it was intended to measure. The quality of the questionnaire is an indicator that certification is one measure of nursing excellence. (c) 2010 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Demographics, farm and reproductive management strategies used in Australian automatic milking systems compared with regionally proximal conventional milking systems.

PubMed

Keeper, D M; Kerrisk, K L; House, J K; Garcia, S C; Thomson, P

2017-09-01

To determine the management practices utilised in automatic milking systems (AMS) that affect reproductive management and performance and how these compare with the management practices used in regionally proximal conventional milking systems (CMS). This study examined demographic and management data from AMS and CMS dairy farms through a survey, with a specific focus on reproductive management procedures. Overall, responses from AMS and CMS dairy farms showed little difference in terms of respondent demographics, farm size, herd structure and most farm management strategies. AMS dairies were more likely to use activity meters or other electronic oestrus detection aids than CMS dairies (P < 0.001) and were also more likely to have changed to electronic recording systems (P = 0.007). Although many respondents indicated that they used key monitoring parameters to assess reproductive performance (e.g. days in milk, conception vs pregnancy rate etc.), the format of responses varied significantly, indicating a relatively widespread (among the respondents) lack of knowledge regarding the meaning and usage of some of these common parameters/terminology. Ultimately, reproductive management practices of AMS dairies were largely similar to those of CMS dairies, indicating that such practices can be implemented in a practical sense, even though the resultant reproductive performance is not yet understood. Understanding that the key reproductive management strategies do not need to change vastly is important to ensure that new adoptees are well informed. Further work is needed to objectively measure AMS performance to increase the knowledge base and generate the confidence that will facilitate further adoption of this innovation. © 2017 Australian Veterinary Association.

Valuing the human asset - the impact of university placements on academic performance and graduate employment amongst management students

NASA Astrophysics Data System (ADS)

Brooks, R.

2012-05-01

The employment market for graduates is competitive with employers requiring appropriate work experience in addition to academic qualifications. Sandwich courses, where up to a year is spent in industry, provide an opportunity for structured work experience to be gained alongside studying. Benefits of placements include improved academic performance and the development of transferable skills to increase employability. This paper evaluates the impact of placements on academic performance and graduate employment among management students. Analysing performance data and graduate destinations data, results indicate that management students completing a placement are more likely to perform better academically with improvements in their personal grades between year 2 and the final year. Additionally, a qualitative themed analysis of student experiences indicates placement students feel more confident in engaging with the graduate recruitment process, with a better understanding of their personal skills and an ability to articulate their experience in relation to the workplace.

Developing an Index to Measure Health System Performance: Measurement for Districts of Nepal.

PubMed

Kandel, N; Fric, A; Lamichhane, J

2014-01-01

Various frameworks for measuring health system performance have been proposed and discussed. The scope of using performance indicators are broad, ranging from examining national health system to individual patients at various levels of health system. Development of innovative and easy index is essential to measure multidimensionality of health systems. We used indicators, which also serve as proxy to the set of activities, whose primary goal is to maintain and improve health. We used eleven indicators of MDGs, which represent all dimensions of health to develop index. These indicators are computed with similar methodology that of human development index. We used published data of Nepal for computation of the index for districts of Nepal as an illustration. To validate our finding, we compared the indices of these districts with other development indices of Nepal. An index for each district has been computed from eleven indicators. Then indices are compared with that of human development index, socio-economic and infrastructure development indices and findings has shown the similarity on distribution of districts. Categories of low and high performing districts on health system performance are also having low and high human development, socio-economic, and infrastructure indices respectively. This methodology of computing index from various indicators could assist policy makers and program managers to prioritize activities based on their performance. Validation of the findings with that of other development indicators show that this can be one of the tools, which can assist on assessing health system performance for policy makers, program managers and others.

Are we measuring what matters in health technology assessment of disease management? Systematic literature review.

PubMed

Steuten, Lotte; Vrijhoef, Bert; Severens, Hans; van Merode, Frits; Spreeuwenberg, Cor

2006-01-01

An overview was produced of indicators currently used to assess disease management programs and, based on these findings, provide a framework regarding sets of indicators that should be used when taking the aims and types of disease management programs into account. A systematic literature review was performed. Thirty-six studies met the inclusion criteria. It appeared that a link between aims of disease management and evaluated structure, process, as well as outcome indicators does not exist in a substantial part of published studies on disease management of diabetes and asthma/chronic obstructive pulmonary disease, especially when efficiency of care is concerned. Furthermore, structure indicators are largely missing from the evaluations, although these are of major importance for the interpretation of outcomes for purposes of decision-making. Efficiency of disease management is mainly evaluated by means of process indicators; the use of outcome indicators is less common. Within a framework, structure, process, and outcome indicators for effectiveness and efficiency are recommended for each type of disease management program. The link between aims of disease management and evaluated structure, process, and outcome indicators does not exist in a substantial part of published studies on disease management. The added value of this study mainly lies in the development of a framework to guide the choice of indicators for health technology assessment of disease management.

Hospital financial management: what is the link between revenue cycle management, profitability, and not-for-profit hospitals' ability to grow equity?

PubMed

Singh, Simone Rauscher; Wheeler, John

2012-01-01

Effective revenue cycle management--from appointment scheduling and patient registration at the front end of the revenue cycle to billing and cash collections at the back end--plays a crucial role in hospitals' efforts to improve their financial performance. Using data for 1,397 bond-issuing, not-for-profit US hospitals for 2000 to 2007, this study analyzed the relationship between hospitals' performance at managing the revenue cycle and their profitability and ability to build equity capital. Hospital-level fixed effects regression analysis was used to model four different measures of profitability and equity capital as functions of two key financial indicators of revenue cycle management--amount of patient revenue and speed of revenue collection. The results indicated that higher amounts of patient revenue in relation to a hospital's assets were associated with statistically significant increases in operating and total profit margins, free cash flow, and equity capital (p < 0.01 for all four models); that is, hospitals that generated more patient revenue per dollar of assets invested reported improved financial performance. Likewise, a statistically significant link existed between lower revenue collection periods and all four indicators of hospital financial performance (p < 0.01 for three models; p < 0.05 for one model). Hospitals that collected faster on their patient revenue reported higher profit margins and larger equity values. For revenue cycle managers, these findings represent good news: Streamlining a hospital's management of the patient revenue cycle can advance the organization's financial viability by improving profitability and enabling equity growth.

Quality indicators for Transfusion Medicine in Spain: a survey among hospital transfusion services.

PubMed

Romon, Iñigo; Lozano, Miguel

2017-05-01

Transfusion services in the European Union must implement quality management systems to improve quality. Quality indicators (QI) play a key role in quality management because they can supply important information about the performance of the transfusion service, which can then be used for benchmarking. However, little is known about the actual use of QI in hospitals. We tried to ascertain the use and characteristics of QI in Spanish hospital transfusion services. We performed a survey among transfusion services in order to learn which QI they use. We classified indicators into categories and concepts, according to the steps of the transfusion process or the activities the indicators referred to. Seventy-six hospitals (17.9% of the hospitals actively transfusing in the country) reported 731 QI. Twenty-two of them (29%) were tertiary level hospitals. The number of indicators per hospital and by activity varied greatly. QI were assigned to some basic categories: transfusion process (23% of indicators), transfusion activity and stock management (22%), haemovigilance (20%), stem cell transplantation (9%), transfusion laboratory (9%), quality management system (8%), blood donation (3.4%), apheresis and therapeutic activities (2.5%) and immunohaematology of pregnancy (2%). Although most hospitals use QI in their quality management system and share a core group of indicators, we found a great dispersion in the number and characteristics of the indicators used. The use of a commonly agreed set of QI could be an aid to benchmarking among hospitals and to improving the transfusion process.

The Proposal of Key Performance Indicators in Facility Management and Determination the Weights of Significance

NASA Astrophysics Data System (ADS)

Rimbalová, Jarmila; Vilčeková, Silvia

2013-11-01

The practice of facilities management is rapidly evolving with the increasing interest in the discourse of sustainable development. The industry and its market are forecasted to develop to include non-core functions, activities traditionally not associated with this profession, but which are increasingly being addressed by facilities managers. The scale of growth in the built environment and the consequential growth of the facility management sector is anticipated to be enormous. Key Performance Indicators (KPI) are measure that provides essential information about performance of facility services delivery. In selecting KPI, it is critical to limit them to those factors that are essential to the organization reaching its goals. It is also important to keep the number of KPI small just to keep everyone's attention focused on achieving the same KPIs. This paper deals with the determination of weights of KPI of FM in terms of the design and use of sustainable buildings.

Developing a Performance Assessment Framework and Indicators for Communicable Disease Management in Natural Disasters.

PubMed

Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbarisari, Ali

2016-02-01

Communicable disease management (CDM) is an important component of disaster public health response operations. However, there is a lack of any performance assessment (PA) framework and related indicators for the PA. This study aimed to develop a PA framework and indicators in CDM in disasters. In this study, a series of methods were used. First, a systematic literature review (SLR) was performed in order to extract the existing PA frameworks and indicators. Then, using a qualitative approach, some interviews with purposively selected experts were conducted and used in developing the PA framework and indicators. Finally, the analytical hierarchy process (AHP) was used for weighting of the developed indicators. The input, process, products, and outcomes (IPPO) framework was found to be an appropriate framework for CDM PA. Seven main functions were revealed to CDM during disasters. Forty PA indicators were developed for the four categories. There is a lack of any existing PA framework in CDM in disasters. Thus, in this study, a PA framework (IPPO framework) was developed for the PA of CDM in disasters through a series of methods. It can be an appropriate framework and its indicators could measure the performance of CDM in disasters.

[Identifying indicators of good practice in clinical and healthcare management].

PubMed

Bermúdez Tamayo, C; Olry de Labry Lima, A; García Mochón, L

To identify good practices in order to develop and implement indicators of health outcomes for clinical and healthcare management, as well as the characteristics for an indicator to be considered adequate. A scoping review was performed, with the following phases: 1) Search and identification of bibliography. 2) Selection of relevant documents. Including those studies that discussed issues related to good practices for the use of health indicators in the management field. Those published in a language other than English or Spanish or before 2006 were excluded. 3) Analysis and extraction of information. 4) Consultation with stakeholders, using a qualitative methodology through Concept Mapping, with the participation of 40 experts (decision-makers, scientific societies, and health professionals). The data collection process included an inductive and structured procedure, with prioritisation of ideas grouped into clusters, according to feasibility and importance criteria (0-10 scale). Good practices identified 2 levels: 1) macro-management: Define a framework for the evaluation of indicators and establish a benchmark of indicators. 2) meso-management: Establish indicators according to evidence and expert consensus, taking into account priority areas and topics, testing before final use, and communicate results adequately. The characteristics of a suitable indicator are: 1) Approach of an important issue, 2) Scientific validity, 3) Possibility of measurement with reliable data, 4) Meaning of useful and applicable measurement, and 5) Wide scope. The best practices for the use of indicators in clinical and healthcare management can make it easier to monitor performance and accountability, as well as to support the decision-making addressed at the development of initiatives for quality improvement. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

78 FR 48726 - Placement of the Georgia Agreement State Program on Probation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... the Integrated Materials Performance Evaluation Program (IMPEP). The Management Review Board (MRB), in... CONTACT: Lisa Dimmick, Office of Federal and State Materials and Environmental Management Programs, U.S... Agreement State radiation control programs, using performance indicators, to ensure that public health and...

From Rationale to Results: Implementing Performance Indicators in a Public Library.

ERIC Educational Resources Information Center

Alston, Ruth

This paper describes the theoretical design and practical implementation of a set of performance indicators in a public library system in London (England). Bromley Libraries has 15 branch libraries and serves 300,000 people. The need for improved management control by assessing performance and monitoring progress, library restructuring, and…

Group assessment of key indicators of sustainable waste management in developing countries.

PubMed

Tot, Bojana; Vujić, Goran; Srđević, Zorica; Ubavin, Dejan; Russo, Mário Augusto Tavares

2017-09-01

Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries. An assessment is performed by 43 decision makers from both developed and developing countries, and the applied methodology is based on a combined use of the analytic hierarchy process, from the multi-criteria decision-making set of tools, and the preferential voting method known as Borda Count, which belongs to social choice theory. Pairwise comparison of indicators is performed with the analytic hierarchy process, and the ranking of indicators once obtained is assessed with Borda Count. Detailed analysis of the final results showed that the Institutional-Administrative indicator was the most important one, with the maximum weight as derived by both groups of decision makers. The results also showed that the combined use of the analytic hierarchy process and Borda Count contributes to the credibility and objectivity of the decision-making process, allowing its use in more complex waste management group decision-making problems to be recommended.

SMART marine goals, targets and management - Is SDG 14 operational or aspirational, is 'Life Below Water' sinking or swimming?

PubMed

Cormier, Roland; Elliott, Michael

2017-10-15

The United Nations Sustainable Development Goals (SDG), adopted in September 2015, are accompanied by targets which have to be met individually and collectively by the signatory states. SDG14 Life Below Water aims to lay the foundation for the integrated and sustainable management of the oceans. However, any environmental management has to be based around targets which are SMART - specific, measurable, achievable, realistic and time bounded - otherwise it is not possible to determine whether management actions are successful and achieve the desired aims. The discussion here shows that many of the targets adopted for SDG14, and especially a detailed analysis of Target 1, are aspirational rather than fully quantified. In order to move towards making the targets operational, we advocate merging the language of environmental management with that used by industry for linking risks to the environment, management performance and ensuing controls. By adopting an approach which uses Key Performance Indicators ('KPIs'), Key Risk Indicators ('KRIs') and Key Control Indicators ('KCIs'), we advocate that a degree of rigour leading to defendable actions can be brought to marine management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship between Managers' Performance and Organizational Health

ERIC Educational Resources Information Center

Mohammadisadr, Mohammad; Siadat, Seyyedali; Arbabisarjou, Azizollah

2012-01-01

The main purpose of this paper is to study the relationship between managers' performance in the field of interpersonal, informational and decision-making tasks with organizational health. To measure the indicators of the model, a questionnaire was prepared and distributed among 113 company of Tehran stock Exchange Market. According to the…

Performance indicators used to assess the quality of primary dental care.

PubMed

González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M

2006-12-01

An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a health care system, the sources for data collection and finally, the dimensions of quality measured by these indicators. An explorative study of the international literature was conducted using medical databases, journals and books, and official websites of organisations and associations. This resulted in a set of 57 indicators, which were classified into the following dimensions for each intended user group: For patients: health outcomes and subjective indicators; for professionals: their performance and the rates of success, failure and complications; for health care system managers and policymakers: their resources, finances and health care utilisation. A set of 57 performance indicators were identified to assess the quality of primary dental care at the levels of patients, professionals and the health care system. These indicators could be used by managers and decision-makers at any level of the health care system according to the characteristics of the services.

Human resources management and firm performance: The differential role of managerial affective and continuance commitment.

PubMed

Gong, Yaping; Law, Kenneth S; Chang, Song; Xin, Katherine R

2009-01-01

In this study, the authors developed a dual-concern (i.e., maintenance and performance) model of human resources (HR) management. The authors identified commonly examined HR practices that apply to the middle manager level and classified them into the maintenance- and performance-oriented HR subsystems. The authors found support for the 2-factor model on the basis of responses from 2,148 managers from 463 firms operating in China. Regression results indicate that the performance-oriented HR subsystems had a positive relationship with firm performance and that the relationship was mediated by middle managers' affective commitment to the firm. The maintenance-oriented HR subsystems had a positive relationship with middle managers' continuance commitment but not with their affective commitment and firm performance. This study contributes to the understanding of how HR practices relate to firm performance and offers an improved test of the argument that valuable and firm-specific HR provide a source of competitive advantage. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

From Information Management to Information Visualization

PubMed Central

Karami, Mahtab

2016-01-01

Summary Objective The development and implementation of a dashboard of medical imaging department (MID) performance indicators. Method Several articles discussing performance measures of imaging departments were searched for this study. All the related measures were extracted. Then, a panel of imaging experts were asked to rate these measures with an open ended question to seek further potential indicators. A second round was performed to confirm the performance rating. The indicators and their ratings were then reviewed by an executive panel. Based on the final panel’s rating, a list of indicators to be used was developed. A team of information technology consultants were asked to determine a set of user interface requirements for the building of the dashboard. In the first round, based on the panel’s rating, a list of main features or requirements to be used was determined. Next, Qlikview was utilized to implement the dashboard to visualize a set of selected KPI metrics. Finally, an evaluation of the dashboard was performed. Results 92 MID indicators were identified. On top of this, 53 main user interface requirements to build of the prototype of dashboard were determined. Then, the project team successfully implemented a prototype of radiology management dashboards into study site. The visual display that was designed was rated highly by users. Conclusion To develop a dashboard, management of information is essential. It is recommended that a quality map be designed for the MID. It can be used to specify the sequence of activities, their related indicators and required data for calculating these indicators. To achieve both an effective dashboard and a comprehensive view of operations, it is necessary to design a data warehouse for gathering data from a variety of systems. Utilizing interoperability standards for exchanging data among different systems can be also effective in this regard. PMID:27437043

Performance and quality indicators for the management of non-cancer chronic pain: a scoping review protocol.

PubMed

Zidarov, Diana; Visca, Regina; Gogovor, Amédé; Ahmed, Sara

2016-02-19

Chronic pain is a public health problem of epidemic proportion in most countries with important physical, psychological, social and economic consequences. The management of chronic pain is complex and requires an integrated network approach between all levels of the healthcare system and the involvement of several health professionals from different disciplines. Measuring the performance of organisations that provide care to individuals with chronic pain is essential to improve quality of care and requires the use of relevant performance and quality indicators. A scoping review methodology will be used to synthesise the evidence on performance and quality indicators developed for non-cancer chronic pain management across the continuum of care. The following electronic databases will be searched from 2000 onwards: Cochrane Effective Practice and Organisation of Care (EPOC) Review Group Specialised Register; Cochrane Library; EMBASE; PubMed; CINAHL; PsycINFO; ProQuest Dissertations and Theses. All types of studies will be included if these are concerned with performance or quality indicators in adults with chronic non-cancer pain. In addition, searches will be conducted on provincial, national and international health organisations as well as health professional and scientific associations' websites. A qualitative descriptive approach will be used to describe characteristics of each indicator. All identified indicators will be classified according to dimensions covered by Donabedian and the Triple Aim frameworks. The scoping review findings will inform the development of a performance measurement system comprising a list of performance indicators with their level of evidence which can be used by stakeholders to evaluate the quality of care for individuals with chronic non-cancer pain at the patient, institutional and system level. The results will be disseminated via several knowledge translation strategies, including 2 stakeholder meetings, publication and presentation at conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluating the Fraser Health Balanced Scorecard--a formative evaluation.

PubMed

Barnardo, Catherine; Jivanni, Amin

2009-01-01

Fraser Health (FH), a large, Canadian, integrated health care network, adopted the Balanced Scorecard (BSC) approach to monitor organizational performance in 2006. This paper reports on the results of a formative evaluation, conducted in April, 2008, to assess the usefulness of the BSC as a performance-reporting system and a performance management tool. Results indicated that the BSC has proven to be useful for reporting performance but is not currently used for performance management in a substantial way.

The Manager's Job: Folklore and Fact

ERIC Educational Resources Information Center

Mintzberg, Henry

1975-01-01

Contrasts popular myths about managers' duties with the facts, as indicated by various studies of managers and how they function. The author argues that managers often have distorted views of their role, and that they must first recognize what their job really involves in order to perform it effectively. (JG)

Six steps to an effective denials management program.

PubMed

Robertson, Brian; Doré, Alexander

2005-09-01

The following six steps can help you manage denials management issues in your organization: Create standard definitions of denial types. Establish a denial hierarchy. Establish a centralized denial database. Develop key performance indicators. Build responsibility matrices. Measure, monitor, and take action.

Performance Indicators and Rational Management Tools: A Comparative Assessment of Projects in North America and Europe. AIR 1993 Annual Forum Paper.

ERIC Educational Resources Information Center

Nedwek, Brian P.; Neal, John E.

This study developed a classification scheme to critically compare performance assessment projects at higher education universities in North America and Europe. Performance indicators and assessment initiatives were compared using nine basic dimensions: (1) locus of control, (2) degree of governmental involvement, (3) focus of performance…

A novel fuzzy expert system to assess the sustainability of the viticulture at the wine-estate scale.

PubMed

Lamastra, L; Balderacchi, M; Di Guardo, A; Monchiero, M; Trevisan, M

2016-12-01

The wine industry is definitely committed in sustainability: the stakeholders' interest for the topic is constantly growing and a wide number of sustainability programs have been launched in recent years. Most of these programs are focusing on the environmental aspects as environmental sustainability indicators, greenhouse gases emissions and the use of Life Cycle Assessment methodology. Among the environmental indicators the carbon and the water footprint are often used. These indicators, while being useful to assess the sustainability performance of the winegrowing farms, do not take into account important aspects related to the agronomic management of the vineyard. To fill this gap a new indicator called "Vigneto" (Vineyard in Italian language) has been developed. "Vigneto" is a multidimensional indicator to evaluate the sustainability of management options adopted at field scale. It considers the main agronomic aspects, which can have an impact on the environment. These include (i) pest management, (ii) soil management (erosion and compaction), (iii) fertility management (soil organic matter management and fertilizer application), (iv) biodiversity management. Those aspects have been related by fuzzy logics and implemented in web GIS software. The application of the model allows obtaining a general judgment of the agronomic sustainability of the vineyard management: the judgment varies from "A" (excellent) to "E" (completely unsustainable). The produced model was validated and tested by four Italian wine estate. The model output reports that the tested wineries have different management strategies: producers manage vineyards in different ways, depending on the different geographical position. The main differences are related to the soil management and to the presence of natural areas different from vineyard. The developed model can be defined as an environmental decision support system that can be used by wine companies' technicians to define the vineyard practices sustainability performance and support them in the definition of more sustainable management practices. Copyright © 2016. Published by Elsevier B.V.

The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries.

PubMed

Rotar, A M; Botje, D; Klazinga, N S; Lombarts, K M; Groene, O; Sunol, R; Plochg, T

2016-05-24

Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of care and efficiency outcomes is supposed to benefit from their involvement. However, international comparative evidence supporting this idea is limited. Just a few studies indicate that there may be a positive relationship between medical doctors being part of hospital boards, and overall hospital performance. More importantly, the assumed relationship between these so-called doctor managers and hospital performance has remained a 'black-box' thus far. However, there is an increasing literature on the implementation of quality management systems in hospitals and their relation with improved performance. It seems therefore fair to assume that the relation between the involvement of doctors in hospital management and improved hospital performance is partly mediated via quality management systems. The threefold aim of this paper is to 1) perform a quick scan of the current situation with regard to doctor managers in hospital management in 19 OECD countries, 2) explore the phenomenon of doctor managers in depth in 7 OECD countries, and 3) investigate whether doctor involvement in hospital management is associated with more advanced implementation of quality management systems. This study draws both on a quick scan amongst country coordinators in OECD's Health Care Quality Indicator program, and on the DUQuE project which focused on the implementation of quality management systems in European hospitals. This paper reports two main findings. First, medical doctors fulfil a broad scope of managerial roles at departmental and hospital level but only partly accompanied by formal decision making responsibilities. Second, doctor managers having more formal decision making responsibilities in strategic hospital management areas is positively associated with the level of implementation of quality management systems. Our findings suggest that doctors are increasingly involved in hospital management in OECD countries, and that this may lead to better implemented quality management systems, when doctors take up managerial roles and are involved in strategic management decision making.

Management Practices. U.S. Companies Improve Performance through Quality Efforts. Report to the Honorable Donald Ritter, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. National Security and International Affairs Div.

The General Accounting Office (GAO) examined the impact of formal total quality management (TQM) practices on the performance of 20 selected U.S. companies that were among the highest-scoring applicants in 1988 and 1989 for the Malcolm Baldridge National Quality Award. Several key indicators used by companies to measure performance were analyzed.…

Evaluation of a Modified User Guide for Hearing Aid Management.

PubMed

Caposecco, Andrea; Hickson, Louise; Meyer, Carly; Khan, Asaduzzaman

2016-01-01

This study investigated if a hearing aid user guide modified using best practice principles for health literacy resulted in superior ability to perform hearing aid management tasks, compared with the user guide in the original form. This research utilized a two-arm study design to compare the original manufacturer's user guide with a modified user guide for the same hearing aid--an Oticon Acto behind-the-ear aid with an open dome. The modified user guide had a lower reading grade level (4.2 versus 10.5), used a larger font size, included more graphics, and had less technical information. Eighty-nine adults ages 55 years and over were included in the study; none had experience with hearing aid use or management. Participants were randomly assigned either the modified guide (n = 47) or the original guide (n = 42). All participants were administered the Hearing Aid Management test, designed for this study, which assessed their ability to perform seven management tasks (e.g., change battery) with their assigned user guide. The regression analysis indicated that the type of user guide was significantly associated with performance on the Hearing Aid Management test, adjusting for 11 potential covariates. In addition, participants assigned the modified guide required significantly fewer prompts to perform tasks and were significantly more likely to perform four of the seven tasks without the need for prompts. The median time taken by those assigned the modified guide was also significantly shorter for three of the tasks. Other variables associated with performance on the Hearing Aid Management test were health literacy level, finger dexterity, and age. Findings indicate that the need to design hearing aid user guides in line with best practice principles of health literacy as a means of facilitating improved hearing aid management in older adults.

The influence of time management skill on the curvilinear relationship between organizational citizenship behavior and task performance.

PubMed

Rapp, Adam A; Bachrach, Daniel G; Rapp, Tammy L

2013-07-01

In this research we integrate resource allocation and social exchange perspectives to build and test theory focusing on the moderating role of time management skill in the nonmonotonic relationship between organizational citizenship behavior (OCB) and task performance. Results from matching survey data collected from 212 employees and 41 supervisors and from task performance metrics collected several months later indicate that the curvilinear association between OCB and task performance is significantly moderated by employees' time management skill. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The Strategic Data Project's Strategic Performance Indicators

ERIC Educational Resources Information Center

Page, Lindsay C.; Fullerton, Jon; Bacher-Hicks, Andrew; Owens, Antoniya; Cohodes, Sarah R.; West, Martin R.; Glover, Sarah

2013-01-01

Strategic Performance Indicators (SPIs) are summary measures derived from parallel, descriptive analyses conducted across educational agencies. The SPIs are designed to inform agency management and efforts to improve student outcomes. We developed the SPIs to reveal patterns common across partner agencies, to highlight exceptions to those…

Introducing Problem-Based Learning to Undergraduate IT Service Management Course: Student Satisfaction and Work Performance

ERIC Educational Resources Information Center

Anicic, Katarina Pažur; Mekovec, Renata

2016-01-01

This paper describes the implementation of problem-based learning (PBL) principles in an undergraduate IT service management course, followed by the results about student satisfaction and work performance. The results indicate the students' general satisfaction with the course implementation, as well as some challenges regarding the…

Organizational Downsizing and Career Development.

ERIC Educational Resources Information Center

Bozionelos, Nikos

2001-01-01

A study of 123 "survivors" of corporate downsizing and 13 senior managers indicated that the organization lacked a coherent career development plan and the performance management/appraisal process was inadequate. Managers perceived lateral transfers as effective; some employees felt they undermined career progression. Employees thought…

The Linear Programming to evaluate the performance of Oral Health in Primary Care.

PubMed

Colussi, Claudia Flemming; Calvo, Maria Cristina Marino; Freitas, Sergio Fernando Torres de

2013-01-01

To show the use of Linear Programming to evaluate the performance of Oral Health in Primary Care. This study used data from 19 municipalities of Santa Catarina city that participated of the state evaluation in 2009 and have more than 50,000 habitants. A total of 40 indicators were evaluated, calculated using the Microsoft Excel 2007, and converted to the interval [0, 1] in ascending order (one indicating the best situation and zero indicating the worst situation). Applying the Linear Programming technique municipalities were assessed and compared among them according to performance curve named "quality estimated frontier". Municipalities included in the frontier were classified as excellent. Indicators were gathered, and became synthetic indicators. The majority of municipalities not included in the quality frontier (values different of 1.0) had lower values than 0.5, indicating poor performance. The model applied to the municipalities of Santa Catarina city assessed municipal management and local priorities rather than the goals imposed by pre-defined parameters. In the final analysis three municipalities were included in the "perceived quality frontier". The Linear Programming technique allowed to identify gaps that must be addressed by city managers to enhance actions taken. It also enabled to observe each municipal performance and compare results among similar municipalities.

Performance indicators and indices of sludge management in urban wastewater treatment plants.

PubMed

Silva, C; Saldanha Matos, J; Rosa, M J

2016-12-15

Sludge (or biosolids) management is highly complex and has a significant cost associated with the biosolids disposal, as well as with the energy and flocculant consumption in the sludge processing units. The sludge management performance indicators (PIs) and indices (PXs) are thus core measures of the performance assessment system developed for urban wastewater treatment plants (WWTPs). The key PIs proposed cover the sludge unit production and dry solids concentration (DS), disposal/beneficial use, quality compliance for agricultural use and costs, whereas the complementary PIs assess the plant reliability and the chemical reagents' use. A key PI was also developed for assessing the phosphorus reclamation, namely through the beneficial use of the biosolids and the reclaimed water in agriculture. The results of a field study with 17 Portuguese urban WWTPs in a 5-year period were used to derive the PI reference values which are neither inherent to the PI formulation nor literature-based. Clusters by sludge type (primary, activated, trickling filter and mixed sludge) and by digestion and dewatering processes were analysed and the reference values for sludge production and dry solids were proposed for two clusters: activated sludge or biofilter WWTPs with primary sedimentation, sludge anaerobic digestion and centrifuge dewatering; activated sludge WWTPs without primary sedimentation and anaerobic digestion and with centrifuge dewatering. The key PXs are computed for the DS after each processing unit and the complementary PXs for the energy consumption and the operating conditions DS-determining. The PX reference values are treatment specific and literature based. The PI and PX system was applied to a WWTP and the results demonstrate that it diagnosis the situation and indicates opportunities and measures for improving the WWTP performance in sludge management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lessons from Philippines MPA Management: Social Ecological Interactions, Participation, and MPA Performance

NASA Astrophysics Data System (ADS)

Twichell, Julia; Pollnac, Richard; Christie, Patrick

2018-06-01

International interest in increasing marine protected area (MPA) coverage reflects broad recognition of the MPA as a key tool for marine ecosystems and fisheries management. Nevertheless, effective management remains a significant challenge. The present study contributes to enriching an understanding of best practices for MPA management through analysis of archived community survey data collected in the Philippines by the Learning Project (LP), a collaboration with United States Coral Triangle Initiative (USCTI), United States Agency for International Development (USAID), and partners. We evaluate stakeholder participation and social ecological interactions among resource users in MPA programs in the Palawan, Occidental Mindoro, and Batangas provinces in the Philippines. Analysis indicates that a complex suite of social ecological factors, including demographics, conservation beliefs, and scientifically correct knowledge influence participation, which in turn is related to perceived MPA performance. Findings indicate positive feedbacks within the system that have potential to strengthen perceptions of MPA success. The results of this evaluation provide empirical reinforcement to current inquiries concerning the role of participation in influencing MPA performance.

Designing Flood Management Systems for Joint Economic and Ecological Robustness

NASA Astrophysics Data System (ADS)

Spence, C. M.; Grantham, T.; Brown, C. M.; Poff, N. L.

2015-12-01

Freshwater ecosystems across the United States are threatened by hydrologic change caused by water management operations and non-stationary climate trends. Nonstationary hydrology also threatens flood management systems' performance. Ecosystem managers and flood risk managers need tools to design systems that achieve flood risk reduction objectives while sustaining ecosystem functions and services in an uncertain hydrologic future. Robust optimization is used in water resources engineering to guide system design under climate change uncertainty. Using principles introduced by Eco-Engineering Decision Scaling (EEDS), we extend robust optimization techniques to design flood management systems that meet both economic and ecological goals simultaneously across a broad range of future climate conditions. We use three alternative robustness indices to identify flood risk management solutions that preserve critical ecosystem functions in a case study from the Iowa River, where recent severe flooding has tested the limits of the existing flood management system. We seek design modifications to the system that both reduce expected cost of flood damage while increasing ecologically beneficial inundation of riparian floodplains across a wide range of plausible climate futures. The first robustness index measures robustness as the fraction of potential climate scenarios in which both engineering and ecological performance goals are met, implicitly weighting each climate scenario equally. The second index builds on the first by using climate projections to weight each climate scenario, prioritizing acceptable performance in climate scenarios most consistent with climate projections. The last index measures robustness as mean performance across all climate scenarios, but penalizes scenarios with worse performance than average, rewarding consistency. Results stemming from alternate robustness indices reflect implicit assumptions about attitudes toward risk and reveal the tradeoffs between using structural and non-structural flood management strategies to ensure economic and ecological robustness.

High Capacity Single Table Performance Design Using Partitioning in Oracle or PostgreSQL

DTIC Science & Technology

2012-03-01

Indicators ( KPIs ) 13  5.  Conclusion 14  List of Symbols, Abbreviations, and Acronyms 15  Distribution List 16 iv List of Figures Figure 1. Oracle...Figure 7. Time to seek and return one record. 4. Additional Key Performance Indicators ( KPIs ) In addition to pure response time, there are other...Laboratory ASM Automatic Storage Management CPU central processing unit I/O input/output KPIs key performance indicators OS operating system

Collegiate and Departmental Performance Indicators: The Measures That Matter! AIR 1997 Annual Forum Paper.

ERIC Educational Resources Information Center

Moloney, Daniel P.; Grotevant, Susan M.

In response to changing management and budgetary strategies that have been driving decision making to the lowest administrative levels, institutional researchers have been attempting to identify indicators which can be used to evaluate institutional performance and progress. This paper reviews efforts to introduce departmental operational…

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience.

PubMed

Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh

2015-06-12

Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. This research was a cross-sectional study. First, reviewing the literature and using experts' viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them.

Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

PubMed

Yang, Ming-Chin; Tung, Yu-Chi

2006-01-01

Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

Development of a performance-based industrial energy efficiency indicator for corn refining plants.

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

Boyd, G. A.; Decision and Information Sciences; USEPA

2006-07-31

Organizations that implement strategic energy management programs have the potential to achieve sustained energy savings if the programs are carried out properly. A key opportunity for achieving energy savings that plant managers can take is to determine an appropriate level of energy performance by comparing their plant's performance with that of similar plants in the same industry. Manufacturing facilities can set energy efficiency targets by using performance-based indicators. The U.S. Environmental Protection Agency (EPA), through its ENERGY STAR{reg_sign} program, has been developing plant energy performance indicators (EPIs) to encourage a variety of U.S. industries to use energy more efficiently. Thismore » report describes work with the corn refining industry to provide a plant-level indicator of energy efficiency for facilities that produce a variety of products--including corn starch, corn oil, animal feed, corn sweeteners, and ethanol--for the paper, food, beverage, and other industries in the United States. Consideration is given to the role that performance-based indicators play in motivating change; the steps needed to develop indicators, including interacting with an industry to secure adequate data for an indicator; and the actual application and use of an indicator when complete. How indicators are employed in the EPA's efforts to encourage industries to voluntarily improve their use of energy is discussed as well. The report describes the data and statistical methods used to construct the EPI for corn refining plants. Individual equations are presented, as are the instructions for using them in an associated Excel spreadsheet.« less

Assessment of the quality of medical care among patients with early stage prostate cancer undergoing expectant management in the United States.

PubMed

Ritchey, Jamie; Gay, E Greer; Spencer, Benjamin A; Miller, David C; Wallner, Lauren P; Stewart, Andrew K; Dunn, Rodney L; Litwin, Mark S; Wei, John T

2012-09-01

Given the increased attention to the quality and cost of medical care, the Institute of Medicine and Centers for Medicare and Medicaid Services have called for performance measurement and reporting. The clinical management of prostate cancer has been outlined, yet is not intended to describe quality prostate cancer care. Therefore, RAND researchers developed quality indicators for early stage prostate cancer. The ACoS (American College of Surgeons) used these indicators to perform the first national assessment to our knowledge of the quality of care among men with early stage prostate cancer undergoing expectant management. Information from medical records was abstracted for evidence of compliance with the RAND indicators (structure and process). Weighted and stratified proportions were calculated to assess indicator compliance. Logistic regression models were fit and evaluated by hospital type and patient factors. A weighted and stratified total of 13,876 early stage prostate cancer cases on expectant management in 2000 to 2001 were investigated. Compliance with structural indicators was high (greater than 80%) and compliance with process indicators varied (19% to 87%). Differences in process indicators were observed from models by hospital type and comorbid conditions, but not for age, race or insurance status. Using the RAND quality indicators this study revealed several process areas for quality improvement among men with early stage prostate cancer on expectant management in the United States. Efforts to improve the quality of early stage prostate cancer care need to move beyond the paradigm of age, race and insurance status. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Development of ecological indicator guilds for land management

USGS Publications Warehouse

Krzysik, A.J.; Balbach, H.E.; Duda, J.J.; Emlen, J.M.; Freeman, D.C.; Graham, J.H.; Kovacic, D.A.; Smith, L.M.; Zak, J.C.

2005-01-01

Agency land-use must be efficiently and cost-effectively monitored to assess conditions and trends in ecosystem processes and natural resources relevant to mission requirements and legal mandates. Ecological Indicators represent important land management tools for tracking ecological changes and preventing irreversible environmental damage in disturbed landscapes. The overall objective of the research was to develop both individual and integrated sets (i.e., statistically derived guilds) of Ecological Indicators to: quantify habitat conditions and trends, track and monitor ecological changes, provide early warning or threshold detection, and provide guidance for land managers. The derivation of Ecological Indicators was based on statistical criteria, ecosystem relevance, reliability and robustness, economy and ease of use for land managers, multi-scale performance, and stress response criteria. The basis for the development of statistically based Ecological Indicators was the identification of ecosystem metrics that analytically tracked a landscape disturbance gradient.

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

Maloney, J.; Kiepper, A.F.; Simonetta, R.J.

The volume examines monitoring and reporting procedures applicable to performance and productivity. The managers of three transit systems of varying sizes discuss how productivity has been increased within their systems. The Pittsburgh discussion reviews a variety of capital projects and management improvement initiatives undertaken by Port Authority Transit, including development of maintenance manuals and an absenteeism reduction project. The Houston discussion describes how the property used a management study to identify needed organizational change and restructuring. The Ann Arbor discussion focuses on a set of service standards and performance indicators adopted to focus the management improvement process.

A strategic management model for evaluation of health, safety and environmental performance.

PubMed

Abbaspour, Majid; Toutounchian, Solmaz; Roayaei, Emad; Nassiri, Parvin

2012-05-01

Strategic health, safety, and environmental management system (HSE-MS) involves systematic and cooperative planning in each phase of the lifecycle of a project to ensure that interaction among the industry group, client, contractor, stakeholder, and host community exists with the highest level of health, safety, and environmental standard performances. Therefore, it seems necessary to assess the HSE-MS performance of contractor(s) by a comparative strategic management model with the aim of continuous improvement. The present Strategic Management Model (SMM) has been illustrated by a case study and the results show that the model is a suitable management tool for decision making in a contract environment, especially in oil and gas fields and based on accepted international standards within the framework of management deming cycle. To develop this model, a data bank has been created, which includes the statistical data calculated by converting the HSE performance qualitative data into quantitative values. Based on this fact, the structure of the model has been formed by defining HSE performance indicators according to the HSE-MS model. Therefore, 178 indicators have been selected which have been grouped into four attributes. Model output provides quantitative measures of HSE-MS performance as a percentage of an ideal level with maximum possible score for each attribute. Defining the strengths and weaknesses of the contractor(s) is another capability of this model. On the other hand, this model provides a ranking that could be used as the basis for decision making at the contractors' pre-qualification phase or during the execution of the project.

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

PubMed

Cheng, Siu Mee; Thompson, Leslee J

2006-01-01

A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. The paper provides an outline of the CCO performance management system. These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Standardization of quality control plans for highway bridges in Europe: COST Action TU 1406

NASA Astrophysics Data System (ADS)

Casas, Joan R.; Matos, Jose Campos e.

2017-09-01

In Europe, as all over the world, the need to manage roadway bridges in an efficient way led to the development of different management systems. Hence, nowadays, many European countries have their own system. Although they present a similar architectural framework, several differences can be appointed. These differences constitute a divergent mechanism that may conduct to different decisions on maintenance actions. Within the roadway bridge management process, the identification of maintenance needs is more effective when developed in a uniform and repeatable manner. This process can be accomplished by the identification of performance indicators and definition of performance goals and key performance indicators (KPI), improving the planning of maintenance strategies. Therefore, a discussion at a European level, seeking to achieve a standardized approach in this subject, will bring significant benefits. Accordingly, a COST Action is under way in Europe with the aim of standardizing the establishment of quality control plans for roadway bridges.

Performance Management in Healthcare Organizations: Concept and Practicum.

PubMed

Dimitropoulos, Panagiotis E

2017-01-01

Organizational performance can create and sustain competitive advantages for corporations and even improve their sustainability and future prospects. Health care organizations present a sector where performance management is structured by multiple dimensions. The scope of this study is to analyze the issue of performance management in healthcare organizations and specifically the implementation of the Balanced Scorecard (BSC) methodology on organizations providing health services. The study provides a discussion on the BSC development process, the steps that management has to take in order to prepare the implementation of the BSC and finally discusses a practical example of a scorecard with specific strategic goals and performance indicators. Managers of healthcare organizations and specifically those providing services to the elderly and the general population could use the propositions of the study as a roadmap for processing, analyzing, evaluating and implementing the balanced scorecard approach in their organizations' daily operations. BSC methodology can give an advantage in terms of enhanced stakeholder management and preservation within a highly volatile and competitive economic environment.

Examining financial performance indicators for acute care hospitals.

PubMed

Burkhardt, Jeffrey H; Wheeler, John R C

2013-01-01

Measuring financial performance in acute care hospitals is a challenge for those who work daily with financial information. Because of the many ways to measure financial performance, financial managers and researchers must decide which measures are most appropriate. The difficulty is compounded for the non-finance person. The purpose of this article is to clarify key financial concepts and describe the most common measures of financial performance so that researchers and managers alike may understand what is being measured by various financial ratios.

UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

PubMed

McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D

2012-10-01

A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting.

Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

PubMed

Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

2015-12-01

Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

20 CFR 670.980 - What are the indicators of performance for Job Corps?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the indicators of performance for Job Corps? 670.980 Section 670.980 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Administrative and Management...

An Analysis of Voluntary Disclosure of Performance Indicators by Canadian Universities

ERIC Educational Resources Information Center

Maingot, Michael; Zeghal, Daniel

2008-01-01

Managing by performance indicators (PIs) is an important and controversial issue for many stakeholders concerned with higher education in the university systems all over the world. This study analyzes the voluntary disclosures of PIs by Canadian universities. The sample consisted of the 44 universities used by Maclean's Canadian Universities…

A comparison of systemwide and hospital-specific performance measurement tools.

PubMed

Yap, Clarence; Siu, Emily; Baker, G Ross; Brown, Adalsteinn D

2005-01-01

Balanced scorecards are being implemented at the system and organizational levels to help managers link their organizational strategies with performance data to better manage their healthcare systems. Prior to this study, hospitals in Ontario, Canada, received two editions of the system-level scorecard (SLS)--a framework, based on the original balanced scorecard, that includes four quadrants: system integration and management innovation (learning and growth), clinical utilization and outcomes (internal processes), patient satisfaction (customer), and financial performance and condition (financial). This study examines the uptake of the SLS framework and indicators into institution-specific scorecards for 22 acute care institutions and 2 non-acute-care institutions. This study found that larger (teaching and community) hospitals were significantly more likely to use the SLS framework to report performance data than did small hospitals (p < 0.0049 and 0.0507) and that teaching hospitals used the framework significantly more than community hospitals did (p < 0.0529). The majority of hospitals in this study used at least one indicator from the SLS in their own scorecards. However, all hospitals in the study incorporated indicators that required data collection and analysis beyond the SLS framework. The study findings suggest that SLS may assist hospitals in developing institution-specific scorecards for hospital management and that the balanced scorecard model can be modified to meet the needs of a variety of hospitals. Based on the insight from this study and other activities that explore top priorities for hospital management, the issues related to efficiency and human resources should be further examined using SLSs.

The Role of the Quality Enhancement Plan in Engendering a Culture of Assessment

ERIC Educational Resources Information Center

Loughman, Thomas P.; Hickson, Joyce; Sheeks, Gina L.; Hortman, J. William

2008-01-01

During the past two decades, colleges and universities have used best practices from corporate management such as total quality management, strategic planning, management by objectives, benchmarking, data warehousing, and performance indicators. Many institutions of higher learning now have adopted comprehensive and multifaceted approaches to…

Managing Service Quality with the Balanced Scorecard.

ERIC Educational Resources Information Center

Poll, Roswitha

In order to evaluate and utilize library data for the management process, a German project, sponsored by the German Research Council, uses the Balanced Scorecard as the concept for integrated quality management. Performance indicators across the following four perspectives are combined to produce a balanced evaluation of the library: (1) users,…

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience

PubMed Central

Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh

2016-01-01

Background and Objectives: Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. Methods: This research was a cross-sectional study. First, reviewing the literature and using experts’ viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). Results: To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. Conclusions: The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them. PMID:26383216

Using lagging and leading indicators for the evaluation of occupational safety and health performance in industry.

PubMed

Pawłowska, Zofia

2015-01-01

Improvement of occupational safety and health (OSH) management is closely related to the development of OSH performance measurement, which should include OSH outcomes (e.g., occupational accidents), OSH inputs (including working conditions) and OSH-related activities. The indicators used to measure the OSH outcomes are often called lagging indicators, and the indicators of inputs and OSH activities are leading indicators. A study was conducted in 60 companies in order to determine what kinds of indicators were used for OSH performance measurement by companies with different levels of OSH performance. The results reveal that the indicators most commonly used in all of the companies are those related to ensuring compliance with the statutory requirements. At the same time, the leading indicators are much more often adopted in companies with a higher performance level. These companies also much more often monitor on a regular basis the indicators adopted for the evaluation of their OSH performance.

Using lagging and leading indicators for the evaluation of occupational safety and health performance in industry

PubMed Central

Pawłowska, Zofia

2015-01-01

Improvement of occupational safety and health (OSH) management is closely related to the development of OSH performance measurement, which should include OSH outcomes (e.g., occupational accidents), OSH inputs (including working conditions) and OSH-related activities. The indicators used to measure the OSH outcomes are often called lagging indicators, and the indicators of inputs and OSH activities are leading indicators. A study was conducted in 60 companies in order to determine what kinds of indicators were used for OSH performance measurement by companies with different levels of OSH performance. The results reveal that the indicators most commonly used in all of the companies are those related to ensuring compliance with the statutory requirements. At the same time, the leading indicators are much more often adopted in companies with a higher performance level. These companies also much more often monitor on a regular basis the indicators adopted for the evaluation of their OSH performance. PMID:26647949

Autonomy to health care professionals as a vehicle for value-based health care? Results of a quasi-experiment in hospital governance.

PubMed

Larsen, Kristian Nørgaard; Kristensen, Søren Rud; Søgaard, Rikke

2018-01-01

Health care systems increasingly aim to create value for money by simultaneous incentivizing of quality along with classical goals such as activity increase and cost containment. It has recently been suggested that letting health care professionals choose the performance metrics on which they are evaluated may improve value of care by facilitating greater employee initiative, especially in the quality domain. There is a risk that this strategy leads to loss of performance as measured by the classical goals, if these goals are not prioritized by health care professionals. In this study we investigate the performance of eight hospital departments in the second largest region of Denmark that were delegated the authority to choose their own performance focus during a three-year test period from 2013 to 2016. The usual activity-based remuneration was suspended and departments were instructed to keep their global budgets and maintain activity levels, while managing according to their newly chosen performance focuses. Our analysis is based on monthly observations from two years before to three years after delegation. We collected data for 32 new performance indicators chosen by hospital department managements; 11 new performance indicators chosen by a centre management under which 5 of the departments were organised; and 3 classical indicators of priority to the central administration (activity, productivity, and cost containment). Interrupted time series analysis is used to estimate the effect of delegation on these indicators. We find no evidence that this particular proposal for giving health care professionals greater autonomy leads to consistent quality improvements but, on the other hand, also no consistent evidence of harm to the classical goals. Future studies could consider alternative possibilities to create greater autonomy for hospital departments. Copyright © 2017 Elsevier Ltd. All rights reserved.

34 CFR 361.89 - Enforcement procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Standards and Performance Indicators § 361.89 Enforcement procedures. (a) If a DSU fails to meet the... satisfactory level on the compliance indicators. (Approved by the Office of Management and Budget under control...

Public Management Reform and Organizational Performance: An Empirical Assessment of the U.K. Labour Government's Public Service Improvement Strategy

ERIC Educational Resources Information Center

Walker, Richard M.; Boyne, George A.

2006-01-01

We present the first empirical assessment of the U.K. Labour government's program of public management reform. This reform program is based on rational planning, devolution and delegation, flexibility and incentives, and enhanced choice. Measures of these variables are tested against external and internal indicators of organizational performance.…

24 CFR 985.3 - Indicators, HUD verification methods and ratings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Indicators, HUD verification..., HUD verification methods and ratings. This section states the performance indicators that are used to assess PHA Section 8 management. HUD will use the verification method identified for each indicator in...

[Development of key indicators for nurses performance evaluation and estimation of their weights for management by objectives].

PubMed

Lee, Eun Hwa; Ahn, Sung Hee

2010-02-01

This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using X(2)-test, factor analysis, and the Analytical Hierarchy Process. Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

[BALANCED SCORECARD AS A MANAGEMENT TOOL IN CLINICAL NUTRITION].

PubMed

Gutiérrez López, Cristina; Mauriz, Jose L; Culebras, Jesús M

2015-07-01

Nowadays, balanced scorecards have updated traditional management systems in the business sector. In this way, Kaplan and Norton propose performance measurement through several perspectives with a logical sequence: internal processes and learning impact client services, so that financial performance is affected. The aim of the present paper is to analyze the main characteristics of balanced scorecard when it is applied to non-for-profit companies and, specifically to the health sector in the clinical nutrition field. This model improves the economic vision of management with clinical indicators that represent healthcare professional's perspective. The balanced scorecard would allow a proper monitoring and tracking system for the main healthcare indicators. This contributes to a better control in comparison with standards that are associated with adequate quality assistance. Owing to the role of management accounting and cost calculations, the definition of healthcare professionals as clients or users, and clinical results relevance, it is necessary to adapt the balanced scorecard to the specific characteristics of the clinical field, redefining both perspectives and indicators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Synthesis of National and International Methodologies Used for Bridge Health Indices

DOT National Transportation Integrated Search

2016-05-01

Bridge performance measures are important components of any successful Bridge Management System. Different types of performance measures have been developed for various purposes. The types of performance measures are usually a reflection of an agency...

The Role of Reliability, Vulnerability and Resilience in the Management of Water Quality Systems

NASA Astrophysics Data System (ADS)

Lence, B. J.; Maier, H. R.

2001-05-01

The risk based performance indicators reliability, vulnerability and resilience provide measures of the frequency, magnitude and duration of the failure of water resources systems, respectively. They have been applied primarily to water supply problems, including the assessment of the performance of reservoirs and water distribution systems. Applications to water quality case studies have been limited, although the need to consider the length and magnitude of violations of a particular water quality standard has been recognized for some time. In this research, the role of reliability, vulnerability and resilience in water quality management applications is investigated by examining their significance as performance measures for water quality systems and assessing their potential for assisting in decision making processes. The importance of each performance indicator is discussed and a framework for classifying such systems, based on the relative significance of each of these indicators, is introduced and illustrated qualitatively with various case studies. Quantitative examples drawn from both lake and river water quality modeling exercises are then provided.

Assessing the significance of health information seeking in chronic condition management.

PubMed

Dean, Caress A; Geneus, Christian J; Rice, Shahida; Johns, Marquisha; Quasie-Woode, Delores; Broom, Kevin; Elder, Keith

2017-08-01

To examine the relationship between health information seeking and confidence in performing self-management activities, and to assess the influence of predisposing, enabling, and perceive need factors on confidence to perform self-management activities among adults with chronic conditions. The sample included 6724 adults from the 2007 Health Tracking Household Survey who were ≥18 years with a chronic condition. Binary logistic regression examined the relationship between health information seeking, predisposing, enabling, and perceive need factors and confidence in performing three self-management activities; prevent symptoms, tell doctor concerns, and know when to get medical care. Analyses indicated that 63.7% of adults sought health information. Rural residents who sought health information had 50% (95% CI: 0.28-0.89) lower odds of being confident to tell doctor concerns compared to urban residents who did not seek health information. The relationship between health information seeking and confidence to perform self-management varies by self-management activity. Rurality, education level, having a usual source of care, and perceived health status strongly predict confidence to perform self-management activities. Self-management strategies should incorporate health information seeking behavior that will enhance confidence to perform specific self-management activities, and should incorporate predisposing, enabling, and perceive need factors. Copyright © 2017 Elsevier B.V. All rights reserved.

Modeling Relationships Between Flight Crew Demographics and Perceptions of Interval Management

NASA Technical Reports Server (NTRS)

Remy, Benjamin; Wilson, Sara R.

2016-01-01

The Interval Management Alternative Clearances (IMAC) human-in-the-loop simulation experiment was conducted to assess interval management system performance and participants' acceptability and workload while performing three interval management clearance types. Twenty-four subject pilots and eight subject controllers flew ten high-density arrival scenarios into Denver International Airport during two weeks of data collection. This analysis examined the possible relationships between subject pilot demographics on reported perceptions of interval management in IMAC. Multiple linear regression models were created with a new software tool to predict subject pilot questionnaire item responses from demographic information. General patterns were noted across models that may indicate flight crew demographics influence perceptions of interval management.

How Are You Doing? Key Performance Indicators and Benchmarking

ERIC Educational Resources Information Center

Fahey, John P.

2011-01-01

School business officials need to "know and show" that their operations are well managed. To do so, they ask themselves questions, such as "How are they doing? How do they compare with others? Are they making progress fast enough? Are they using the best practices?" Using key performance indicators (KPIs) and benchmarking as regular parts of their…

Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service.

PubMed

Solomons, Luke C; Thachil, Ajoy; Burgess, Caroline; Hopper, Adrian; Glen-Day, Vicky; Ranjith, Gopinath; Hodgkiss, Andrew

2011-01-01

To explore the experience of senior staff on acute medical wards using an established inpatient liaison psychiatry service and obtain their views on clinically relevant performance measures. Semistructured face-to-face interviews with consultants and senior nurses were taped, transcribed and analyzed manually using the framework method of analysis. Twenty-five referrers were interviewed. Four key themes were identified - benefits of the liaison service, potential areas of improvement, indices of service performance such as speed and quality of response and expanded substance misuse service. Respondents felt the liaison service benefited patients, staff and service delivery in the general hospital. Medical consultants wanted stepped management plans devised by consultant liaison psychiatrists. Senior nurses, who perceived themselves as frontline crisis managers, valued on-the-spot input on patient management. Consultants and senior nurses differed in their expectations of liaison psychiatry. Referrers valued speed of response and regarded time from referral to definitive management plan as a key performance indicator for benchmarking services. Copyright © 2011 Elsevier Inc. All rights reserved.

Constructing a strategy map for banking institutions with key performance indicators of the balanced scorecard.

PubMed

Wu, Hung-Yi

2012-08-01

This study presents a structural evaluation methodology to link key performance indicators (KPIs) into a strategy map of the balanced scorecard (BSC) for banking institutions. Corresponding with the four BSC perspectives (finance, customer, internal business process, and learning and growth), the most important evaluation indicators of banking performance are synthesized from the relevant literature and screened by a committee of experts. The Decision Making Trial and Evaluation Laboratory (DEMATEL) method, a multiple criteria analysis tool, is then employed to determine the causal relationships between the KPIs, to identify the critical central and influential factors, and to establish a visualized strategy map with logical links to improve banking performance. An empirical application is provided as an example. According to the expert evaluations, the three most essential KPIs for banking performance are customer satisfaction, sales performance, and customer retention rate. The DEMATEL results demonstrate a clear road map to assist management in prioritizing the performance indicators and in focusing attention on the strategy-related activities of the crucial indicators. According to the constructed strategy map, management could better invest limited resources in the areas that need improvement most. Although these strategy maps of the BSC are not universal, the research results show that the presented approach is an objective and feasible way to construct strategy maps more justifiably. The proposed framework can be applicable to institutions in other industries as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

Quantitative performance targets by using balanced scorecard system: application to waste management and public administration.

PubMed

Mendes, Paula; Nunes, Luis Miguel; Teixeira, Margarida Ribau

2014-09-01

This article demonstrates how decision-makers can be guided in the process of defining performance target values in the balanced scorecard system. We apply a method based on sensitivity analysis with Monte Carlo simulation to the municipal solid waste management system in Loulé Municipality (Portugal). The method includes two steps: sensitivity analysis of performance indicators to identify those performance indicators with the highest impact on the balanced scorecard model outcomes; and sensitivity analysis of the target values for the previously identified performance indicators. Sensitivity analysis shows that four strategic objectives (IPP1: Comply with the national waste strategy; IPP4: Reduce nonrenewable resources and greenhouse gases; IPP5: Optimize the life-cycle of waste; and FP1: Meet and optimize the budget) alone contribute 99.7% of the variability in overall balanced scorecard value. Thus, these strategic objectives had a much stronger impact on the estimated balanced scorecard outcome than did others, with the IPP1 and the IPP4 accounting for over 55% and 22% of the variance in overall balanced scorecard value, respectively. The remaining performance indicators contribute only marginally. In addition, a change in the value of a single indicator's target value made the overall balanced scorecard value change by as much as 18%. This may lead to involuntarily biased decisions by organizations regarding performance target-setting, if not prevented with the help of methods such as that proposed and applied in this study. © The Author(s) 2014.

Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

PubMed

Granata, Randy L; Hamilton, Karen

2015-01-01

Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

University and Polytechnic Objectives, Resource Allocation and Performance Indices in the Central Services. Program on Institutional Management in Higher Education.

ERIC Educational Resources Information Center

Norris, Graeme, Ed.

Research progress by member institutions is reviewed with regard to university administration, computing, committees, libraries, and student welfare. Consideration is given to effectiveness and efficiency, management information, management by objectives, periodic review of objectives, strategy, and analytic resource allocation. Two research…

Stress management standards: a warning indicator for employee health.

PubMed

Kazi, A; Haslam, C O

2013-07-01

Psychological stress is a major cause of lost working days in the UK. The Health & Safety Executive (HSE) has developed management standards (MS) to help organizations to assess work-related stress. To investigate the relationships between the MS indicator tool and employee health, job attitudes, work performance and environmental outcomes. The first phase involved a survey employing the MS indicator tool, General Health Questionnaire-12 (GHQ-12), job attitudes, work performance and environmental measures in a call centre from a large utility company. The second phase comprised six focus groups to investigate what employees believed contributed to their perceived stress. Three hundred and four call centre employees responded with a response rate of 85%. Significant negative correlations were found between GHQ-12 and two MS dimensions; demands (Rho = -0.211, P < 0.001) and relationships (Rho= -0.134, P < 0.05). Other dimensions showed no significant relationship with GHQ-12. Higher levels of stress were associated with reduced job performance, job motivation and increased intention to quit but low stress levels were associated with reduced job satisfaction. Lack of management support, recognition and development opportunities were identified as sources of stress. The findings support the utility of the MS as a measure of employee attitudes and performance.

Managing for Results in America's Great City Schools: A Report of the Performance Measurement and Benchmarking Project of the Council of the Great City Schools

ERIC Educational Resources Information Center

Eugene, Michael; Carlson, Robert; Hrowal, Heidi; Fahey, John; Ronnei, Jean; Young, Steve; Gomez, Joseph; Thomas, Michael

2007-01-01

This report describes 50 initial statistical indicators developed by the Council of the Great City Schools and its member districts to measure big-city school performance on a range of operational and business functions, and presents data city-by-city on those indicators. The analysis marks the first time that such indicators have been developed…

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

PubMed Central

Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke

2018-01-01

Objective To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. Design An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Setting Western Europe and the USA. Participants Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Measures Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. Results In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. Conclusion The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. PMID:29549210

Exploring the link between meteorological drought and streamflow to inform water resource management

NASA Astrophysics Data System (ADS)

Lennard, Amy; Macdonald, Neil; Hooke, Janet

2015-04-01

Drought indicators are an under-used metric in UK drought management. Standardised drought indicators offer a potential monitoring and management tool for operational water resource management. However, the use of these metrics needs further investigation. This work uses statistical analysis of the climatological drought signal based on meteorological drought indicators and observed streamflow data to explore the link between meteorological drought and hydrological drought to inform water resource management for a single water resource region. The region, covering 21,000 km2 of the English Midlands and central Wales, includes a variety of landscapes and climatological conditions. Analysis of the links between meteorological drought and hydrological drought performed using streamflow data from 'natural' catchments indicates a close positive relationship between meteorological drought indicators and streamflow, enhancing confidence in the application of drought indicators for monitoring and management. However, many of the catchments in the region are subject to modification through impoundments, abstractions and discharge. Therefore, it is beneficial to explore how climatological drought signal propagates into managed hydrological systems. Using a longitudinal study of catchments and sub-catchments that include natural and modified river reaches the relationship between meteorological and hydrological drought is explored. Initial statistical analysis of meteorological drought indicators and streamflow data from modified catchments shows a significantly weakened statistical relationship and reveals how anthropogenic activities may alter hydrological drought characteristics in modified catchments. Exploring how meteorological drought indicators link to streamflow across the water supply region helps build an understanding of their utility for operational water resource management.

Performance of the Defense Acquisition System, 2013 Annual Report

DTIC Science & Technology

2013-06-28

well beyond their start dates, which could indicate factors not attributable to the initial management of the contracts. Figure 2-13. DoD Total ...Attributed to W. Edwards Deming While the United States achieves its national security missions by equipping its military forces with the best weapons...annual reports on the performance of the defense acquisition system—its programs, institutions, workforce, managers , executives, and industrial partners

Effects of flow sheet implementation on physician performance in the management of asthmatic patients.

PubMed

Ruoff, Gary

2002-01-01

This project focused on increasing compliance, in a large family practice group, with quality indicators for the management of asthma. The objective was to determine if use of a flow sheet incorporating the Global Initiative for Asthma (GINA) guidelines could improve compliance with those guidelines if the flow sheet was placed in patients' medical records. After review and selection of 14 clinical quality indicators, physicians in the practice implemented a flow sheet as an intervention. These flow sheets were inserted into the records of 122 randomly selected patients with asthma. Medical records were reviewed before the flow sheets were placed in the records, and again approximately 6 months later, to determine if there was a change in compliance with the quality indicators. Improvement of documentation was demonstrated in 13 of the 14 quality indicators. The results indicate that compliance with asthma management quality indicators can improve with the use of a flow sheet.

Simulation of the hydraulic performance of highway filter drains through laboratory models and stormwater management tools.

PubMed

Sañudo-Fontaneda, Luis A; Jato-Espino, Daniel; Lashford, Craig; Coupe, Stephen J

2017-05-23

Road drainage is one of the most relevant assets in transport infrastructure due to its inherent influence on traffic management and road safety. Highway filter drains (HFDs), also known as "French Drains", are the main drainage system currently in use in the UK, throughout 7000 km of its strategic road network. Despite being a widespread technique across the whole country, little research has been completed on their design considerations and their subsequent impact on their hydraulic performance, representing a gap in the field. Laboratory experiments have been proven to be a reliable indicator for the simulation of the hydraulic performance of stormwater best management practices (BMPs). In addition to this, stormwater management tools (SMT) have been preferentially chosen as a design tool for BMPs by practitioners from all over the world. In this context, this research aims to investigate the hydraulic performance of HFDs by comparing the results from laboratory simulation and two widely used SMT such as the US EPA's stormwater management model (SWMM) and MicroDrainage®. Statistical analyses were applied to a series of rainfall scenarios simulated, showing a high level of accuracy between the results obtained in laboratory and using SMT as indicated by the high and low values of the Nash-Sutcliffe and R 2 coefficients and root-mean-square error (RMSE) reached, which validated the usefulness of SMT to determine the hydraulic performance of HFDs.

Integrating clinical performance improvement across physician organizations: the PhyCor experience.

PubMed

Loeppke, R; Howell, J W

1999-02-01

There is a paucity of literature describing the implementation of clinical performance improvement (CPI) efforts across geographically dispersed multispecialty group practices and independent practice associations. PhyCor, a physician management company based in Nashville, Tennessee, has integrated CPI initiatives into its operating infrastructure. PhyCor CPI INITIATIVES: The strategic framework guiding PhyCor's CPI initiatives is built around a physician-driven, patient-centered model. Physician/administrator leadership teams develop and implement a clinical and financial strategic plan for performance improvement; adopt local clinical and operational performance indicators; and agree on and gain consensus with local physician champions to engage in CPI initiatives. The area/regional leadership councils integrate and coordinate regional medical management and CPI initiatives among local groups and independent practice associations. In addition to these councils and a national leadership council, condition-specific care management councils have also been established. These councils develop condition-specific protocols and outcome measures and lead the implementation of CPI initiatives at their own clinics. Key resources supporting CPI initiatives include information/knowledge management, education and training, and patient education and consumer decision support. Localized efforts in both the asthma care and diabetes management initiatives have led to some preliminary improvements in quality of care indicators. Physician leadership and strategic vision, CPI-oriented organizational infrastructure, broad-based physician involvement in CPI, providing access to performance data, parallel incentives, and creating a sense of urgency for accelerated change are all critical success factors to the implementation of CPI strategies at the local, regional, and national levels.

The relationship between quality management practices and organisational performance: A structural equation modelling approach

NASA Astrophysics Data System (ADS)

Jamaluddin, Z.; Razali, A. M.; Mustafa, Z.

2015-02-01

The purpose of this paper is to examine the relationship between the quality management practices (QMPs) and organisational performance for the manufacturing industry in Malaysia. In this study, a QMPs and organisational performance framework is developed according to a comprehensive literature review which cover aspects of hard and soft quality factors in manufacturing process environment. A total of 11 hypotheses have been put forward to test the relationship amongst the six constructs, which are management commitment, training, process management, quality tools, continuous improvement and organisational performance. The model is analysed using Structural Equation Modeling (SEM) with AMOS software version 18.0 using Maximum Likelihood (ML) estimation. A total of 480 questionnaires were distributed, and 210 questionnaires were valid for analysis. The results of the modeling analysis using ML estimation indicate that the fits statistics of QMPs and organisational performance model for manufacturing industry is admissible. From the results, it found that the management commitment have significant impact on the training and process management. Similarly, the training had significant effect to the quality tools, process management and continuous improvement. Furthermore, the quality tools have significant influence on the process management and continuous improvement. Likewise, the process management also has a significant impact to the continuous improvement. In addition the continuous improvement has significant influence the organisational performance. However, the results of the study also found that there is no significant relationship between management commitment and quality tools, and between the management commitment and continuous improvement. The results of the study can be used by managers to prioritize the implementation of QMPs. For instances, those practices that are found to have positive impact on organisational performance can be recommended to managers so that they can allocate resources to improve these practices to get better performance.

Does adoption of electronic health records improve the quality of care management in France? Results from the French e-SI (PREPS-SIPS) study.

PubMed

Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Biron, Pierre; Philip, Irène; Perrier, Lionel

2017-06-01

Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including the promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the quality of care management in acute care hospitals throughout France. This retrospective study was based on data derived from three national databases for the year 2011: IPAQSS (indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. Several multivariate models were used to examine the association between the use of EHRs and specific EHR features with four quality indicators: the quality of patient record, the delay in sending information at hospital discharge, the pain status evaluation, and the nutritional status evaluation, while also adjusting for hospital characteristics. The models revealed a significant positive impact of EHR use on the four quality indicators. Additionally, they showed a differential impact according to the functionality of the element of the health record that was computerized. All four quality indicators were also impacted by the type of hospital, the geographical region, and the severity of the pathology. These results suggest that, to improve the quality of care management in hospitals, EHR adoption represents an important lever. They complete previous work dealing with EHR and the organizational performance of hospital surgical units. Copyright © 2017 Elsevier B.V. All rights reserved.

[Management practices in medium-sized private hospitals in São Paulo, Brazil].

PubMed

Brito, Luiz Artur Ledur; Malik, Ana Maria; Brito, Eliane; Bulgacov, Sergio; Andreassi, Tales

2017-04-03

Traditional management practices are sometimes considered merely a necessary condition for superior performance. Other resources and competencies with higher barriers to imitation are assumed to be potential sources of competitive advantage. This study describes and analyzes the effect of traditional management practices on the performance of medium-sized hospitals. Medium-sized companies frequently display the greatest differences in management practices, and only recently did the hospital sector seek ways to develop its competitiveness in the administrative arena. The results generally indicate that basic management practices can make differences in performance, offering support for the new practice-based view (PBV). Hospitals with the highest rate of adoption of practices had the highest occupancy rate, hospital-bed admissions, and accreditation. Lack of adoption of management practices by medium-sized hospitals limits their competitive capacity and can be viewed as a component of the so-called Brazil cost, but in this case an internal component.

Pricing and performance in health maintenance organizations: a strategic management perspective.

PubMed

Conant, J S; Mokwa, M P; Burnett, J J

1989-03-01

Innovative, consumer-oriented pricing strategies have contributed to the impressive growth of health maintenance organizations (HMOs). In a national study of HMO marketing directors, the relationships between strategic management style and (1) the relative importance of pricing in competitive marketing strategy, (2) the effectiveness of price strategy planning, and (3) financial performance are examined. The findings indicate that HMOs practicing effective price planning also perform well on an overall basis. Insight into the content and substance of HMO pricing strategies is also provided.

Effects of an Incentive Based Budgeting System on Institutional Performance Indicators: An Exploratory Longitudinal Case Study of a Public University

ERIC Educational Resources Information Center

Willett, Michael S.

2013-01-01

The purpose of this exploratory longitudinal case study was to examine how the implementation of an Incentive Based Budgeting (IBB) system (i.e., Responsibility-Centered Management [RCM]) affected selected institutional performance indicators at the campus level and two comparable schools at a large Mid-Western public University. The value of…

U.S. Coast Guard Officer Performance Management System: An Analysis of Current Commitment Levels and Potential Effectiveness Indicators.

DTIC Science & Technology

1983-03-01

dons separately by Ivancevich (Ref. 23], and Latham [Ref. 24], indicate tha- these skills(performance measurement anr communication skills) are best...56, p. 295-247,254, 1977 ... . 22. Argyris,C. and Schon,D.A., Oranizaticnal Learning: a Wes ey, 7-11 1Pe 23. Ivancevich ,J.M., "A Longitudinal Study of

Managing for Results in America's Great City Schools. A Report of the Performance Measurement and Benchmarking Project

ERIC Educational Resources Information Center

Council of the Great City Schools, 2008

2008-01-01

This report describes statistical indicators developed by the Council of the Great City Schools and its member districts to measure big-city school performance on a range of operational functions in business, finance, human resources and technology. The report also presents data city-by-city on those indicators. This is the second time that…

Patients' satisfaction: customer relationship management as a new opportunity for quality improvement in thoracic surgery.

PubMed

Rocco, Gaetano; Brunelli, Alessandro

2012-11-01

Clinical and nonclinical indicators of performance are meant to provide the surgeon with tools to identify weaknesses to be improved. The World Health Organization's Performance Evaluation Systems represent a multidimensional approach to quality measurement based on several categories made of different indicators. Indicators for patient satisfaction may include overall perceived quality, accessibility, humanization and patient involvement, communication, and trust in health care providers. Patient satisfaction is included among nonclinical indicators of performance in thoracic surgery and is increasingly recognized as one of the outcome measures for delivered quality of care. Copyright © 2012 Elsevier Inc. All rights reserved.

Secure and Resilient Functional Modeling for Navy Cyber-Physical Systems

DTIC Science & Technology

2017-05-24

Functional Modeling Compiler (SCCT) FM Compiler and Key Performance Indicators (KPI) May 2018 Pending. Model Management Backbone (SCCT) MMB Demonstration...implement the agent- based distributed runtime. - KPIs for single/multicore controllers and temporal/spatial domains. - Integration of the model management ...Distributed Runtime (UCI) Not started. Model Management Backbone (SCCT) Not started. Siemens Corporation Corporate Technology Unrestricted

Systematic review: work-related stress and the HSE management standards.

PubMed

Brookes, K; Limbert, C; Deacy, C; O'Reilly, A; Scott, S; Thirlaway, K

2013-10-01

The Health and Safety Executive (HSE) has defined six management standards representing aspects of work that, if poorly managed, are associated with lower levels of employee health and productivity, and increased sickness absence. The HSE indicator tool aims to measure organizations' performance in managing the primary stressors identified by the HSE management standards. The aims of the study are to explore how the HSE indicator tool has been implemented within organizations and to identify contexts in which the tool has been used, its psychometric properties and relationships with alternative measures of well-being and stress. Studies that matched specific criteria were included in the review. Abstracts were considered by two researchers to ensure a reliable process. Full texts were obtained when abstracts met the inclusion criteria. Thirteen papers were included in the review. Using factor analysis and measures of reliability, the studies suggest that the HSE indicator tool is a psychometrically sound measure. The tool has been used to measure work-related stress across different occupational groups, with a clear relationship between the HSE tool and alternative measures of well-being. Limitations of the tool and recommendations for future research are discussed. The HSE indicator tool is a psychometrically sound measure of organizational performance against the HSE management standards. As such it can provide a broad overview of sources of work-related stress within organizations. More research is required to explore the use of the tool in the design of interventions to reduce stress, and its use in different contexts and with different cultural and gender groups.

[Organizational climate in management teams and its relationship with health care outcomes].

PubMed

Peña-Viveros, Raúl; Hernández-Hernández, Dulce María; Vélez-Moreno, Ana María Luz; García-Sandoval, Martha Gabriela; Reyes-Tellez, María Araceli; Ureña-Bogarin, Enrique L

2015-01-01

To identify the relationship between organizational climate of management teams and the performance of health services. A transversal and analytical study was designed. The Organizational Climate Scale (OCS) was utilized and performance was assessed by the achievement indicators through correlation analysis and multiple regression. Thirty four medical benefits services headquarters (JSPM) were measured of the Mexican Social Security Institute. Of 862 participating, 238 (27.6%) evaluated the climate of their organizations with a high level; the maximal score was 56%. Average performance value was 0.79 ± 0.07 (minimal: 0.65; maximal: 0.92). A positive correlation was demonstrated between organizational climate level and performance (r=0.4; p=0.008). The organizational climate of the health services managers (JSPM) is directly related with performance in health care.

Development and pilot test of a new set of good practice indicators for chronic non-malignant pain management.

PubMed

Saturno, Pedro Jesus; Angel-García, Daniel; Martínez-Nicolás, Ismael; López Soriano, Francisco; Escolar Reina, Maria Pilar; Guerrero Díaz, María Beatriz; Ros Martínez, María Encarnación; Medina Mirapeix, Francesc; Saturno Marcos, Mayo

2018-06-08

This study was designed to address the current relative void of valid measures by developing evidence-based quality indicators for pain management of chronic non-malignant pain. We performed a 10-year literature search to identify guidelines and review articles on chronic pain management to identify evidence-based recommendations for the different conditions associated to chronic pain. A complementary search of indicators and indicator-related articles was also performed. Then, we built new indicators or adapted existing ones to cover all the evidence-based recommendations we found. The resulting set was pilot-tested for feasibility, reliability (kappa) and usefulness to identify quality problems, using the Lot Quality Acceptance method, α≤0.05 y β≤0.01, for 75% (40% threshold) and 95% (70% threshold) compliance standards, and estimates with binomial exact 95% confidence intervals. The study reviews clinical records from a primary-care centre, a medium-size hospital (250 beds) and a large hospital (500 beds). Forty-six indicators were developed (six general and forty condition-specific). Thirty-three were feasible in primary care and/or hospitals. Feasible indicators were also reliable (most kappa>0.7). Regarding compliance, four quality indicators obtained compliance levels over 60%, addressing pharmacological treatment, multimodal approach and appropriate use of neuro-image tests; while sixteen obtained compliance scores under 15% (six with 0% compliance). The created set has tested to be feasible, reliable, and useful, with the capacity to serve as the baseline for developing the necessary strategies to improve the management of chronic non-malignant pain, by monitoring and evaluating quality of care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Business process performance measurement: a structured literature review of indicators, measures and metrics.

PubMed

Van Looy, Amy; Shafagatova, Aygun

2016-01-01

Measuring the performance of business processes has become a central issue in both academia and business, since organizations are challenged to achieve effective and efficient results. Applying performance measurement models to this purpose ensures alignment with a business strategy, which implies that the choice of performance indicators is organization-dependent. Nonetheless, such measurement models generally suffer from a lack of guidance regarding the performance indicators that exist and how they can be concretized in practice. To fill this gap, we conducted a structured literature review to find patterns or trends in the research on business process performance measurement. The study also documents an extended list of 140 process-related performance indicators in a systematic manner by further categorizing them into 11 performance perspectives in order to gain a holistic view. Managers and scholars can consult the provided list to choose the indicators that are of interest to them, considering each perspective. The structured literature review concludes with avenues for further research.

FPI: FM Success through Analytics

ERIC Educational Resources Information Center

Hickling, Duane

2013-01-01

The APPA Facilities Performance Indicators (FPI) is perhaps one of the most powerful analytical tools that institutional facilities professionals have at their disposal. It is a diagnostic facilities performance management tool that addresses the essential questions that facilities executives must answer to effectively perform their roles. It…

Multi-objective, multiple participant decision support for water management in the Andarax catchment, Almeria

NASA Astrophysics Data System (ADS)

van Cauwenbergh, N.; Pinte, D.; Tilmant, A.; Frances, I.; Pulido-Bosch, A.; Vanclooster, M.

2008-04-01

Water management in the Andarax river basin (Almeria, Spain) is a multi-objective, multi-participant, long-term decision-making problem that faces several challenges. Adequate water allocation needs informed decisions to meet increasing socio-economic demands while respecting the environmental integrity of this basin. Key players in the Andarax water sector include the municipality of Almeria, the irrigators involved in the intensive greenhouse agricultural sector, and booming second residences. A decision support system (DSS) is developed to rank different sustainable planning and management alternatives according to their socio-economic and environmental performance. The DSS is intimately linked to sustainability indicators and is designed through a public participation process. Indicators are linked to criteria reflecting stakeholders concerns in the 2005 field survey, such as fulfilling water demand, water price, technical and economical efficiency, social and environmental impacts. Indicators can be partly quantified after simulating the operation of the groundwater reservoir over a 20-year planning period and partly through a parallel expert evaluation process. To predict the impact of future water demand in the catchment, several development scenarios are designed to be evaluated in the DSS. The successive multi-criteria analysis of the performance indicators permits the ranking of the different management alternatives according to the multiple objectives formulated by the different sectors/participants. This allows more informed and transparent decision-making processes for the Andarax river basin, recognizing both the socio-economic and environmental dimensions of water resources management.

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

PubMed

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

[OR-management and self-improvement - a discrepancy?].

PubMed

Casutt, Mattias; Konrad, Christoph; Schüpfer, Guido

2014-10-01

Today, operating room management is essential for a modern hospital. The strategic controls of this cost-intensive area and the ongoing cost pressure have necessitated management attention to this area. Economical, processual and quality data are well-known and established, although analysis of different health delivering organisations by benchmarking is still difficult. It remains still a severe task for the management of an OR and anaesthesia department. For these fields data is needed to identify and measure the performance of these departments in the dimensions of finances, development, processes and patient's needs. The key performance indicators are exemplified for an anaesthesia department and discussed. © Georg Thieme Verlag Stuttgart · New York.

Implementation of BMP Strategies for Adaptation to Climate Change and Land Use Change in a Pasture-Dominated Watershed

PubMed Central

Chiang, Li-Chi; Chaubey, Indrajeet; Hong, Nien-Ming; Lin, Yu-Pin; Huang, Tao

2012-01-01

Implementing a suite of best management practices (BMPs) can reduce non-point source (NPS) pollutants from various land use activities. Watershed models are generally used to evaluate the effectiveness of BMP performance in improving water quality as the basis for watershed management recommendations. This study evaluates 171 management practice combinations that incorporate nutrient management, vegetated filter strips (VFS) and grazing management for their performances in improving water quality in a pasture-dominated watershed with dynamic land use changes during 1992–2007 by using the Soil and Water Assessment Tool (SWAT). These selected BMPs were further examined with future climate conditions (2010–2069) downscaled from three general circulation models (GCMs) for understanding how climate change may impact BMP performance. Simulation results indicate that total nitrogen (TN) and total phosphorus (TP) losses increase with increasing litter application rates. Alum-treated litter applications resulted in greater TN losses, and fewer TP losses than the losses from untreated poultry litter applications. For the same litter application rates, sediment and TP losses are greater for summer applications than fall and spring applications, while TN losses are greater for fall applications. Overgrazing management resulted in the greatest sediment and phosphorus losses, and VFS is the most influential management practice in reducing pollutant losses. Simulations also indicate that climate change impacts TSS losses the most, resulting in a larger magnitude of TSS losses. However, the performance of selected BMPs in reducing TN and TP losses was more stable in future climate change conditions than in the BMP performance in the historical climate condition. We recommend that selection of BMPs to reduce TSS losses should be a priority concern when multiple uses of BMPs that benefit nutrient reductions are considered in a watershed. Therefore, the BMP combination of spring litter application, optimum grazing management and filter strip with a VFS ratio of 42 could be a promising alternative for use in mitigating future climate change. PMID:23202767

Illusion or delusion--Lean management in the health sector.

PubMed

McIntosh, Bryan; Sheppy, Bruce; Cohen, Ivan

2014-01-01

There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic. Secondary research. Despite widespread enthusiasm about the potential of Lean management processes, evidence about its contribution to higher organisational performance remains inconsistent. This paper engages with the major Lean concepts of operations management and human resource management, including just-in-time, total quality management, total productive maintenance and does not engage in-depth with concepts related to employee empowerment, and training This paper contributes to the organisational management literature in healthcare by showing that although Lean management seems to have the potential to improve organisational performance it is far from a panacea against under performing hospitals. It informs policy making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than the adoption of practices from any particular managerial approach. This paper provides a critical evaluation of the impact of Lean practices in informing healthcare policy. The paper contributes to the organisational management literature in healthcare by showing that even though Lean management in healthcare appears to have the potential to improve organisational performance; there remain problems with its application.

Assessment of management approaches in a public water utility: A case study of the Namibia water corporation (NAMWATER)

NASA Astrophysics Data System (ADS)

Ndokosho, Johnson; Hoko, Zvikomborero; Makurira, Hodson

More than 90% of urban water supply and sanitation services in developing countries are provided by public organizations. However, public provision of services has been inherently inefficient. As a result a number of initiatives have emerged in recent years with a common goal to improve service delivery. In Namibia, the water sector reform resulted in the creation of a public utility called the Namibia Water Corporation (NAMWATER) which is responsible for bulk water supply countrywide. Since its inception in 1998, NAMWATER has been experiencing poor financial performance. This paper presents the findings of a case study that compared the management approaches of NAMWATER to the New Public Management (NPM) paradigm. The focus of the NPM approach is for the public water sector to mirror private sector methods of management so that public utilities can accrue the benefits of effectiveness, efficiency and flexibility often associated with private sector. The study tools used were a combination of literature review, interviews and questionnaires. It was found out that NAMWATER has a high degree of autonomy in its operations, albeit government approved tariffs and sourcing of external financing. The utility reports to government annually to account for results. The utility embraces a notion of good corporate culture and adheres to sound management practices. NAMWATER demonstrated a strong market-orientation indicated by the outsourcing of non-core functions but benchmarking was poorly done. NAMWATER’s customer-orientation is poor as evidenced by the lack of customer care facilities. NAMWATER’s senior management delegated operational authority to lower management to facilitate flexibility and eliminate bottlenecks. The lower management is in turn held accountable for performance by the senior management. There are no robust methods of ensuring sufficient accountability indicated by absence of performance contracts or service level agreements. It was concluded that NAMWATER’s management approaches adhere to the NPM paradigm but some NPM core-ideas such as customer orientation and external accountability (performance contracts) were visibly missing.

A Survey of Managers' Access to Key Performance Indicators via HIS: The Case of Iranian Teaching Hospitals.

PubMed

Ahmadi, Maryam; Khorrami, Farid; Dehnad, Afsaneh; Golchin, Mohammad H; Azad, Mohsen; Rahimi, Shafei

2018-01-01

The challenges of using health information systems in developing countries are different from developed countries for various reasons such as infrastructure and data culture of organizations. The aim of this study is to assess managers' access to key performance indicators (KPI) via Hospital Information System (HIS) in teaching hospitals of Iran. All managers (Census method) of the four teaching hospitals affiliated to Hormozgan University of Medical Sciences (HUMS) were included in this study. KPIs which are linked to the strategic objectives of organizations were adopted from the strategic plan of HUMS. The questionnaire used in this study included three categories: Financial, Human Resources and clinical. One-sample t-test was used and the significant difference score was calculated for the acceptable level. We found that HIS cannot facilitate access to KPIs for managers in the main categories, but it was effective in two subcategories of income (p = 0.314) and salary (P = 0.289)). A study of barriers to the use of managers of HIS in hospitals is suggested.

Assessment of Factor Affecting Institutional Performance: The Case of Wolaita Sodo University

ERIC Educational Resources Information Center

Shibru, Sintayehu; Bibiso, Mesfin; Ousman, Kedir

2017-01-01

The purpose of this study is to explore factors that affect institutional performance of Wolaita Sodo University. The study has identified middle level manager's perceptions toward institutional performance to indicate the key factors that seem to affect the performance of the university. Data were collected using structured questionnaires and…

Lean Information Management: Criteria For Selecting Key Performance Indicators At Shop Floor

NASA Astrophysics Data System (ADS)

Iuga, Maria Virginia; Kifor, Claudiu Vasile; Rosca, Liviu-Ion

2015-07-01

Most successful organizations worldwide use key performance indicators as an important part of their corporate strategy in order to forecast, measure and plan their businesses. Performance metrics vary in their purpose, definition and content. Therefore, the way organizations select what they think are the optimal indicators for their businesses varies from company to company, sometimes even from department to department. This study aims to answer the question of what is the most suitable way to define and select key performance indicators. More than that, it identifies the right criteria to select key performance indicators at shop floor level. This paper contributes to prior research by analysing and comparing previously researched selection criteria and proposes an original six-criteria-model, which caters towards choosing the most adequate KPIs. Furthermore, the authors take the research a step further by further steps to closed research gaps within this field of study.

Managing for Results in America's Great City Schools. A Report of the Performance Measurement and Benchmarking Project, Spring 2008

ERIC Educational Resources Information Center

Council of the Great City Schools, 2008

2008-01-01

This report describes statistical indicators developed by the Council of the Great City Schools and its member districts to measure big-city school performance on a range of operational functions in business, finance, human resources and technology. The report also presents data city-by-city on those indicators. This is the second time that…

Idaho National Laboratory Integrated Safety Management System FY 2016 Effectiveness Review and Declaration Report

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

Hunt, Farren J.

Idaho National Laboratory’s (INL’s) Integrated Safety Management System (ISMS) effectiveness review of fiscal year (FY) 2016 shows that INL has integrated management programs and safety elements throughout the oversight and operational activities performed at INL. The significant maturity of Contractor Assurance System (CAS) processes, as demonstrated across INL’s management systems and periodic reporting through the Management Review Meeting process, over the past two years has provided INL with current real-time understanding and knowledge pertaining to the health of the institution. INL’s sustained excellence of the Integrated Safety and effective implementation of the Worker Safety and Health Program is also evidencedmore » by other external validations and key indicators. In particular, external validations include VPP, ISO 14001, DOELAP accreditation, and key Laboratory level indicators such as ORPS (number, event frequency and severity); injury/illness indicators such as Days Away, Restricted and Transfer (DART) case rate, back & shoulder metric and open reporting indicators, demonstrate a continuous positive trend and therefore improved operational performance over the last few years. These indicators are also reflective of the Laboratory’s overall organizational and safety culture improvement. Notably, there has also been a step change in ESH&Q Leadership actions that have been recognized both locally and complex-wide. Notwithstanding, Laboratory management continues to monitor and take action on lower level negative trends in numerous areas including: Conduct of Operations, Work Control, Work Site Analysis, Risk Assessment, LO/TO, Fire Protection, and Life Safety Systems, to mention a few. While the number of severe injury cases has decreased, as evidenced by the reduction in the DART case rate, the two hand injuries and the fire truck/ambulance accident were of particular concern. Aggressive actions continue in order to understand the causes and define actions needed to prevent similar injuries and accidents in the future. While our injury rate is not where we want it to be, it is not the only indicator that defines our ISMS program, safety culture, and efforts to be a continuous learning organization. When reviewing the entire year’s performance, and all areas that integrate ISMS principles and core functions, INL has an “effective” ISMS program that is continually improving.« less

Financial arrangement selection for energy management projects

NASA Astrophysics Data System (ADS)

Woodroof, Eric Aubrey

Scope and method of study. The purpose of this study was to develop a model (E-FUND) to help facility managers select financial arrangements for energy management projects (EMPs). The model was developed with the help of a panel of expert financiers. The panel also helped develop a list of key objectives critical to the decision process. The E-FUND model was tested by a population of facility managers in four case studies. Findings and conclusions. The results may indicate that having a high economic benefit (from an EMP) is not overwhelmingly important, when compared to other qualitative objectives. The results may also indicate that the true lease and performance contract may be the most applicable financial arrangements for EMPs.

Using key performance indicators as knowledge-management tools at a regional health-care authority level.

PubMed

Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

2005-06-01

The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

Auditing emergency management programmes: Measuring leading indicators of programme performance.

PubMed

Tomsic, Heather

Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

Evaluation of Currently Used Dental Management Indicators and Development of New Management and Performance Indicators.

DTIC Science & Technology

1981-07-01

for selected procedures g. Pericdontal Procedures Per Dentist Formula: Number of Perio Procedures Comr’.neted* Nunber of Dentists Assigned *See appendi...02336 - Resin, Complex A-2 Selected Endodontic Procedures for Endo teeth per assigned DDS ratio: 03311 - Anterior, 1 Canal Filled 03312 - Anterior, 2 or...04271 - Free Soft Tissue Graft 04272 - Vestibulo.-lasty 04340 - Perio Scale and Root Planning *Some or these procedures are not end-item entities as are

The Gender Difference: Validity of Standardized Admission Tests in Predicting MBA Performance.

ERIC Educational Resources Information Center

Hancock, Terence

1999-01-01

Of 120 female and 149 male master of business administration (MBA) students, women performed significantly less well on the Graduate Management Admission Test (GMAT). There were no differences in overall MBA grade point average, indicating no strong correlation between the GMAT and MBA performance. (SK)

Anger, Violence, and Academic Performance: A Study of Troubled Minority Youth.

ERIC Educational Resources Information Center

Fleming, Jacqueline; Barner, Celious III; Hudson, Betsy; Rosignon-Carmouche, Lee A.

2000-01-01

Examined the relationship between anger, violence, and academic performance among troubled adolescents participating in a risk reduction intervention that stressed emotional confrontation and behavior change support. Surveys indicated that anger management was unrelated to violence or academic performance. Loss of control over time, concentration,…

Health maintenance organization (HMO) performance and consumer complaints: an empirical study of frustrating HMO activities.

PubMed

Born, Patricia H; Query, J Tim

2004-01-01

Growing public interest in the operations of managed care plans has fueled a variety of activities to collect and analyze their performance. These activities include studies of financial performance, analysis of enrollment decisions, and, more recently, the development of systems for measuring healthcare quality to improve accountability to consumers. In this study, the authors focus on the activities of managed care plans that may frustrate patients and providers and, subsequently, motivate patients to file complaints. Using data from three sources, they evaluate the relationships between complaints against managed care plans and two metrics of performance: (a) the financial performance of the plan, and (b) the quality of care provided. Their findings indicate that complaints against health maintenance organizations are significantly related to the plans' levels of quality and to actions that may impede access to care.

Performance Management and Optimization of Semiconductor Design Projects

NASA Astrophysics Data System (ADS)

Hinrichs, Neele; Olbrich, Markus; Barke, Erich

2010-06-01

The semiconductor industry is characterized by fast technological changes and small time-to-market windows. Improving productivity is the key factor to stand up to the competitors and thus successfully persist in the market. In this paper a Performance Management System for analyzing, optimizing and evaluating chip design projects is presented. A task graph representation is used to optimize the design process regarding time, cost and workload of resources. Key Performance Indicators are defined in the main areas cost, profit, resources, process and technical output to appraise the project.

Development of an Integrated Performance Measurement (PM) Model for Pharmaceutical Industry

PubMed Central

Shabaninejad, Hosein; Mirsalehian, Mohammad Hossein; Mehralian, Gholamhossein

2014-01-01

With respect to special characteristics of pharmaceutical industry and lack of reported performance measure, this study tries to design an integrated PM model for pharmaceutical companies. For generating this model; we first identified the key performance indicators (KPIs) and the key result indicators (KRIs) of a typical pharmaceutical company. Then, based on experts᾽ opinions, the identified indicators were ranked with respect to their importance, and the most important of them were selected to be used in the proposed model; In this model, we identified 25 KPIs and 12 KRIs. Although, this model is mostly appropriate to measure the performances of pharmaceutical companies, it can be also used to measure the performances of other industries with some modifications. We strongly recommend pharmaceutical managers to link these indicators with their payment and reward system, which can dramatically affect the performance of employees, and consequently their organization`s success. PMID:24711848

[Supply services at health facilities: measuring performance].

PubMed

Dacosta Claro, I

2001-01-01

Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals.

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study.

PubMed

Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke

2018-03-16

To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Western Europe and the USA. Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

New Economic and Financial Indicators of Sustainability

ERIC Educational Resources Information Center

Pittman, James; Wilhelm, Kevin

2007-01-01

Financial accounting methods fall short of fully accounting for the relative sustainability of college and university operations. Management of social, environmental, and economic performance will be aided by changes to and new developments in financial accounting practices to complement other indicators of sustainability.

Human Factors and Modeling Methods in the Development of Control Room Modernization Concepts

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

Hugo, Jacques V.; Slay III, Lorenzo

nuclear power plants. Although the nuclear industry has made steady improvement in outage optimization, each day of a refueling outage still represents an opportunity to save millions of dollars and each day an outage extends past its planned end date represents millions of dollars that may have been spent unnecessarily. Reducing planned outage duration or preventing outage extensions requires careful management of the outage schedule as well as constant oversight and monitoring of work completion during the outage execution. During a typical outage, there are typically more than 10,000 activities on the schedule that, if not managed efficiently, may causemore » expensive outage delays. Management of outages currently relies largely on paper-based resources and general-purpose office software. A typical tool currently used to monitor work performance is a burn-down curve, where total remaining activities are plotted against the baseline schedule to track bulk work completion progress. While these tools are useful, there is still considerable uncertainty during a typical outage that bulk work progress is adequate and therefore a lot of management time is spent analyzing the situation on a daily basis. This paper describes recent advances made in developing a framework for the design of visual outage information presentation, as well as an overview of the scientific principles that informed the development of the visualizations. To test the utility of advanced visual outage information presentation, an outage management dashboard software application was created as part of the Department of Energy’s Advanced Outage Control Center project. This dashboard is intended to present all the critical information an outage manager would need to understand the current status of a refueling outage. The dashboard presents the critical path, bulk work performance, key performance indicators, outage milestones and metrics relating current performance to historical performance. Additionally, the dashboard includes data analysis tools to allow outage managers to drill down into the underlying data to understand the drivers of the indicators.« less

Post-fire wood management alters water stress, growth, and performance of pine regeneration in a Mediterranean ecosystem

USGS Publications Warehouse

Maranon-Jimenez, Sara; Castro, Jorge; Querejeta, José Ignacio; Fernandez-Ondono, Emilia; Allen, Craig D.

2013-01-01

Extensive research has focused on comparing the impacts of post-fire salvage logging versus those of less aggressive management practices on forest regeneration. However, few studies have addressed the effects of different burnt-wood management options on seedling/sapling performance, or the ecophysiological mechanisms underlying differences among treatments. In this study, we experimentally assess the effects of post-fire management of the burnt wood on the growth and performance of naturally regenerating pine seedlings (Pinus pinaster). Three post-fire management treatments varying in degree of intervention were implemented seven months after a high-severity wildfire burned Mediterranean pine forests in the Sierra Nevada, southeast Spain: (a) “No Intervention” (NI, all burnt trees left standing); (b) “Partial Cut plus Lopping” (PCL, felling most of the burnt trees, cutting off branches, and leaving all the biomass on site without mastication); and (c) “Salvage Logging” (SL, felling the burnt trees, piling up the logs and masticating the fine woody debris). Three years after the fire, the growth, foliar nutrient concentrations, and leaf carbon, nitrogen and oxygen isotopic composition (δ13C, δ18O and δ15N) of naturally regenerating seedlings were measured in all the treatments. Pine seedlings showed greatest vigor and size in the PCL treatment, whereas growth was poorest in SL. The nutrient concentrations were similar among treatments, although greater growth in the two treatments with residual wood present indicated higher plant uptake. Seedlings in the SL treatment showed high leaf δ13C and δ18O values indicating severe water stress, in contrast to significantly alleviated water stress indications in the PCL treatment. Seedling growth and physiological performance in NI was intermediate between that of PCL and SL. After six growing seasons, P. pinaster saplings in PCL showed greater growth and cone production than SL saplings. In summary, salvage logging has a detrimental effect on the ecophysiological performance and growth of naturally regenerating pine seedlings, compared to alternative post-fire management practices in which burnt logs and branches are left in situ. Improved seedling growth and performance is associated with the amelioration of microsite/microclimate conditions by the presence of residual burnt wood, which alleviates seedling drought stress and improves nutrient availability through the decomposition of woody debris.

Performance indicators of work activity.

PubMed

Lahoz, Manoela de Assis; Camarotto, João Alberto

2012-01-01

The measurement of performance is a current topic in the management of people in companies, used as a parameter of effectiveness of processes and operations of production. The methods and models of the indicators of current use in the production have concentrated in the assessment of people's performance as determinative resource of the organizational success in the search for the competitiveness. Associated with the classic indicators of performance assessment of the production proceeding, other indicators are used in the assessment of risks and hazards, however with methods focused in the tasks, without connection with the real work activity. The present article explores literature on the models of performance measurement in use in companies and a field research to understand how companies interpret and use indicators that relate health and work, to direct future studies on the subject. Regarding the literature review, one can see that health indicators can be basically divided into two major groups: the legal and managerial indicators. When conducting case studies, it can be realized that companies do not have precisely the concept of health indicator, or were unable to define which of the indicators could be considered indicators of health, considering that absenteeism was the indicator mentioned by the four companies.

"It breaks your soul": An in-depth exploration of workplace injustice in nursing.

PubMed

Skinner, Natalie; Van Dijk, Paul; Stothard, Christina; Fein, Erich C

2018-03-01

To understand nurses' experiences of injustice in the workplace and to identify the impact of injustice on well-being. Little is known about how nurses view injustice or its effects on their well-being, although research indicates that such perceptions are central to workplace practices such as performance management and outcomes such as employee well-being. A qualitative study was conducted with semi-structured interviews for nurses employed in Australian public hospitals. Data were analysed using content analysis. Experiences of injustice and unfairness negatively impacted on performance and the personal health of nurses. Unfair treatment was met with reduced effort and commitment. This study provides valuable insights into how nurses perceive and experience injustice at work and supports the link between injustice and nurses' decreased well-being and effectiveness. Implications for nurse managers include the need for managers to engage in regular conversations regarding systemic barriers to performance and implementing performance management as an ongoing dialogue designed for employee voice and relationship management. This process also suggests a need for leadership development in nursing management. Using such steps and strategies would significantly enhance best practice in nursing management. © 2018 John Wiley & Sons Ltd.

48 CFR 52.222-46 - Evaluation of Compensation for Professional Employees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contract. The Government will evaluate the plan to assure that it reflects a sound management approach and... understanding of work to be performed and should indicate the capability of the proposed compensation structure... of sound management judgment and lack of understanding of the requirement. (c) The Government is...

CCSF Management Plan, 2002/2003.

ERIC Educational Resources Information Center

City Coll. of San Francisco, CA.

This is the 2001-2002 management plan for the City College of San Francisco (CCSF), California. The plan contains the following sections: (1) Overview of Planning and Budgeting; (2) Vision, Values, and Mission; (3) College Goals and Strategic Priorities; (4) Annual Institutional Plan CCSF 2002-03; (5) College Core Performance Indicators; and (6)…

A Strategic Plan for Introducing, Implementing, Managing, and Monitoring an Urban Extension Platform

ERIC Educational Resources Information Center

Warner, Laura A.; Vavrina, Charlie S.; Campbell, Mary L.; Elliott, Monica L.; Northrop, Robert J.; Place, Nick T.

2017-01-01

Florida's Strategic Plan for Extension in Metropolitan Regions reflects an adaptive management approach to the state's urban Extension mission within the context of establishing essential elements, performance indicators, key outcomes, and suggested alternatives for action. Extension leadership has adopted the strategic plan, and implementation…

24 CFR 902.1 - Purpose, scope, and general matters.

Code of Federal Regulations, 2011 CFR

2011-04-01

... agencies (PHAs), public housing residents, and the general public, by providing a management tool for... requirements for poor performers. (b) Scope. PHAS is a strategic measure of the essential housing operations of... indicators, which are more fully addressed in § 902.9: Physical condition, financial condition, management...

University-Industry Collaboration, Knowledge Management and Enterprise Innovation Performance: An Empirical Study

ERIC Educational Resources Information Center

Chen, Jin; Wei, Shiyang

2008-01-01

This empirical study is concerned with university-industry collaboration from a knowledge management perspective. The authors introduce the concepts of "enterprise-level core elements" to define the principle status of an enterprise during university-industry collaboration, and "network embeddedness" as an indication of the…

A multilevel modelling approach to analysis of patient costs under managed care.

PubMed

Carey, K

2000-07-01

The growth of the managed care model of health care delivery in the USA has led to broadened interest in the performance of health care providers. This paper uses multilevel modelling to analyse the effects of managed care penetration on patient level costs for a sample of 24 medical centres operated by the Veterans Health Administration (VHA). The appropriateness of a two level approach to this problem over ordinary least squares (OLS) is demonstrated. Results indicate a modicum of difference in institutions' performance after controlling for patient effects. Facilities more heavily penetrated by the managed care model may be more effective at controlling costs of their sicker patients. Copyright 2000 John Wiley & Sons, Ltd.

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique.

PubMed

Edwards, Laura J; Moisés, Abú; Nzaramba, Mathias; Cassimo, Aboobacar; Silva, Laura; Mauricio, Joaquim; Wester, C William; Vermund, Sten H; Moon, Troy D

2015-03-12

Avante Zambézia is an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia's 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM's first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management. Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator's mean success ratio across all districts submitting a report over time. Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress. Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities. © 2015 by Kerman University of Medical Sciences.

Results-Based Financing in Mozambique's Central Medical Store: A Review After 1 Year.

PubMed

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-03-01

Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short-they address technical weaknesses, but not the incentives that motivate staff to perform better. We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store-Central de Medicamentos e Artigos Medicos (CMAM)-by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick-i.e., shared financial incentives, plus increased accountability for results-will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. We found that CMAM's performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. © Mukuria et al.

Results-Based Financing in Mozambique’s Central Medical Store: A Review After 1 Year

PubMed Central

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-01-01

ABSTRACT Background: Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short—they address technical weaknesses, but not the incentives that motivate staff to perform better. Methods: We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store—Central de Medicamentos e Artigos Medicos (CMAM)—by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. Implementation: The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick—i.e., shared financial incentives, plus increased accountability for results—will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. Findings: We found that CMAM’s performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Conclusion: Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. PMID:27016552

Health system frameworks and performance indicators in eight countries: A comparative international analysis

PubMed Central

Braithwaite, Jeffrey; Hibbert, Peter; Blakely, Brette; Plumb, Jennifer; Hannaford, Natalie; Long, Janet Cameron; Marks, Danielle

2017-01-01

Objectives: Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. Few studies make comparative assessments of different countries’ performance indicator frameworks. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Methods: Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Two dimensions of indicators – that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) – were deemed important. Results: The most commonly used domains in performance frameworks were safety, effectiveness and access. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. Of these, 45 indicators are reported in more than one country. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Conclusion: These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets. PMID:28228948

Evaluation of time management behaviors and its related factors in the senior nurse managers, Kermanshah-Iran.

PubMed

Ziapour, Arash; Khatony, Alireza; Jafari, Faranak; Kianipour, Neda

2015-01-21

Time management is an extensive concept that is associated with promoting the performance of managers. The present study was carried out to investigate the time management behaviors along with its related factors among senior nurse mangers. In this descriptive-analytical study, 180 senior nurse managers were selected using census method. The instrument for data collection was a standard time behavior questionnaire. Data were analyzed by descriptive and analytical statistics. The findings showed that among the dimensions of time management behaviors, setting objectives and prioritization, and mechanics of time management dimensions obtained the highest and lowest frequency, respectively. Comparison of the mean scores of time management behaviors indicated a significant difference in the gender (p<0.05), age (p<0.001), education (p=0.015), job experience (p<0.001), managerial experience (p<0.001) and management rank management (p<0.029). On the whole, senior nurse managers enjoyed a favorable time management skill. Given the importance of time management behaviors, it seems that teaching these behaviors more seriously through regular educational programs can effectively promote the performance of senior nurse managers.

Business Intelligence in Hospital Management.

PubMed

Escher, Achim; Hainc, Nicolin; Boll, Daniel

2016-01-01

Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.

A Hierarchical structure of key performance indicators for operation management and continuous improvement in production systems

PubMed Central

Kang, Ningxuan; Zhao, Cong; Li, Jingshan; Horst, John A.

2018-01-01

Key performance indicators (KPIs) are critical for manufacturing operation management and continuous improvement (CI). In modern manufacturing systems, KPIs are defined as a set of metrics to reflect operation performance, such as efficiency, throughput, availability, from productivity, quality and maintenance perspectives. Through continuous monitoring and measurement of KPIs, meaningful quantification and identification of different aspects of operation activities can be obtained, which enable and direct CI efforts. A set of 34 KPIs has been introduced in ISO 22400. However, the KPIs in a manufacturing system are not independent, and they may have intrinsic mutual relationships. The goal of this paper is to introduce a multi-level structure for identification and analysis of KPIs and their intrinsic relationships in production systems. Specifically, through such a hierarchical structure, we define and layer KPIs into levels of basic KPIs, comprehensive KPIs and their supporting metrics, and use it to investigate the relationships and dependencies between KPIs. Such a study can provide a useful tool for manufacturing engineers and managers to measure and utilize KPIs for CI. PMID:29398722

A Hierarchical structure of key performance indicators for operation management and continuous improvement in production systems.

PubMed

Kang, Ningxuan; Zhao, Cong; Li, Jingshan; Horst, John A

2016-01-01

Key performance indicators (KPIs) are critical for manufacturing operation management and continuous improvement (CI). In modern manufacturing systems, KPIs are defined as a set of metrics to reflect operation performance, such as efficiency, throughput, availability, from productivity, quality and maintenance perspectives. Through continuous monitoring and measurement of KPIs, meaningful quantification and identification of different aspects of operation activities can be obtained, which enable and direct CI efforts. A set of 34 KPIs has been introduced in ISO 22400. However, the KPIs in a manufacturing system are not independent, and they may have intrinsic mutual relationships. The goal of this paper is to introduce a multi-level structure for identification and analysis of KPIs and their intrinsic relationships in production systems. Specifically, through such a hierarchical structure, we define and layer KPIs into levels of basic KPIs, comprehensive KPIs and their supporting metrics, and use it to investigate the relationships and dependencies between KPIs. Such a study can provide a useful tool for manufacturing engineers and managers to measure and utilize KPIs for CI.

Solid waste management in primary healthcare centers: application of a facilitation tool 1

PubMed Central

Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

2016-01-01

Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. PMID:27556874

Establishing sustainable performance-based incentive schemes: views of rural health workers from qualitative research in three sub-Saharan African countries.

PubMed

Yé, M; Aninanya, G A; Sié, A; Kakoko, D C V; Chatio, S; Kagoné, M; Prytherch, H; Loukanova, S; Williams, J E; Sauerborn, R

2014-01-01

Performance-based incentives (PBIs) are currently receiving attention as a strategy for improving the quality of care that health providers deliver. Experiences from several African countries have shown that PBIs can trigger improvements, particularly in the area of maternal and neonatal health. The involvement of health workers in deciding how their performance should be measured is recommended. Only limited information is available about how such schemes can be made sustainable. This study explored the types of PBIs that rural health workers suggested, their ideas regarding the management and sustainability of such schemes, and their views on which indicators best lend themselves to the monitoring of performance. In this article the authors reported the findings from a cross-country survey conducted in Burkina Faso, Ghana and Tanzania. The study was exploratory with qualitative methodology. In-depth interviews were conducted with 29 maternal and neonatal healthcare providers, four district health managers and two policy makers (total 35 respondents) from one district in each of the three countries. The respondents were purposively selected from six peripheral health facilities. Care was taken to include providers who had a management role. By also including respondents from district and policy level a comparison of perspectives from different levels of the health system was facilitated. The data that was collected was coded and analysed with support of NVivo v8 software. The most frequently suggested PBIs amongst the respondents in Burkina Faso were training with per-diems, bonuses and recognition of work done. The respondents in Tanzania favoured training with per-diems, as well as payment of overtime, and timely promotion. The respondents in Ghana also called for training, including paid study leave, payment of overtime and recognition schemes for health workers or facilities. Respondents in the three countries supported the mobilisation of local resources to make incentive schemes more sustainable. There was a general view that it was easier to integrate the cost of non-financial incentives in local budgets. There were concerns about the fairness of such schemes from the provider level in all three countries. District managers were worried about the workload that would be required to manage the schemes. The providers themselves were less clear about which indicators best lent themselves to the purpose of performance monitoring. District managers and policy makers most commonly suggested indicators that were in line with national maternal and neonatal healthcare indicators. The study showed that health workers have considerable interest in performance-based incentive schemes and are concerned about their sustainability. There is a need to further explore the use of non-financial incentives in PBI schemes, as such incentives were considered to stand a greater chance of being integrated into local budgets. Ensuring participation of healthcare providers in the design of such schemes is likely to achieve buy-in and endorsement from the health workers involved. However, input from managers and policy makers is essential to keep expectations realistic and to ensure the indicators selected fit the purpose and are part of routine reporting systems.

High Performance Work Systems and Organizational Outcomes: The Mediating Role of Information Quality.

ERIC Educational Resources Information Center

Preuss, Gil A.

2003-01-01

A study of the effect of high-performance work systems on 935 nurses and 182 nurses aides indicated that quality of decision-making information depends on workers' interpretive skills and partially mediated effects of work design and total quality management on organizational performance. Providing relevant knowledge and opportunities to use…

Strengthening the revenue cycle: a 4-step method for optimizing payment.

PubMed

Clark, Jonathan J

2008-10-01

Four steps for enhancing the revenue cycle to ensure optimal payment are: *Establish key performance indicator dashboards in each department that compare current with targeted performance; *Create proper organizational structures for each department; *Ensure that high-performing leaders are hired in all management and supervisory positions; *Implement efficient processes in underperforming operations.

Evaluation of advanced cooling therapy's esophageal cooling device for core temperature control.

PubMed

Naiman, Melissa; Shanley, Patrick; Garrett, Frank; Kulstad, Erik

2016-05-01

Managing core temperature is critical to patient outcomes in a wide range of clinical scenarios. Previous devices designed to perform temperature management required a trade-off between invasiveness and temperature modulation efficiency. The Esophageal Cooling Device, made by Advanced Cooling Therapy (Chicago, IL), was developed to optimize warming and cooling efficiency through an easy and low risk procedure that leverages heat transfer through convection and conduction. Clinical data from cardiac arrest, fever, and critical burn patients indicate that the Esophageal Cooling Device performs very well both in terms of temperature modulation (cooling rates of approximately 1.3°C/hour, warming of up to 0.5°C/hour) and maintaining temperature stability (variation around goal temperature ± 0.3°C). Physicians have reported that device performance is comparable to the performance of intravascular temperature management techniques and superior to the performance of surface devices, while avoiding the downsides associated with both.

A Methodology for Evaluating and Ranking Water Quantity Indicators in Support of Ecosystem-Based Management

NASA Astrophysics Data System (ADS)

James, C. Andrew; Kershner, Jessi; Samhouri, Jameal; O'Neill, Sandra; Levin, Phillip S.

2012-03-01

Ecosystem-based Management (EBM) is an approach that includes different management priorities and requires a balance between anthropogenic and ecological resource demands. Indicators can be used to monitor ecosystem status and trends, and assess whether projects and/or programs are leading to the achievement of management goals. As such, the careful selection of a suite of indicators is a crucial exercise. In this paper we describe an indicator evaluation and selection process designed to support the EBM approach in Puget Sound. The first step in this process was the development of a general framework for selecting indicators. The framework, designed to transparently include both scientific and policy considerations into the selection and evaluation process, was developed and then utilized in the organization and determination of a preliminary set of indicators. Next, the indicators were assessed against a set of nineteen distinct criteria that describe the model characteristics of an indicator. A literature review was performed for each indicator to determine the extent to which it satisfied each of the evaluation criteria. The result of each literature review was summarized in a numerical matrix, allowing comparison, and demonstrating the extent of scientific reliability. Finally, an approach for ranking indicators was developed to explore the effects of intended purpose on indicator selection. We identified several sets of scientifically valid and policy-relevant indicators that included metrics such as annual-7 day low flow and water system reliability, which are supportive of the EBM approach in the Puget Sound.

Analyzing key performance indicators (KPIs) for E-commerce and Internet marketing of elderly products: a review.

PubMed

Tsai, Yuan-Cheng; Cheng, Yu-Tien

2012-01-01

With the transformation of its population structure and economic environment, Taiwan is rapidly becoming an aging society. There is a growing need for elderly products, and therefore the operation of web shops that sell elderly products is important. In an era which values performance management, searching for key performance indicators (KPIs) helps to reveal, if the goals of a web shop are achieved. In the current study, researchers adopted the constructs of the Balanced Scorecard (BSC) to evaluate web shop performance. Additionally, the Delphi method, along with questionnaires, was used to develop 29 indicators. Finally, the decision making trial and evaluation laboratory (DEMATEL) method assisted in identifying the level of importance of the constructs, in which "internal process" ranked top, followed by "learning and growth", "customer", and "financial". "Internal process" was the key construct that impacted other factors, while "customer" was an important construct affected by other factors. By understanding the influences and relationships among the constructs, enterprises can conduct additional monitoring and management to achieve functions of prevention, continuous improvement, and innovation in order to shape their core competence. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Does a chest x-ray alter the management of new patients attending a geriatric day hospital?

PubMed

Logan, J A; Vallance, R; Williams, B O; Paul, H

1997-01-01

Studies have suggested that routine chest x-ray is never indicated but all new attenders at our day hospitals have a chest x-ray carried out. Our aim was to determine if this investigation altered the clinical management of patients and to try to select those patients in whom a chest x-ray is indicated. A prospective study was carried out over a 7 month period from February to September 1995. All new patients had cardiorespiratory symptoms/signs documented and a management plan made. A chest x-ray was then carried out and change in management as a result of the x-ray report noted. Knightswood and Drumchapel Geriatric Day Hospitals, West Glasgow University NHS Trust. All new Day Hospital attenders. Of 207 new Day Hospital attenders, 53 had no clinical indication for a chest x-ray and although 70% had an abnormal film in no case was patient management changed as a result of this. A chest x-ray was indicated in 154 patients and of these 114 (74%) had an abnormal film with a resultant change in management in 23 patients (this comprised either a change in drug treatment or a further investigation.) Of those whose management was changed as a result of the x-ray report 61% had respiratory symptoms. We would recommend that chest x-ray should be performed in those patients who have a clear clinical indication and that the diagnostic yield is highest in the presence of respiratory symptoms or signs.

Percutaneous magnetic resonance imaging-guided bone tumor management and magnetic resonance imaging-guided bone therapy.

PubMed

Sequeiros, Roberto Blanco; Fritz, Jan; Ojala, Risto; Carrino, John A

2011-08-01

Magnetic resonance imaging (MRI) is promising tool for image-guided therapy. In musculoskeletal setting, image-guided therapy is used to direct diagnostic and therapeutic procedures and to steer patient management. Studies have demonstrated that MRI-guided interventions involving bone, soft tissue, joints, and intervertebral disks are safe and in selected indications can be the preferred action to manage clinical situation. Often, these procedures are technically similar to those performed in other modalities (computed tomography, fluoroscopy) for bone and soft tissue lesions. However, the procedural perception to the operator can be very different to other modalities because of the vastly increased data.Magnetic resonance imaging guidance is particularly advantageous should the lesion not be visible by other modalities, for selective lesion targeting, intra-articular locations, cyst aspiration, and locations adjacent to surgical hardware. Palliative tumor-related pain management such as ablation therapy forms a subset of procedures that are frequently performed under MRI. Another suitable entity for MRI guidance are the therapeutic percutaneous osseous or joint-related benign or reactive conditions such as osteoid osteoma, epiphyseal bone bridging, osteochondritis dissecans, bone cysts, localized bone necrosis, and posttraumatic lesions. In this article, we will describe in detail the technical aspects of performing MRI-guided therapeutic musculoskeletal procedures as well as the clinical indications.

Management and Prevalence of Long-Term Conditions in Primary Health Care for Adults with Intellectual Disabilities Compared with the General Population: A Population-Based Cohort Study

ERIC Educational Resources Information Center

Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

2018-01-01

Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term…

The dynamic model of enterprise revenue management

NASA Astrophysics Data System (ADS)

Mitsel, A. A.; Kataev, M. Yu; Kozlov, S. V.; Korepanov, K. V.

2017-01-01

The article presents the dynamic model of enterprise revenue management. This model is based on the quadratic criterion and linear control law. The model is founded on multiple regression that links revenues with the financial performance of the enterprise. As a result, optimal management is obtained so as to provide the given enterprise revenue, namely, the values of financial indicators that ensure the planned profit of the organization are acquired.

A Holistic Management Architecture for Large-Scale Adaptive Networks

DTIC Science & Technology

2007-09-01

transmission and processing overhead required for management. The challenges of building models to describe dynamic systems are well-known to the field of...increases the challenge of finding a simple approach to assessing the state of the network. Moreover, the performance state of one network link may be... challenging . These obstacles indicate the need for a less comprehensive-analytical, more systemic-holistic approach to managing networks. This approach might

Managing Student Learning: Schools as Multipliers of Intangible Resources

ERIC Educational Resources Information Center

Paletta, Angelo

2011-01-01

The conceptual categories that underlie the business analysis of intellectual capital are relevant to providing an explanation of school performance. By gathering data on student learning, this research provides empirical evidence for the use of school results as an accurate indicator of the effectiveness of the management of public education.…

Project Success Environment: A Positive Contingency Program for Elementary Teachers Management.

ERIC Educational Resources Information Center

Thompson, Marion; And Others

The third year of the project, funded under Elementary Secondary Education Act Title III, was essentially a replication of Year Two. Second Year results indicated that the success technique had provided inner-city teachers with both an effective classroom management system, and an effective program for the acceleration of academic performance.…

Change Management and the SENCo Role: Developing Key Performance Indicators of Inclusivity

ERIC Educational Resources Information Center

Done, Elizabeth; Murphy, Mike; Bedford, Clare

2016-01-01

This article highlights the changing role of special educational needs co-ordinators (SENCos) in England. SENCos are now required to manage change strategically and deliver inclusive school cultures. A school-based evaluative study undertaken by a teacher who is studying for the postgraduate National Award for SEN Co-ordination (NASENCO) for…

A Review of Literature on Teacher Efficacy and Classroom Management

ERIC Educational Resources Information Center

Dibapile, Waitshega Tefo Smitta

2012-01-01

The purpose of this paper was to review the literature on teacher efficacy and classroom management. The conceptual framework of this paper was based on the theories of Rotter (1966) and Bandura (1977). The review of literature indicated that teacher efficacy helps teachers plan effective instructional strategies, increases performance, and…

Workload and time management in central cancer registries: baseline data and implication for registry staffing.

PubMed

Chapman, Susan A; Mulvihill, Linda; Herrera, Carolina

2012-01-01

The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions,together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey.Results indicate that registries faced reductions in budgeted staffing from 2008-2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing,case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however,estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines.

Workload and Time Management in Central Cancer Registries: Baseline Data and Implication for Registry Staffing

PubMed Central

Chapman, Susan A.; Mulvihill, Linda; Herrera, Carolina

2015-01-01

The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions, together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey. Results indicate that registries faced reductions in budgeted staffing from 2008–2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing, case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however, estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines. PMID:23493024

Prioritizing chemicals for environmental management in China based on screening of potential risks

NASA Astrophysics Data System (ADS)

Yu, Xiangyi; Mao, Yan; Sun, Jinye; Shen, Yingwa

2014-03-01

The rapid development of China's chemical industry has created increasing pressure to improve the environmental management of chemicals. To bridge the large gap between the use and safe management of chemicals, we performed a comprehensive review of the international methods used to prioritize chemicals for environmental management. By comparing domestic and foreign methods, we confirmed the presence of this gap and identified potential solutions. Based on our literature review, we developed an appropriate screening method that accounts for the unique characteristics of chemical use within China. The proposed method is based on an evaluation using nine indices of the potential hazard posed by a chemical: three environmental hazard indices (persistence, bioaccumulation, and eco-toxicity), four health hazard indices (acute toxicity, carcinogenicity, mutagenicity, and reproductive and developmental toxicity), and two environmental exposure hazard indices (chemical amount and utilization pattern). The results of our screening agree with results of previous efforts from around the world, confirming the validity of the new system. The classification method will help decisionmakers to prioritize and identify the chemicals with the highest environmental risk, thereby providing a basis for improving chemical management in China.

Management Strategy Evaluation Applied to Coral Reef Ecosystems in Support of Ecosystem-Based Management.

PubMed

Weijerman, Mariska; Fulton, Elizabeth A; Brainard, Russell E

2016-01-01

Ecosystem modelling is increasingly used to explore ecosystem-level effects of changing environmental conditions and management actions. For coral reefs there has been increasing interest in recent decades in the use of ecosystem models for evaluating the effects of fishing and the efficacy of marine protected areas. However, ecosystem models that integrate physical forcings, biogeochemical and ecological dynamics, and human induced perturbations are still underdeveloped. We applied an ecosystem model (Atlantis) to the coral reef ecosystem of Guam using a suite of management scenarios prioritized in consultation with local resource managers to review the effects of each scenario on performance measures related to the ecosystem, the reef-fish fishery (e.g., fish landings) and coral habitat. Comparing tradeoffs across the selected scenarios showed that each scenario performed best for at least one of the selected performance indicators. The integrated 'full regulation' scenario outperformed other scenarios with four out of the six performance metrics at the cost of reef-fish landings. This model application quantifies the socio-ecological costs and benefits of alternative management scenarios. When the effects of climate change were taken into account, several scenarios performed equally well, but none prevented a collapse in coral biomass over the next few decades assuming a business-as-usual greenhouse gas emissions scenario.

From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study.

PubMed

Jacobs, Bart; Thomé, Jean-Marc; Overtoom, Rob; Sam, Sam Oeun; Indermühle, Lorenz; Price, Neil

2010-05-01

Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period-notably the development of performance indicators and targets and the performance monitoring.

Management Strategy Evaluation Applied to Coral Reef Ecosystems in Support of Ecosystem-Based Management

PubMed Central

Weijerman, Mariska; Fulton, Elizabeth A.; Brainard, Russell E.

2016-01-01

Ecosystem modelling is increasingly used to explore ecosystem-level effects of changing environmental conditions and management actions. For coral reefs there has been increasing interest in recent decades in the use of ecosystem models for evaluating the effects of fishing and the efficacy of marine protected areas. However, ecosystem models that integrate physical forcings, biogeochemical and ecological dynamics, and human induced perturbations are still underdeveloped. We applied an ecosystem model (Atlantis) to the coral reef ecosystem of Guam using a suite of management scenarios prioritized in consultation with local resource managers to review the effects of each scenario on performance measures related to the ecosystem, the reef-fish fishery (e.g., fish landings) and coral habitat. Comparing tradeoffs across the selected scenarios showed that each scenario performed best for at least one of the selected performance indicators. The integrated ‘full regulation’ scenario outperformed other scenarios with four out of the six performance metrics at the cost of reef-fish landings. This model application quantifies the socio-ecological costs and benefits of alternative management scenarios. When the effects of climate change were taken into account, several scenarios performed equally well, but none prevented a collapse in coral biomass over the next few decades assuming a business-as-usual greenhouse gas emissions scenario. PMID:27023183

Comparing clinical quality indicators for asthma management in children with outcome measures used in randomised controlled trials: a protocol.

PubMed

Choong, Miew Keen; Tsafnat, Guy; Hibbert, Peter; Runciman, William B; Coiera, Enrico

2015-09-08

Clinical quality indicators are necessary to monitor the performance of healthcare services. The development of indicators should, wherever possible, be based on research evidence to minimise the risk of bias which may be introduced during their development, because of logistic, ethical or financial constraints alone. The development of automated methods to identify the evidence base for candidate indicators should improve the process of indicator development. The objective of this study is to explore the relationship between clinical quality indicators for asthma management in children with outcome and process measurements extracted from randomised controlled clinical trial reports. National-level indicators for asthma management in children will be extracted from the National Quality Measures Clearinghouse (NQMC) database and the National Institute for Health and Care Excellence (NICE) quality standards. Outcome measures will be extracted from published English language randomised controlled trial (RCT) reports for asthma management in children aged below 12 years. The two sets of measures will be compared to assess any overlap. The study will provide insights into the relationship between clinical quality indicators and measurements in RCTs. This study will also yield a list of measurements used in RCTs for asthma management in children, and will find RCT evidence for indicators used in practice. Ethical approval is not necessary because this study will not include patient data. Findings will be disseminated through peer-reviewed publications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Vulvar intraepithelial neoplasia--the need for auditable measures of management.

PubMed

Athavale, Ram; Naik, R; Godfrey, K A; Cross, P; Hatem, M H; de Barros Lopes, A

2008-03-01

Surgical excision is currently the standard treatment for vulvar intraepithelial neoplasia (VIN). To date it has proved difficult to evaluate the management of VIN in reported series due to heterogeneity in datasets. The objective of this study was to justify standardised data presentation to permit comparison between series and facilitate determination of an optimal strategy for management of VIN. We propose auditable indicators of performance to benchmark management and outcomes. This may also enable definition of a surgical control arm for future novel therapy studies. Data from the Northern Gynaecological Oncology Centre (NGOC), UK on women with proven VIN diagnosed between 1989 and 2004 who attended the vulvar review clinic are presented and analysed alongside three large retrospective series by Jones et al. [Jones RW, Rowan DM, Stewart AW. Vulvar intraepithelial neoplasia: aspects of the natural history and outcome in 405 women. Obstet Gynecol 2005;106(6):1319-26], Herod et al. [Herod JJ, Shafi MI, Rollason TP, Jordan JA, Luesley DM. Vulvar intraepithelial neoplasia: long term follow up of treated and untreated women. Br J Obstet Gynaecol 1996;103(5):446-52], McNally et al. [McNally OM, Mulvany NJ, Pagano R, Quinn MA, Rome RM. VIN 3: a clinicopathologic review. Int J Gynecol Cancer 2002;12(5):490-5] against proposed performance indicators to illustrate the deficiencies in current data presentation. Demographics and indicators such as degree of pathological expertise, definition of early stromal invasion and use of International Society for the study of Vulvovaginal Disease (ISSVD) classification were usually well documented. The description of lesions including size and focality were not always documented, nor the proportion examined by co-specialists. Numbers of primary treatments were well described but the indications for treatment, completeness of excision and VIN subclassification were not. Subsequent surgical treatments were inconsistently reported including the pathological details and intervals between treatments. Symptomatology was not well reported. Information on follow-up intervals and duration of follow-up with an indication of patient compliance was inadequate. Outcome data on recurrence of VIN and progression to carcinoma (early stromal invasion or frankly invasive carcinoma) were included in all series. Consensus on the ideal management of VIN or evaluation of new strategies will prove impossible without standardised data presentation. We propose a number of performance indicators that will facilitate evaluation of future studies or series against the current benchmark of surgical treatment for VIN.

Sustainability Assessment of indicators for integrated water resources management.

PubMed

Pires, A; Morato, J; Peixoto, H; Botero, V; Zuluaga, L; Figueroa, A

2017-02-01

The scientific community strongly recommends the adoption of indicators for the evaluation and monitoring of progress towards sustainable development. Furthermore, international organizations consider that indicators are powerful decision-making tools. Nevertheless, the quality and reliability of the indicators depends on the application of adequate and appropriate criteria to assess them. The general objective of this study was to evaluate how indicators related to water use and management perform against a set of sustainability criteria. Our research identified 170 indicators related to water use and management. These indicators were assessed by an international panel of experts that evaluated whether they fulfil the four sustainability criteria: social, economic, environmental, and institutional. We employed an evaluation matrix that classified all indicators according to the DPSIR (Driving Forces, Pressures, States, Impacts and Responses) framework. A pilot study served to test and approve the research methodology before carrying out the full implementation. The findings of the study show that 24 indicators comply with the majority of the sustainability criteria; 59 indicators are bi-dimensional (meaning that they comply with two sustainability criteria); 86 are one-dimensional indicators (fulfilling just one of the four sustainability criteria) and one indicator do not fulfil any of the sustainability criteria. Copyright © 2016. Published by Elsevier B.V.

Performance indicators in water and sanitation for developing areas.

PubMed

Pybus, P; Schoema, G

2001-01-01

There is a move throughout the developed world to introduce benchmarking techniques to the management of water and sanitation systems. The indicators that are being considered for benchmarking purposes tend to cover a broad band of activities that are part of the scope of management of large organisations. Most of the lists that have been prepared do not really cater for the implementation and operation of small rural schemes. The greatest need is the implementation of sustainable schemes for this category of consumer. The implementation of a rural water and sanitation scheme involves the negotiation in the initial stages with the local community representatives of what the community wants and how it will be provided and operated. This may have to be preceded by a period of empowerment so that the negotiations can be conducted by informed people. At the conclusion of the negotiations a business plan can be prepared that should be implemented in association with the community. The project is at this stage mainly in the control of a professional engineer, responsible for the technical interpretation of the business plan and the management of the construction phase. Finally, after commissioning, a water service provider will be responsible for the operation, management and maintenance of the scheme on a sustainable basis. The key actions and activities are identified and performance criteria defined. As communication at the beginning of the project is a critical component, the success of this is confirmed by examination and discussion as to how much has in fact been communicated and understood correctly. Other performance indicators for the operational phase are derived from the conventional ones used in the developed world. Finally, it is important that the participants, do not see the measurement of performance as a threatening situation, but rather a stepping stone to improvement of not only performance, but also of subsequent reward.

Bullying among radiation therapists: effects on job performance and work environment.

PubMed

Trad, Megan; Johnson, Jordan

2014-01-01

To identify the effects of workplace bullying in the radiation therapy department on job performance and explore the environment and morale of individuals who work with a bully. A quantitative research study was designed to assess the prevalence and effects of bullying in the radiation therapy workplace. A total of 308 radiation therapists participated in the study for a return rate of 46%. Of those, 194 indicated that workplace bullying was present either in their current workplace or in a previous radiation therapy environment and that it negatively affected job performance and satisfaction. Findings of this study indicate a need for evaluation of the radiation therapy workplace, education on how to identify and prevent bullying behavior, and better communication among members of the radiation therapy environment. Participants indicated that working in a hostile environment led to forgetfulness, ineffective communication, and perceived discrepancies in promotion and treatment by management. Any bullying behavior contributes to an overall toxic work environment, which is unhealthy and unsafe for patients and therapists. Those who manage therapists should promote a culture of safety and embrace their staff's independence.

Exploring the state of health and safety management system performance measurement in mining organizations.

PubMed

Haas, Emily Joy; Yorio, Patrick

2016-03-01

Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions , organizational performance , and worker performance . A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research.

Exploring the state of health and safety management system performance measurement in mining organizations

PubMed Central

Haas, Emily Joy; Yorio, Patrick

2016-01-01

Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions, organizational performance, and worker performance. A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research. PMID:26823642

Time management training and perceived control of time at work.

PubMed

Häfner, Alexander; Stock, Armin

2010-01-01

The purpose of the present study was to examine the effects of time management training, which was based on psychological theory and research, on perceived control of time, perceived stress, and performance at work. The authors randomly assigned 71 employees to a training group (n = 35) or a waiting-list control group (n = 36). As hypothesized, time management training led to an increase in perceived control of time and a decrease in perceived stress. Time management training had no impact on different performance indicators. In particular, the authors explored the use and the perceived usefulness of the techniques taught. Participants judged the taught techniques as useful, but there were large differences concerning the actual use of the various techniques.

Performance Indicators: Sickness and Absence Rates as Indicators of Staff Morale.

ERIC Educational Resources Information Center

Parker, Sandra

Employee absenteeism is a problem faced by all library and information service managers as it erodes both salary budgets and productivity. It can have an undermining effect on staff morale, and may be an indicator of low staff motivation levels. There are two types of absence, unavoidable and avoidable, which can be measured using lost time and…

The coronary artery disease quality dashboard: a chronic care disease management tool in an electronic health record.

PubMed

Jung, Eunice; Schnipper, Jeffrey L; Li, Qi; Linder, Jeffrey A; Rose, Alan F; Li, Ruzhuo; Eskin, Michael S; Housman, Dan; Middleton, Blackford; Einbinder, Jonathan S

2007-10-11

Quality reporting tools, integrated with ambulatory electronic health records (EHRs), may help clinicians understand performance, manage populations, and improve quality. The Coronary Artery Disease Quality Dash board (CAD QD) is a secure web report for performance measurement of a chronic care condition delivered through a central data warehouse and custom-built reporting tool. Pilot evaluation of the CAD Quality Dash board indicates that clinicians prefer a quality report that combines not only structured data from EHRs but one that facilitates actions to be taken on individual patients or on a population, i.e., for case management.

Implementation and use of a microcomputer-based management information system to monitor dairy herd performance

PubMed Central

Lissemore, Kerry D.; Leslie, Ken E.; Menzies, Paula I.; Martin, S. Wayne; Meek, Alan H.; Etherington, Wayne G.

1992-01-01

A microcomputer-based herd management information system was implemented as part of the herd health program provided to 13 dairy clients by the Ontario Veterinary College, University of Guelph. The study was conducted over a two year period. Data were collected from on-farm event diaries, veterinary visit reports, and production testing information. Selected indices of reproduction, udder health, production, and heifer performance were reported. It was concluded that the implementation of a microcomputer-based information management system, operated as a bureau service, was feasible. However, limitations to the implementation in veterinary practice were identified. PMID:17423945

Developing and Using Dashboard Indicators in Student Affairs Assessment

ERIC Educational Resources Information Center

Mitchell, Joshua J.; Ryder, Andrew J.

2013-01-01

Dashboard systems are increasingly popular as assessment and performance management tools in higher education. This chapter examines the use of dashboards in student affairs, including examples of key indicators and considerations for developing and implementing these tools. The chapter begins with an overview of the origins of dashboards, from…

24 CFR 902.79 - Verification and records.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... All project and PHA certifications, year-end financial information, and supporting documentation are... supporting documents for any certifications and for asset management reviews for at least 3 years. Failure to...), or other methods used to assess performance shall result in a score of zero for the indicator(s) or...

Development of efficiency indicators of operating room management for multi-institutional comparisons.

PubMed

Tanaka, Masayuki; Lee, Jason; Ikai, Hiroshi; Imanaka, Yuichi

2013-04-01

The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-institutional comparisons. The aim of this study was to develop indicators of OR management efficiency that would take into account differences in hospital size and manpower, which may then be applied to multi-institutional comparisons. Using administrative data from 224 hospitals in Japan from 2008 to 2010, we performed four multiple linear regression analyses at the hospital level, in which the dependent variables were the number of operations per OR per month, procedural fees per OR per month, total utilization times per OR per month and total fees per OR per month for each of the models. The expected values of these four indicators were produced using multiple regression analysis results, adjusting for differences in hospital size and manpower, which are beyond the control of process owners' management. However, more than half of the variations in three of these four indicators were shown to be explained by differences in hospital size and manpower. Using the ratio of observed to expected values (OE ratio), as well as the difference between the two values (OE difference) allows hospitals to identify weaknesses in efficiency with more validity when compared to unadjusted indicators. The new indicators may support the improvement and sustainment of a high-quality health care system. © 2012 Blackwell Publishing Ltd.

Assessing the environmental performance of construction materials testing using EMS: An Australian study.

PubMed

Dejkovski, Nick

2016-10-01

This paper reports the audit findings of the waste management practices at 30 construction materials testing (CMT) laboratories (constituting 4.6% of total accredited CMT laboratories at the time of the audit) that operate in four Australian jurisdictions and assesses the organisation's Environmental Management System (EMS) for indicators of progress towards sustainable development (SD). In Australia, waste indicators are 'priority indicators' of environmental performance yet the quality and availability of waste data is poor. National construction and demolition waste (CDW) data estimates are not fully disaggregated and the contribution of CMT waste (classified as CDW) to the national total CDW landfill burden is difficult to quantify. The environmental and human impacts of anthropogenic release of hazardous substances contained in CMT waste into the ecosphere can be measured by construing waste indicators from the EMS. An analytical framework for evaluating the EMS is developed to elucidate CMT waste indicators and assess these indicators against the principle of proportionality. Assessing against this principle allows for: objective evaluations of whether the environmental measures prescribed in the EMS are 'proportionate' to the 'desired' (subjective) level of protection chosen by decision-makers; and benchmarking CMT waste indicators against aspirational CDW targets set by each Australian jurisdiction included in the audit. Construed together, the EMS derived waste indicators and benchmark data provide a composite indicator of environmental performance and progress towards SD. The key audit findings indicate: CMT laboratories have a 'poor' environmental performance (and overall progress towards SD) when EMS waste data are converted into indicator scores and assessed against the principle of proportionality; CMT waste recycling targets are lower when benchmarked against jurisdictional CDW waste recovery targets; and no significant difference in the average quantity of waste diversion away from landfill was observed for laboratories with ISO14001 EMS certification compared to non-ISO14001 certified laboratories. Copyright © 2016 Elsevier Ltd. All rights reserved.

Performance-based building codes: a call for injury prevention indicators that bridge health and building sectors.

PubMed

Edwards, N

2008-10-01

The international introduction of performance-based building codes calls for a re-examination of indicators used to monitor their implementation. Indicators used in the building sector have a business orientation, target the life cycle of buildings, and guide asset management. In contrast, indicators used in the health sector focus on injury prevention, have a behavioural orientation, lack specificity with respect to features of the built environment, and do not take into account patterns of building use or building longevity. Suggestions for metrics that bridge the building and health sectors are discussed. The need for integrated surveillance systems in health and building sectors is outlined. It is time to reconsider commonly used epidemiological indicators in the field of injury prevention and determine their utility to address the accountability requirements of performance-based codes.

The effects of performance appraisal in the Norwegian municipal health services: a case study

PubMed Central

2011-01-01

Introduction Previous research in performance appraisal (PA) indicates that variation exists in learning and job motivation from performance appraisal between occupational groups. This research evaluates the potential effect of job motivation, learning and self-assessment through performance appraisals for health personnel. Case description This article focuses on goal-setting, feedback, participation and training in performance appraisals in municipal health services in Norway; and job motivation, learning and self-assessment of performance are the dependent factors. Questionnaires were distributed to a representative sample of 600 health personnel from the Norwegian municipal health service, with a response rate of 62%. Factor analysis and regression analysis were run in SPSS 12. Discussion and evaluation The study suggests that respondents learn from performance appraisal. Nurses experienced some higher job motivation from performance appraisal than auxiliary nurses. All subordinates perceived higher job motivation after performance appraisal than managers. Conclusion Useful feedback, active participation and higher education are fundamental elements of discussion in performance appraisal, as well as the role of increasing employees' job motivation. In this study, nurses' job motivation seems to be more effected by PA, than for auxiliary nurses. Both nurses and auxiliary nurses indicate that there is a learning effect from PA. This study may be of interest to health researchers and managers in municipal health services. PMID:21974831

Development of performance indicators for municipal solid waste management (PIMS): A review.

PubMed

Sanjeevi, V; Shahabudeen, P

2015-12-01

The aim of this paper is to review papers on municipal solid waste management (SWM) systems, especially on performance indicators (PIs), and suggest practical methods to manage the same by administrators. Worldwide, about 4 billion metric tons of solid waste (SW) is generated annually; the management of SW across cities is increasingly getting more complex and the funds available for providing service to citizens are shrinking. Analysis of the non-technical research papers shows that focus areas on SW can be grouped into 18 types, one being PIs. Historically, PIs for municipal SWM (PIMS) commenced with the publication of guidelines by various government agencies, starting in 1969. This was followed by a few benchmarking studies, commencing in 1998, by various international institutions. Many published comparative studies also disseminated good practices across the cities. From the 1990s onwards, research work started defining PIMS. These initiatives by various researchers took multiple dimensions and are reviewed in this paper. In almost all studies, the PIMS is measured in terms of investment decisions, public acceptance levels, social participation and environmental needs. The multiple indicators are complex, however, and managers of cities need simple tools to use. To make it simple, five-factor PIs are arrived at, considering simplicity and covering all the factors. A research agenda is outlined for future directions in the areas of cost reduction, citizens' services, citizen involvement and environmental impact. © The Author(s) 2015.

Disciplinary processes and the management of poor performance among UK nurses: bad apple or systemic failure? A scoping study.

PubMed

Traynor, Michael; Stone, Katie; Cook, Hannah; Gould, Dinah; Maben, Jill

2014-03-01

The rise of managerialism within healthcare systems has been noted globally. This paper uses the findings of a scoping study to investigate the management of poor performance among nurses and midwives in the United Kingdom within this context. The management of poor performance among clinicians in the NHS has been seen as a significant policy problem. There has been a profound shift in the distribution of power between professional and managerial groups in many health systems globally. We examined literature published between 2000 and 10 to explore aspects of poor performance and its management. We used Web of Science, CINAHL, MEDLINE, British Nursing Index, HMIC, Cochrane Library and PubMed. Empirical data are limited but indicate that nurses and midwives are the clinical groups most likely to be suspended and that poor performance is often represented as an individual deficit. A focus on the individual as a source of trouble can serve as a distraction from more complex systematic problems. © 2013 John Wiley & Sons Ltd.

Reverse quality management: developing evidence-based best practices in health emergency management.

PubMed

Lynch, Tim; Cox, Paul

2006-01-01

The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

Do Business Communication Courses Improve Student Performance in Introductory Marketing?

ERIC Educational Resources Information Center

Marcal, Leah E.; Hennessey, Judith E.; Curren, Mary T.; Roberts, William W.

2005-01-01

In this study, the authors investigated whether completion of a business communications course improved student performance in an introductory marketing management course. Regression analysis indicated that students who completed the communications course received higher grades than the otherwise comparable students. In addition, marketing majors…

34 CFR 361.89 - Enforcement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... revisions until the DSU sustains satisfactory performance based on the current performance levels over a period of more than 1 year. (d) If the Secretary determines that a DSU with less than satisfactory... satisfactory level on the compliance indicators. (Approved by the Office of Management and Budget under control...

Assessing plant protection practices using pressure indicator and toxicity risk indicators: analysis of therelationship between these indicators for improved risk management, application in viticulture.

PubMed

Oussama, Mghirbi; Kamel, Ellefi; Philippe, Le Grusse; Elisabeth, Mandart; Jacques, Fabre; Habiba, Ayadi; Jean-Paul, Bord

2015-06-01

The excessive use of plant protection products (PPPs) has given rise to issues of public and environmental health because of their toxicity. Reducing the use of toxic PPPs and replacing them with products that are less toxic for human health and the environment have become socially, environmentally and economically indispensable. In this article, we assess the plant protection practices of a small group of winegrowers practicing "integrated agriculture" in the south of France, in order to measure the benefit of using toxicity risk indicators as a decision-support tool for different players in land management. An analysis of plant protection practices using indicators of the risk to operator health and the environment (IRSA, IRTE), together with a frequency-of-treatment indicator (TFI), enabled us to (i) show the variability of these indicators depending on the production system and farmers' pesticide use strategies and (ii) calculate correlations between these indicators. This analysis of plant protection practices at different scales (farm, field), carried out in collaboration with the growers, enabled us to perform an initial validation of decision-support tools for determining risk management strategies regarding the use of pesticides.

Advances in space robotics

NASA Technical Reports Server (NTRS)

Varsi, Giulio

1989-01-01

The problem of the remote control of space operations is addressed by identifying the key technical challenge: the management of contact forces and the principal performance parameters. Three principal classes of devices for remote operation are identified: anthropomorphic exoskeletons, computer aided teleoperators, and supervised telerobots. Their fields of application are described, and areas in which progress has reached the level of system or subsystem laboratory demonstrations are indicated. Key test results, indicating performance at a level useful for design tradeoffs, are reported.

Disability management: the application of preventive measures, health promotion and case management in Italy.

PubMed

La Torre, G; De Giusti, M; Mannocci, A; De Waure, C; Agostinelli, A; Schena, S; Capelli, G; Ricciardi, W; Boccia, A; Damiani, G; von Pinoci, M; Fanton, C; Federico, B

2009-03-01

Disability Management can be defined as a practice to improve workers' health and to reduce the impact and costs of disability. The aim of the study was to estimate the diffusion of DM in Italian companies. A survey was conducted using a questionnaire, the Worksite Disability Management Audit. The questionnaire was structured into five parts addressing the following domains: 1) characteristics of the company; 2) health promotion activities; 3) preventive measures; 4) case management; 5) disability management. We selected public and private companies and collected information by direct interview. Twenty companies entered the survey. Twelve Companies (60%) indicated that health promotion programs and sensibilisation campaigns are usually carried out. The presence of an individual who provided workplace safety indications and materials was stated by 19 companies (95%). Periodical medical examinations are carried out by 19 companies (95%); 16 (80%) have an evaluation process for ergonomics concerns. Risk assessment and analysis are performed by all companies and the security procedures and policies are updated at least once in a year in 40% of cases. Health status monitoring of injured workers is performed in eight (40%) of the companies, while Disability Management is present as a whole in only three companies. This survey highlights that Disability Management is not undertaken in most companies and that, where applied, there is still confusion and disorganization about ways to promote health and manage workers' illness and disability. Hence, there is still the need to promote an all-inclusive evaluation and management of workers' safety, illness and disabilities.

The Pioneer Projects - Economical exploration of the solar system

NASA Technical Reports Server (NTRS)

Spahr, J. R.; Hall, C. F.

1975-01-01

The interplanetary Pioneer missions are reviewed in terms of management implications and cost control. The responsibilities, organizational structure, and management practices of the Pioneer Projects are presented. The lines of authority and areas of responsibility of the principal organizational elements supporting the Pioneer missions are identified, and the methods employed for maintaining effective and timely interactions among these elements are indicated. The technical and administrative functions of various organizational elements of the project are described. The management and control of activities prior to and during the hardware procurement phase are described to indicate the basis for obtaining visibility of the technical progress, utilization of resources, and cost performance of the contractors and other institutions supporting the Pioneer projects.

A Cost and Performance System (CAPS) in a Federal agency

NASA Technical Reports Server (NTRS)

Huseonia, W. F.; Penton, P. G.

1994-01-01

Cost and Performance System (CAPS) is an automated system used from the planning phase through implementation to analysis and documentation. Data is retrievable or available for analysis of cost versus performance anomalies. CAPS provides a uniform system across intra- and international elements. A common system is recommended throughout an entire cost or profit center. Data can be easily accumulated and aggregated into higher levels of tracking and reporting of cost and performance.The level and quality of performance or productivity is indicated in the CAPS model and its process. The CAPS model provides the necessary decision information and insight to the principal investigator/project engineer for a successful project management experience. CAPS provides all levels of management with the appropriate detailed level of data.

Embedded fiber-optic sensing for accurate internal monitoring of cell state in advanced battery management systems part 1: Cell embedding method and performance

NASA Astrophysics Data System (ADS)

Raghavan, Ajay; Kiesel, Peter; Sommer, Lars Wilko; Schwartz, Julian; Lochbaum, Alexander; Hegyi, Alex; Schuh, Andreas; Arakaki, Kyle; Saha, Bhaskar; Ganguli, Anurag; Kim, Kyung Ho; Kim, ChaeAh; Hah, Hoe Jin; Kim, SeokKoo; Hwang, Gyu-Ok; Chung, Geun-Chang; Choi, Bokkyu; Alamgir, Mohamed

2017-02-01

A key challenge hindering the mass adoption of Lithium-ion and other next-gen chemistries in advanced battery applications such as hybrid/electric vehicles (xEVs) has been management of their functional performance for more effective battery utilization and control over their life. Contemporary battery management systems (BMS) reliant on monitoring external parameters such as voltage and current to ensure safe battery operation with the required performance usually result in overdesign and inefficient use of capacity. More informative embedded sensors are desirable for internal cell state monitoring, which could provide accurate state-of-charge (SOC) and state-of-health (SOH) estimates and early failure indicators. Here we present a promising new embedded sensing option developed by our team for cell monitoring, fiber-optic sensors. High-performance large-format pouch cells with embedded fiber-optic sensors were fabricated. The first of this two-part paper focuses on the embedding method details and performance of these cells. The seal integrity, capacity retention, cycle life, compatibility with existing module designs, and mass-volume cost estimates indicate their suitability for xEV and other advanced battery applications. The second part of the paper focuses on the internal strain and temperature signals obtained from these sensors under various conditions and their utility for high-accuracy cell state estimation algorithms.

Evaluation of Time Management Behaviors and Its Related Factors in the Senior Nurse Managers, Kermanshah-Iran

PubMed Central

Ziapour, Arash; Khatony, Alireza; Jafari, Faranak; Kianipour, Neda

2015-01-01

Background and Objective: Time management is an extensive concept that is associated with promoting the performance of managers. The present study was carried out to investigate the time management behaviors along with its related factors among senior nurse mangers. Materials and Methods: In this descriptive-analytical study, 180 senior nurse managers were selected using census method. The instrument for data collection was a standard time behavior questionnaire. Data were analyzed by descriptive and analytical statistics. Results: The findings showed that among the dimensions of time management behaviors, setting objectives and prioritization, and mechanics of time management dimensions obtained the highest and lowest frequency, respectively. Comparison of the mean scores of time management behaviors indicated a significant difference in the gender (p<0.05), age (p<0.001), education (p=0.015), job experience (p<0.001), managerial experience (p<0.001) and management rank management (p<0.029). Conclusion: On the whole, senior nurse managers enjoyed a favorable time management skill. Given the importance of time management behaviors, it seems that teaching these behaviors more seriously through regular educational programs can effectively promote the performance of senior nurse managers. PMID:25716413

Use of Balanced Indicators as a Management Tool in Nursing.

PubMed

Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

2015-01-01

To develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. A single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. We identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

Using a Dual Role Assignment to Improve Group Dynamics and Performance: The Effects of Facilitating Social Capital in Teams

ERIC Educational Resources Information Center

Aquino, Karl; Serva, Mark A.

2005-01-01

This article describes a project that simulates the interplay between management and development project teams in a business environment. Each student team was assigned a management role supervising one project and a development role implementing another project. Results indicate that teams that communicate regularly and interact socially outside…

Forest inventory: role in accountability for sustainable forest management

Treesearch

Lloyd C. Irland

2007-01-01

Forest inventory can play several roles in accountability for sustainable forest management. A first dimension is accountability for national performance. The new field of Criteria and Indicators is an expression of this need. A more familiar role for the U.S. Department of Agriculture Forest Service Forest Inventory and Analysis (FIA) program is for assessment and...

Knowledge Management Systems and Open Innovation in Second Tier UK Universities

ERIC Educational Resources Information Center

Chaston, Ian

2012-01-01

The purpose of this paper is to examine the performance of second tier UK universities in relation to the effectiveness of their knowledge management systems and involvement in open innovation. Data were acquired using a mail survey of academic staff in social science and business faculties in second tier institutions. The results indicate that…

Change Management and the SENCo Role: Developing Key Performance Indicators in the Strategic Development of Inclusivity

ERIC Educational Resources Information Center

Done, Liz; Murphy, Mike; Watt, Mia

2016-01-01

This article follows an earlier publication highlighting the changing role of special educational needs co-ordinators (SENCos) in England. SENCos are now required to manage change strategically and deliver inclusive school cultures. School-based action research undertaken by a teacher studying for the postgraduate National Award for SEN…

Performance assessment of a closed-loop system for diabetes management.

PubMed

Martinez-Millana, A; Fico, G; Fernández-Llatas, C; Traver, V

2015-12-01

Telemedicine systems can play an important role in the management of diabetes, a chronic condition that is increasing worldwide. Evaluations on the consistency of information across these systems and on their performance in a real situation are still missing. This paper presents a remote monitoring system for diabetes management based on physiological sensors, mobile technologies and patient/doctor applications over a service-oriented architecture that has been evaluated in an international trial (83,905 operation records). The proposed system integrates three types of running environments and data engines in a single service-oriented architecture. This feature is used to assess key performance indicators comparing them with other type of architectures. Data sustainability across the applications has been evaluated showing better outcomes for full integrated sensors. At the same time, runtime performance of clients has been assessed spotting no differences regarding the operative environment.

Management options of non-syndromic sagittal craniosynostosis.

PubMed

Lee, Bryan S; Hwang, Lee S; Doumit, Gaby D; Wooley, Joseph; Papay, Francis A; Luciano, Mark G; Recinos, Violette M

2017-05-01

There have been various effective surgical procedures for the treatment of non-syndromic sagittal craniosynostosis, but no definitive guidelines for management have been established. We conducted a study to elucidate the current state of practice and establish a warranted standard of care. An Internet-based study was sent to 180 pediatric neurosurgeons across the country and 102 craniofacial plastic surgeons in fourteen different countries, to collect data for primary indication for surgical management, preference for timing and choice of surgery, and pre-, peri-, and post-operative management options. The overall response rate from both groups was 32% (n=90/284). Skull deformity was the primary indication for surgical treatment in patients without signs of hydrocephalus for both neurosurgeons and craniofacial surgeons (80% and 63%, respectively). Open surgical management was most commonly performed at six months of age by neurosurgeons (46%) and also by craniofacial surgeons (35%). Open surgical approach was favored for patients younger than four months of age by neurosurgeons (50%), but endoscopic approach was favored by craniofacial surgeons (35%). When performing an open surgical intervention, most neurosurgeons preferred pi or reversed pi procedure (27%), whereas total cranial vault remodeling was the most commonly performed procedure by craniofacial surgeons (37%). The data demonstrated a discrepancy in the treatment options for non-syndromic sagittal craniosynostosis. By conducting/comparing a wide survey to collect consolidative data from both groups of pediatric neurosurgeons and craniofacial plastic surgeons, we can attempt to facilitate the establishment of standard of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

A system of safety management practices and worker engagement for reducing and preventing accidents: an empirical and theoretical investigation.

PubMed

Wachter, Jan K; Yorio, Patrick L

2014-07-01

The overall research objective was to theoretically and empirically develop the ideas around a system of safety management practices (ten practices were elaborated), to test their relationship with objective safety statistics (such as accident rates), and to explore how these practices work to achieve positive safety results (accident prevention) through worker engagement. Data were collected using safety manager, supervisor and employee surveys designed to assess and link safety management system practices, employee perceptions resulting from existing practices, and safety performance outcomes. Results indicate the following: there is a significant negative relationship between the presence of ten individual safety management practices, as well as the composite of these practices, with accident rates; there is a significant negative relationship between the level of safety-focused worker emotional and cognitive engagement with accident rates; safety management systems and worker engagement levels can be used individually to predict accident rates; safety management systems can be used to predict worker engagement levels; and worker engagement levels act as mediators between the safety management system and safety performance outcomes (such as accident rates). Even though the presence of safety management system practices is linked with incident reduction and may represent a necessary first-step in accident prevention, safety performance may also depend on mediation by safety-focused cognitive and emotional engagement by workers. Thus, when organizations invest in a safety management system approach to reducing/preventing accidents and improving safety performance, they should also be concerned about winning over the minds and hearts of their workers through human performance-based safety management systems designed to promote and enhance worker engagement. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Does teaching crisis resource management skills improve resuscitation performance in pediatric residents?*.

PubMed

Blackwood, Jaime; Duff, Jonathan P; Nettel-Aguirre, Alberto; Djogovic, Dennis; Joynt, Chloe

2014-05-01

The effect of teaching crisis resource management skills on the resuscitation performance of pediatric residents is unknown. The primary objective of this pilot study was to determine if teaching crisis resource management to residents leads to improved clinical and crisis resource management performance in simulated pediatric resuscitation scenarios. A prospective, randomized control pilot study. Simulation facility at tertiary pediatric hospital. Junior pediatric residents. Junior pediatric residents were randomized to 1 hour of crisis resource management instruction or no additional training. Time to predetermined resuscitation tasks was noted in simulated resuscitation scenarios immediately after intervention and again 3 months post intervention. Crisis resource management skills were evaluated using the Ottawa Global Rating Scale. Fifteen junior residents participated in the study, of which seven in the intervention group. The intervention crisis resource management group placed monitor leads 24.6 seconds earlier (p = 0.02), placed an IV 47.1 seconds sooner (p = 0.04), called for help 50.4 seconds faster (p = 0.03), and checked for a pulse after noticing a rhythm change 84.9 seconds quicker (p = 0.01). There was no statistically significant difference in time to initiation of cardiopulmonary resuscitation (p = 0.264). The intervention group had overall crisis resource management performance scores 1.15 points higher (Ottawa Global Rating Scale [out of 7]) (p = 0.02). Three months later, these differences between the groups persisted. A 1-hour crisis resource management teaching session improved time to critical initial steps of pediatric resuscitation and crisis resource management performance as measured by the Ottawa Global Rating Scale. The control group did not develop these crisis resource management skills over 3 months of standard training indicating that obtaining these skills requires specific education. Larger studies of crisis resource education are required.

Employee Perceptions and Value of Performance Appraisals

ERIC Educational Resources Information Center

Bagnell, Rhea

2012-01-01

Performance appraisals traditionally have been studied quantitatively, from the manager's point of view, without considering their value or lack of value to workers. The absence of this information indicates that workers' perceptions and feelings have not always been considered. Therefore, the purpose of this phenomenological study was…

Learning Organization and Transfer: Strategies for Improving Performance

ERIC Educational Resources Information Center

Weldy, Teresa G.

2009-01-01

Purpose: This study aims to explore a relationship between the learning organization and transfer of training as strategies for learning and managing knowledge to make performance improvements and gain or maintain a competitive advantage. Design/methodology/approach: Various similarities are identified in the literature that are indicative of a…

The use of neuroimaging in the management of chronic headache in children in clinical practice versus clinical practice guidelines.

PubMed

Prpić, Igor; Ahel, Tea; Rotim, Krešimir; Gajski, Domagoj; Vukelić, Petar; Sasso, Antun

2014-12-01

In daily practice, neuroimaging studies are frequently performed for the management of childhood headache. The aim of this study was to determine whether there is significant discrepancy between clinical practice and clinical practice guidelines on the indications for neuroimaging studies. Medical records of children with chronic headache, aged 2 to 18 years and treated at Rijeka University Hospital Center, Kantrida Department of Pediatrics, were retrospectively reviewed. Indications for brain magnetic resonance imaging and computed tomography (MRI/CT) scanning were reviewed and compared with clinical practice guidelines. Brain imaging was performed in 164 (76.3%) of 215 children, MRI in 93 (56.7%) and CT in 71 (43.3%) children. Indications for brain MRI/CT were as follows: anxiety and/or insistence by the child's family (71.3%), presence of associated features suggesting neurologic dysfunction (13.4%), age under 5 years (12.8%) and abnormal neurologic examination (2.4%). The majority of children (71.4%) had normal neuroimaging findings. In the rest of imaging studies (28.1%), MRI/CT revealed different intracerebral/extracerebral findings not influencing changes in headache management. Only one (0.60%) patient required change in headache management after MRI/CT. Study results proved that, despite available evidence-based clinical guidelines, brain imaging in children with chronic headaches is overused, mostly in order to decrease anxiety of the family/patient.

Capacity of English NHS hospitals to monitor quality in infection prevention and control using a new European framework: a multilevel qualitative analysis

PubMed Central

Iwami, Michiyo; Ahmad, Raheelah; Castro-Sánchez, Enrique; Birgand, Gabriel; Johnson, Alan P; Holmes, Alison

2017-01-01

Objective (1) To assess the extent to which current English national regulations/policies/guidelines and local hospital practices align with indicators suggested by a European review of effective strategies for infection prevention and control (IPC); (2) to examine the capacity of local hospitals to report on the indicators and current use of data to inform IPC management and practice. Design A national and local-level analysis of the 27 indicators was conducted. At the national level, documentary review of regulations/policies/guidelines was conducted. At the local level data collection comprised: (a) review of documentary sources from 14 hospitals, to determine the capacity to report performance against these indicators; (b) qualitative interviews with 3 senior managers from 5 hospitals and direct observation of hospital wards to find out if these indicators are used to improve IPC management and practice. Setting 2 acute English National Health Service (NHS) trusts and 1 NHS foundation trust (14 hospitals). Participants 3 senior managers from 5 hospitals for qualitative interviews. Primary and secondary outcome measures As primary outcome measures, a ‘Red-Amber-Green’ (RAG) rating was developed reflecting how well the indicators were included in national documents or their availability at the local organisational level. The current use of the indicators to inform IPC management and practice was also assessed. The main secondary outcome measure is any inconsistency between national and local RAG rating results. Results National regulations/policies/guidelines largely cover the suggested European indicators. The ability of individual hospitals to report some of the indicators at ward level varies across staff groups, which may mask required improvements. A reactive use of staffing-related indicators was observed rather than the suggested prospective strategic approach for IPC management. Conclusions For effective patient safety and infection prevention in English hospitals, routine and proactive approaches need to be developed. Our approach to evaluation can be extended to other country settings. PMID:28115331

The impact of the board's strategy-setting role on board-management relations and hospital performance.

PubMed

Büchner, Vera Antonia; Schreyögg, Jonas; Schultz, Carsten

2014-01-01

The appropriate governance of hospitals largely depends on effective cooperation between governing boards and hospital management. Governing boards play an important role in strategy-setting as part of their support for hospital management. However, in certain situations, this active strategic role may also generate discord within this relationship. The objective of this study is to investigate the impact of the roles, attributes, and processes of governing boards on hospital performance. We examine the impact of the governing board's strategy-setting role on board-management collaboration quality and on financial performance while also analyzing the interaction effects of board diversity and board activity level. The data are derived from a survey that was sent simultaneously to German hospitals and their associated governing board, combined with objective performance information from annual financial statements and quality reports. We use a structural equation modeling approach to test the model. The results indicate that different board characteristics have a significant impact on hospital performance (R = .37). The strategy-setting role and board-management collaboration quality have a positive effect on hospital performance, whereas the impact of strategy-setting on collaboration quality is negative. We find that the positive effect of strategy-setting on performance increases with decreasing board diversity. When board members have more homogeneous backgrounds and exhibit higher board activity levels, the negative effect of the strategy-setting on collaboration quality also increases. Active strategy-setting by a governing board may generally improve hospital performance. Diverse members of governing boards should be involved in strategy-setting for hospitals. However, high board-management collaboration quality may be compromised if managerial autonomy is too highly restricted. Consequently, hospitals should support board-management collaboration about empowered contrasting board roles.

Management by objectives and its impact on specialist prescription quality at discharge and in external consultations.

PubMed

Olmo, M; Galvan, L; Capdevila, J; Serna, C; Mangues, I; Schoenenberger, J A

2011-01-01

To verify that implementing a policy of management by objectives, based on collaboration between hospital pharmacy, primary care and specialised medical managers, improves prescription quality indicators in specialised care and reduces unwanted "induced" prescriptions (i.e. those issued by specialists, hospital doctors or the patients themselves) in primary care. A four year quasi-experimental controlled intervention study on prescription at discharge and in outpatient hospital consultations was conducted. In hospital A, a quality cycle was applied: assessment, identifying improvement opportunities, implementing corrective actions and re-assessment. However, it was not applied in control hospital B. The indicators chosen were the percentage of generic medicines prescribed, the percentage of prescriptions for new therapies with no added value and the percentage of prescriptions for ACE inhibitors recommended. In hospital A, an increase in indicators 1 and 3 has been observed, both being statistically significant, between the last year of intervention and the year previous to intervention. Hospital A managed to reduce indicator 2 to 4.5%, while this indicator increased in hospital B to 8.8%. Furthermore, a statistically significant difference in indicators between the two hospitals has been registered. Pay-for-Performance programs in prescription practices of hospital physicians are effective actions to improve quality indicators of medication use. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

Research Frontiers in Public Sector Performance Measurement

NASA Astrophysics Data System (ADS)

Zhonghua, Cai; Ye, Wang

In "New Public Management" era, performance measurement has been widely used in managerial practices of public sectors. From the content and features of performance measurement, this paper aims to explore inspirations on Chinese public sector performance measurement, which based on a review of prior literatures including influencial factors, methods and indicators of public sector performance evaluation. In the end, arguments are presented in this paper pointed out the direction of future researches in this field.

Doing Good While Performing Well at Flemish Universities: Benchmarking Higher Education Institutions in Terms of Social Inclusion and Market Performance

ERIC Educational Resources Information Center

Haezendonck, Elvira; Willems, Kim; Hillemann, Jenny

2017-01-01

Universities, and higher education institutions in general, are ever more influenced by output-driven performance indicators and models that originally stem from the profit-organisational context. As a result, universities are increasingly considering management tools that support them in the (decision) process for attaining their strategic goals.…

Stress in crisis managers: evidence from self-report and psychophysiological assessments.

PubMed

Janka, A; Adler, C; Fischer, L; Perakakis, P; Guerra, P; Duschek, S

2015-12-01

Directing disaster operations represents a major professional challenge. Despite its importance to health and professional performance, research on stress in crisis management remains scarce. The present study aimed to investigate self-reported stress and psychophysiological stress responses in crisis managers. For this purpose, 30 crisis managers were compared with 30 managers from other disciplines, in terms of self-reported stress, health status and psychophysiological reactivity to crisis-related and non-specific visual and acoustic aversive stimuli and cognitive challenge. Crisis managers reported lower stress levels, a more positive strain-recuperation-balance, greater social resources, reduced physical symptoms, as well as more physical exercise and less alcohol consumption. They exhibited diminished electrodermal and heart rate responses to crisis-related and non-specific stressors. The results indicate reduced stress and physical complaints, diminished psychophysiological stress reactivity, and a healthier life-style in crisis managers. Improved stress resistance may limit vulnerability to stress-related performance decline and facilitate preparedness for major incidents.

Implementing a balanced scorecard as a strategic management tool in a long-term care organization.

PubMed

Schalm, Corinne

2008-01-01

The Capital Care Group, the largest public sector continuing care organization in Canada, had no ready access to information on its own performance and therefore was limited in its pursuit of evidence-informed decision-making. To remedy this, it was decided to introduce a balanced scorecard. A literature review was conducted together with interviews with 10 other health care organizations which had implemented balanced scorecards. With this information, a workshop was held that resulted in a framework and about 120 potential indicators. Subsequently the number of indicators was reduced to 29, using pre-determined criteria. Development of a corporate balanced scorecard facilitated executive strategic thinking and clarified the organization's strategic direction. In parallel, scorecards were developed at the level of care centres. These had a common core of indicators, plus some site-specific ones. Development of the corporate scorecard took three years and an additional six months for the care centre scorecards. A formal implementation plan has been accepted by the executive team. Key to this is communicating to staff the role of scorecards for strategic management and not just performance measurement. Traditional thinking needs to change from a short-term operational focus to long-term strategy. In addition, champions need to be identified in each care centre and they need to be networked together. Finally, the scorecard is being integrated into existing operational management as a routine component together with resources to support its use. The balanced scorecard has focused on its role as a strategic management tool. The indicators and dimensions need to be customized to the organization. Senior management must be seen to be driving its introduction. It is worth spending sufficient time developing and implementing a scorecard rather than trying to rush its introduction. The scorecard needs to be integrated with existing management processes and sufficient resources must be assigned. However, success will ultimately depend on the culture of the organization being appropriate and receptive.

Balancing the balanced scorecard for a New Zealand mental health service.

PubMed

Coop, Colleen F

2006-05-01

Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

Modeling of Karachaganak field development

NASA Astrophysics Data System (ADS)

Sadvakasov, A. A.; Shamsutdinova, G. F.; Almukhametova, E. M.; Gabdrakhmanov, N. Kh

2018-05-01

Management of a geological deposit includes the study and analysis of oil recovery, identification of factors influencing production performance and oil-bearing rock flooding, reserve recovery and other indicators characterizing field development in general. Regulation of oil deposits exploitation is a mere control over the fluid flow within a reservoir, which is ensured through the designed system of development via continuous improvement of production and injection wells placement, optimum performance modes, service conditions of downhole and surface oil-field equipment taking into account various changes and physical-geological properties of a field when using modern equipment to obtain the best performance indicators.

The Management and Security Expert (MASE)

NASA Technical Reports Server (NTRS)

Miller, Mark D.; Barr, Stanley J.; Gryphon, Coranth D.; Keegan, Jeff; Kniker, Catherine A.; Krolak, Patrick D.

1991-01-01

The Management and Security Expert (MASE) is a distributed expert system that monitors the operating systems and applications of a network. It is capable of gleaning the information provided by the different operating systems in order to optimize hardware and software performance; recognize potential hardware and/or software failure, and either repair the problem before it becomes an emergency, or notify the systems manager of the problem; and monitor applications and known security holes for indications of an intruder or virus. MASE can eradicate much of the guess work of system management.

Can hospital dashboards provide visibility of information from bedside to board? A case study approach.

PubMed

Pace, Adriana; Buttigieg, Sandra C

2017-04-10

Purpose The purpose of this paper is to analyse hospital dashboards' visibility of information at different management levels to improve quality and performance in an acute general hospital. Design/methodology/approach Data were generated via 21 semi-structured interviews across different management levels. Findings All management levels had greater visibility of information, could make informed decisions, and registered performance improvement. Specifically, waiting time improved, however since introduction of hospital dashboards was work-in-progress at time of study, managers could not record improvement in terms of cost reductions, clinical effectiveness, patient safety and patient satisfaction. Different managerial levels had different visibility with top management having the greatest. Research limitations/implications In single case studies, where only one context is used, the findings cannot be reproduced in different contexts; even though most of the results could be matched with the current literature. Practical implications The need to have balanced key performance indicators that take into account other facets of improvements, apart from time, has been emphasised. Furthermore, if middle and departmental managers have greater visibility, this would allow them to work towards a strategic fit between the departments that they manage with the rest of the hospital. Originality/value There is scant literature regarding performance dashboards' enhancement of visibility of information at different management levels. Furthermore, according to the authors' knowledge, no other paper has tried to identify and discuss the different levels of information, which should be visible from bedside to board namely to management, clinicians and public.

Iranian Expert Opinion about Necessary Criteria for Hospitals Management Performance Assessments

PubMed Central

Dadgar, Elham; Janati, Ali; Tabrizi, Jafar Sadegh; Asghari-Jafarabadi, Mohammad; Barati, Omid

2012-01-01

Background: Managers in the hospital should have enough managerial skill to be coordinated with the complex environment. Defining a competency framework assessment for hospital man-agement will help to establish core competencies for hospital managers. The aim of this study was to develop concrete and suitable performance assessment criteria using expert's view. Methods: In this qualitative study in total, 20 professionals participated in the interview and Fo¬cus Group Discussions (FGD). Two of informants were interviewed and 18 professionals par¬ticipants in three focus group discussions. Discussions and interviews were well planned, the FGD environments were suitable and after interviews completion the notes were checked with participant for completeness. Thematic analysis method was used for the analysis of qualitative data. Results: Findings from 3 FGDs and 2 semi structured interviews done with 20 professionals were categorized accordance to themes. The findings were classified in 7 major and 41 sub themes. The major themes include competency related to planning, organization and staff per-formance management, leadership, information management, and clinical governance and per-formance indicators. Conclusion: All participants had hospital administration experience; so their explanation impor¬tant in identifying the criteria and developing hospital managers’ performance assessment tool. In addition to professional perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adopt the obtained findings to the local hospital conditions. PMID:24688938

Leadership roles, competencies, and education: how prepared are our nurse managers?

PubMed

Kleinman, Carol S

2003-09-01

Although they are responsible for the operation of business units, nurse managers are often less well prepared to manage the business activities than the clinical activities. Perceptions of nurse managers and nurse executives regarding competencies required for nursing management roles and the educational preparation required to attain them were examined. Results indicate the groups are in basic agreement about required competencies, though nurse managers appear less clear about nurse executive role responsibilities. Nurse executives value the acquisition of a master's degree as essential for nurse manager performance, while fewer nurse managers agree. Strategies nurse executives may employ to develop nurse manager business knowledge include traditional undergraduate and graduate degree programs, online programs, certificate programs, continuing education, inservice education offerings, seminars, and mentoring activities.

A New Approach of Measuring Hospital Performance for Low- and Middle-income Countries

PubMed Central

Sapkota, Vishnu Prasad; Supakankunti, Siripen

2015-01-01

Efficiency of the hospitals affects the price of health services. Health care payments have equity implications. Evidence on hospital performance can support to design the policy; however, the recent literature on hospital efficiency produced conflicting results. Consequently, policy decisions are uncertain. Even the most of evidence were produced by using data from high income countries. Conflicting results were produced particularly due to differences in methods of measuring performance. Recently a management approach has been developed to measure the hospital performance. This approach to measure the hospital performance is very useful from policy perspective to improve health system from cost-effective way in low and middle income countries. Measuring hospital performance through management approach has some basic characteristics such as scoring management practices through double blind survey, measuring hospital outputs using various indicators, estimating the relationship between management practices and outputs of the hospitals. This approach has been successfully applied to developed countries; however, some revisions are required without violating the fundamental principle of this approach to replicate in low- and middle-income countries. The process has been clearly defined and applied to Nepal. As the results of this, the approach produced expected results. The paper contributes to improve the approach to measure hospital performance. PMID:26617448

Aspects of transport system management within mining complex using information and telecommunication systems

NASA Astrophysics Data System (ADS)

Semykina, A. S.; Zagorodniy, N. A.; Konev, A. A.; Duganova, E. V.

2018-05-01

The paper considers aspects of transport system management within the mining complex. It indicates information and telecommunication systems that are used to increase transportation efficiency. It also describes key advantages and disadvantages. It is found that software products of the Modular Company used in pits allow increasing transport performance, minimizing losses and ensuring efficient transportation of minerals.

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Approaches to chronic disease management evaluation in use in Europe: a review of current methods and performance measures.

PubMed

Conklin, Annalijn; Nolte, Ellen; Vrijhoef, Hubertus

2013-01-01

An overview was produced of approaches currently used to evaluate chronic disease management in selected European countries. The study aims to describe the methods and metrics used in Europe as a first to help advance the methodological basis for their assessment. A common template for collection of evaluation methods and performance measures was sent to key informants in twelve European countries; responses were summarized in tables based on template evaluation categories. Extracted data were descriptively analyzed. Approaches to the evaluation of chronic disease management vary widely in objectives, designs, metrics, observation period, and data collection methods. Half of the reported studies used noncontrolled designs. The majority measure clinical process measures, patient behavior and satisfaction, cost and utilization; several also used a range of structural indicators. Effects are usually observed over 1 or 3 years on patient populations with a single, commonly prevalent, chronic disease. There is wide variation within and between European countries on approaches to evaluating chronic disease management in their objectives, designs, indicators, target audiences, and actors involved. This study is the first extensive, international overview of the area reported in the literature.

Evaluation of Disaster Preparedness Based on Simulation Exercises: A Comparison of Two Models.

PubMed

Rüter, Andres; Kurland, Lisa; Gryth, Dan; Murphy, Jason; Rådestad, Monica; Djalali, Ahmadreza

2016-08-01

The objective of this study was to highlight 2 models, the Hospital Incident Command System (HICS) and the Disaster Management Indicator model (DiMI), for evaluating the in-hospital management of a disaster situation through simulation exercises. Two disaster exercises, A and B, with similar scenarios were performed. Both exercises were evaluated with regard to actions, processes, and structures. After the exercises, the results were calculated and compared. In exercise A the HICS model indicated that 32% of the required positions for the immediate phase were taken under consideration with an average performance of 70%. For exercise B, the corresponding scores were 42% and 68%, respectively. According to the DiMI model, the results for exercise A were a score of 68% for management processes and 63% for management structure (staff skills). In B the results were 77% and 86%, respectively. Both models demonstrated acceptable results in relation to previous studies. More research in this area is needed to validate which of these methods best evaluates disaster preparedness based on simulation exercises or whether the methods are complementary and should therefore be used together. (Disaster Med Public Health Preparedness. 2016;10:544-548).

The relationships between OHS prevention costs, safety performance, employee satisfaction and accident costs.

PubMed

Bayram, Metin; Ünğan, Mustafa C; Ardıç, Kadir

2017-06-01

Little is known about the costs of safety. A literature review conducted for this study indicates there is a lack of survey-based research dealing with the effects of occupational health and safety (OHS) prevention costs. To close this gap in the literature, this study investigates the interwoven relationships between OHS prevention costs, employee satisfaction, OHS performance and accident costs. Data were collected from 159 OHS management system 18001-certified firms operating in Turkey and analyzed through structural equation modeling. The findings indicate that OHS prevention costs have a significant positive effect on safety performance, employee satisfaction and accident costs savings; employee satisfaction has a significant positive effect on accident costs savings; and occupational safety performance has a significant positive effect on employee satisfaction and accident costs savings. Also, the results indicate that safety performance and employee satisfaction leverage the relationship between prevention costs and accident costs.

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

PubMed Central

Edwards, Laura J.; Moisés, Abú; Nzaramba, Mathias; Cassimo, Aboobacar; Silva, Laura; Mauricio, Joaquim; Wester, C. William; Vermund, Sten H.; Moon, Troy D.

2015-01-01

Background: Avante Zambézia is an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia’s 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM’s first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management. Methods: Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator’s mean success ratio across all districts submitting a report over time. Results: Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress. Conclusion: Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities. PMID:26029894

How to Improve a School that Is Already High Performing: Innovation in the Field of Education

ERIC Educational Resources Information Center

Caridas, Evangeline; Hammer, Mark

2006-01-01

(Purpose) The case study's purpose was to examine Participative Management Style, high performance strategies, intangible and tangible indicators, trust and its creation of superior achievement in a school district for elementary and middle school children (Illinois). (Methodology) A collaboration effort by Superintendent, administrative staff,…

Acts of Fabrication in the Performance Management of Teachers' Work

ERIC Educational Resources Information Center

Naidu, Sham

2012-01-01

"Performativity," it is argued, is a new mode of state regulation which makes it possible to govern in an "advanced liberal" way. It requires individual [teachers] to organize themselves as a response to targets, indicators and evaluations. To set aside personal beliefs and commitments and live an existence of calculation. The…

Performance-Based Rewards and Work Stress

ERIC Educational Resources Information Center

Ganster, Daniel C.; Kiersch, Christa E.; Marsh, Rachel E.; Bowen, Angela

2011-01-01

Even though reward systems play a central role in the management of organizations, their impact on stress and the well-being of workers is not well understood. We review the literature linking performance-based reward systems to various indicators of employee stress and well-being. Well-controlled experiments in field settings suggest that certain…

Performance evaluation model of a pilot food waste collection system in Suzhou City, China.

PubMed

Wen, Zongguo; Wang, Yuanjia; De Clercq, Djavan

2015-05-01

This paper analyses the food waste collection and transportation (C&T) system in a pilot project in Suzhou by using a novel performance evaluation method. The method employed to conduct this analysis involves a unified performance evaluation index containing qualitative and quantitative indicators applied to data from Suzhou City. Two major inefficiencies were identified: a) low system efficiency due to insufficient processing capacity of commercial food waste facilities; and b) low waste resource utilization due to low efficiency of manual sorting. The performance evaluation indicated that the pilot project collection system's strong points included strong economics, low environmental impact and low social impact. This study also shows that Suzhou's integrated system has developed a comprehensive body of laws and clarified regulatory responsibilities for each of the various government departments to solve the problems of commercial food waste management. Based on Suzhou's experience, perspectives and lessons can be drawn for other cities and areas where food waste management systems are in the planning stage, or are encountering operational problems. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conscientiousness, openness to experience and extraversion as predictors of nursing work performance: a facet-level analysis.

PubMed

Ellershaw, Julia; Fullarton, Christie; Rodwell, John; Mcwilliams, John

2016-03-01

This study examined the relationships between the personality traits of conscientiousness, openness and extraversion at trait and facet-levels and three indicators of work role performance; proficiency, 'adaptivity' and proactivity measured at individual, team and organisational levels. This is one of the first studies to explore the relationship between personality, measured at trait and facet-level and performance using a comprehensive range of performance indicators. An online survey of 393 nurses from health-care organisations across Australia was conducted to test hypothesised relationships. Path analyses revealed numerous relationships between personality, measured at both trait and facet-levels, and work role performance. Conscientiousness was highlighted as the strongest driver of work role performance across all the indicators, with extraversion also strongly associated with work role performance. Openness to experience, previously considered a week predictor of performance, was, when examined at the facet-level, related to all of the work role performance indicators. Results suggests a bandwidth effect, where the personality traits drive global performance while the facets drive specific performance. Better understanding of the relationship between personality and work role performance will help nurse managers to foster the fit between individual and organisation, improving job satisfaction, engagement, retention and performance in role. © 2015 John Wiley & Sons Ltd.

Statistical analysis in MSW collection performance assessment.

PubMed

Teixeira, Carlos Afonso; Avelino, Catarina; Ferreira, Fátima; Bentes, Isabel

2014-09-01

The increase of Municipal Solid Waste (MSW) generated over the last years forces waste managers pursuing more effective collection schemes, technically viable, environmentally effective and economically sustainable. The assessment of MSW services using performance indicators plays a crucial role for improving service quality. In this work, we focus on the relevance of regular system monitoring as a service assessment tool. In particular, we select and test a core-set of MSW collection performance indicators (effective collection distance, effective collection time and effective fuel consumption) that highlights collection system strengths and weaknesses and supports pro-active management decision-making and strategic planning. A statistical analysis was conducted with data collected in mixed collection system of Oporto Municipality, Portugal, during one year, a week per month. This analysis provides collection circuits' operational assessment and supports effective short-term municipality collection strategies at the level of, e.g., collection frequency and timetables, and type of containers. Copyright © 2014 Elsevier Ltd. All rights reserved.

How are arbuscular mycorrhizal associations related to maize growth performance during short-term cover crop rotation?

PubMed

Higo, Masao; Takahashi, Yuichi; Gunji, Kento; Isobe, Katsunori

2018-03-01

Better cover crop management options aiming to maximize the benefits of arbuscular mycorrhizal fungi (AMF) to subsequent crops are largely unknown. We investigated the impact of cover crop management methods on maize growth performance and assemblages of AMF colonizing maize roots in a field trial. The cover crop treatments comprised Italian ryegrass, wheat, brown mustard and fallow in rotation with maize. The diversity of AMF communities among cover crops used for maize management was significantly influenced by the cover crop and time course. Cover crops did not affect grain yield and aboveground biomass of subsequent maize but affected early growth. A structural equation model indicated that the root colonization, AMF diversity and maize phosphorus uptake had direct strong positive effects on yield performance. AMF variables and maize performance were related directly or indirectly to maize grain yield, whereas root colonization had a positive effect on maize performance. AMF may be an essential factor that determines the success of cover crop rotational systems. Encouraging AMF associations can potentially benefit cover cropping systems. Therefore, it is imperative to consider AMF associations and crop phenology when making management decisions. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Indicators of the Practice of Power in Language Classrooms

ERIC Educational Resources Information Center

Milal, A. Dzo'ul

2011-01-01

This paper attempts to reveal some strategies performed by a teacher which indicate that s/he is exercising power in managing and conducting language teaching and learning process. Such power may be manifested in terms of the frequency of directives or of the holding of control over the interaction process. Despite the fact that exercising power…

Corneal transplantation trends in France from 2004 to 2015: A 12-year review.

PubMed

Bigan, Guillaume; Puyraveau, Marc; Saleh, Maher; Gain, Philippe; Martinache, Isabelle; Delbosc, Bernard; Gauthier, Anne-Sophie

2018-04-01

The aim of this study was to report the 12-year longitudinal trends in indication and corneal transplantation techniques in France from 2004 to 2015. The records of all corneal transplantations performed from 2004 to 2015 in France were retrospectively reviewed. The patient indications and types of transplant performed were analyzed. A total of 46,658 corneal transplantations were performed between 2004 and 2015, with 34,187 (73.3%) penetrating keratoplasty and 10,452 (22.4%) lamellar keratoplasty. The leading surgical indications were secondary endothelial failure (24.3%), keratoconus (18.8%), regraft (13.5%), and Fuchs endothelial corneal dystrophy (15.1%). Endothelial keratoplasty became the preferred technique for endothelial diseases and deep anterior lamellar keratoplasty the preferred technique for keratoconus, surpassing penetrating keratoplasty in 2013. Secondary endothelial failure is the top indication for performing a keratoplasty over the 12-year period. There was a shift from penetrating keratoplasty to endothelial keratoplasty performed for Fuchs endothelial corneal dystrophy and secondary endothelial failure, and to deep anterior lamellar keratoplasty, performed for keratoconus. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.

Frequency and perceived burden of diabetes self-management activities in employees with insulin-treated diabetes: relationships with health outcomes.

PubMed

Weijman, Iris; Ros, Wynand J G; Rutten, Guy E H M; Schaufeli, Wilmar B; Schabracq, Marc J; Winnubst, Jacques A M

2005-04-01

We explored the relationship between frequency and perceived burden of different self-management activities and HbA1c%, symptoms of diabetes, fatigue, depression, and quality of life in 292 employees between 30 and 60 years of age with insulin-treated diabetes. Participants completed questionnaires that assess self-management and health-related variables. t-Tests were performed for type 1 (DM1) and type 2 diabetes (DM2) separately to compare the mean health scores of individuals who frequently or infrequently perform self-management activities and who do or do not perceive this as a burden. Participants frequently perform their self-management activities, particularly injection of insulin (96.1%), following dietary guidelines (70.8%) and eating regularly (65.6%). Dietary self-management is most often seen as a burden (70.4%), while injecting insulin is seen as least burdensome (12.8%). The perceived burden of self-management is more strongly related to health than the frequency of self-management. Frequency of self-management especially relates to HbA1c% in DM1. People with DM2 who frequently follow the dietary guidelines have more positive health outcomes. Participants who perceive dietary self-management and injecting insulin as a burden have more negative health outcomes. Because different relationships were found between frequency and perceived burden of self-management and health indicators, both aspects should be assessed and considered separately when evaluating self-management and examining patient's health.

Human factors in safety and business management.

PubMed

Vogt, Joachim; Leonhardt, Jorg; Koper, Birgit; Pennig, Stefan

2010-02-01

Human factors in safety is concerned with all those factors that influence people and their behaviour in safety-critical situations. In aviation these are, for example, environmental factors in the cockpit, organisational factors such as shift work, human characteristics such as ability and motivation of staff. Careful consideration of human factors is necessary to improve health and safety at work by optimising the interaction of humans with their technical and social (team, supervisor) work environment. This provides considerable benefits for business by increasing efficiency and by preventing incidents/accidents. The aim of this paper is to suggest management tools for this purpose. Management tools such as balanced scorecards (BSC) are widespread instruments and also well known in aviation organisations. Only a few aviation organisations utilise management tools for human factors although they are the most important conditions in the safety management systems of aviation organisations. One reason for this is that human factors are difficult to measure and therefore also difficult to manage. Studies in other domains, such as workplace health promotion, indicate that BSC-based tools are useful for human factor management. Their mission is to develop a set of indicators that are sensitive to organisational performance and help identify driving forces as well as bottlenecks. Another tool presented in this paper is the Human Resources Performance Model (HPM). HPM facilitates the integrative assessment of human factors programmes on the basis of a systematic performance analysis of the whole system. Cause-effect relationships between system elements are defined in process models in a first step and validated empirically in a second step. Thus, a specific representation of the performance processes is developed, which ranges from individual behaviour to system performance. HPM is more analytic than BSC-based tools because HPM also asks why a certain factor is facilitating or obstructing success. A significant need for research and development is seen here because human factors are of increasing importance for organisational success. This paper suggests integrating human factors in safety management of aviation businesses - a top-ranking partner of technology and finance - and managing it with professional tools. The tools HPM and BSC were identified as potentially useful for this purpose. They were successfully applied in case studies briefly presented in this paper. In terms of specific safety-steering tools in the aviation industry, further elaboration and empirical study is crucial. Statement of Relevance: The importance of human factors is recognised by operators at the sharp end of aviation, where flights are conducted or coordinated. At the blunt end, measurement tools are needed to manage operational resources.

Prioritizing public- private partnership models for public hospitals of iran based on performance indicators.

PubMed

Gholamzadeh Nikjoo, Raana; Jabbari Beyrami, Hossein; Jannati, Ali; Asghari Jaafarabadi, Mohammad

2012-01-01

The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software's. In quality - effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial - efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri¬oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in¬dicator areas. This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

Prioritizing Public- Private Partnership Models for Public Hospitals of Iran Based on Performance Indicators

PubMed Central

Gholamzadeh Nikjoo, Raana; Jabbari Beyrami, Hossein; Jannati, Ali; Asghari Jaafarabadi, Mohammad

2012-01-01

Background: The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. Methods: In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software’s. Results: In quality – effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial – efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri¬oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in¬dicator areas. Conclusion: This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different. PMID:24688942

Quality indicators for the assessment and management of pain in the emergency department: a systematic review.

PubMed

Stang, Antonia Schirmer; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

2014-01-01

Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas.

A model for evaluating the social performance of construction waste management

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

Yuan Hongping, E-mail: hpyuan2005@gmail.com

Highlights: Black-Right-Pointing-Pointer Scant attention is paid to social performance of construction waste management (CWM). Black-Right-Pointing-Pointer We develop a model for assessing the social performance of CWM. Black-Right-Pointing-Pointer With the model, the social performance of CWM can be quantitatively simulated. - Abstract: It has been determined by existing literature that a lot of research efforts have been made to the economic performance of construction waste management (CWM), but less attention is paid to investigation of the social performance of CWM. This study therefore attempts to develop a model for quantitatively evaluating the social performance of CWM by using a system dynamicsmore » (SD) approach. Firstly, major variables affecting the social performance of CWM are identified and a holistic system for assessing the social performance of CWM is formulated in line with feedback relationships underlying these variables. The developed system is then converted into a SD model through the software iThink. An empirical case study is finally conducted to demonstrate application of the model. Results of model validation indicate that the model is robust and reasonable to reflect the situation of the real system under study. Findings of the case study offer helpful insights into effectively promoting the social performance of CWM of the project investigated. Furthermore, the model exhibits great potential to function as an experimental platform for dynamically evaluating effects of management measures on improving the social performance of CWM of construction projects.« less

Ecological and socio-cultural factors influencing plant management in Náhuatl communities of the Tehuacán Valley, Mexico.

PubMed

Blancas, José; Casas, Alejandro; Pérez-Salicrup, Diego; Caballero, Javier; Vega, Ernesto

2013-06-02

Management types and their intensity may vary according to indicators such as: (1) practices complexity, (2) degree of techniques specialization, (3) occurrence and types of social regulations, (4) artificial selection intensity, (5) energy invested, (6) tools types, and (7) amounts of resources obtained. Management types of edible plants were characterized and analyzed in Náhuatl communities of the Tehuacán Valley. We expected that both natural and human pressures generate risk on plant resources availability, influencing human responses of management directed to decrease risk. We particularly hypothesized that magnitude of risk would be a direct function of human pressures favored by cultural and economic value and ecological factors such as scarcity (restricted distribution and abundance). Management practices may decrease risk of plant resources, more effectively when they are more intense; however, absence or insufficiency of management practices on endangered plants may favor loss of their populations. Understanding current management motives and their consequences on the purpose of ensuring availability of plant resources might allow us to understand similar processes occurring in the past. This issue is particularly important to be studied in the Tehuacán Valley, where archaeologists documented possible scenarios motivating origins of plant management by agriculture during prehistory. Through ethnobotanical collecting, 55 semi-structured and free listing interviews we inventoried edible plant species used in five villages of Coyomeapan, Mexico. We identified: (1) native plant species whose products are obtained exclusively through simple gathering, (2) native species involving simple gathering and other management types, and (3) non-native species managed by agricultural management. We conducted in depth studies on the 33 native species managed through gathering and other types of practices. We carried out a total of 660 sessions of detailed interviews to 20 households randomly selected. We showed to people voucher specimens and photos of the sample of species chosen and documented their cultural and economic values. Spatial availability of these plant species was evaluated through vegetation sampling. Values for each cultural, economic, and ecological indicator were codified and averaged or summed and weighed according to frequency of interviewees' responses or ecological conditions per plant species. With the standardized values of these indicators we performed a PCA and scores of the first principal component were considered as a risk index, which summarizes information of thirteen indicators of human use, demand and scarcity of each plant species. Similarly, eleven indicators of energy invested, complexity, tools and management strategies were used for performing PCA and scores of the first principal component were considered as management intensity index for each plant species. A linear regression analysis was performed to analyze the relation between risk and management intensity indexes. Amounts of variation of management data explained by ecological, cultural and economic information, as well as their risk level were analyzed through canonical correspondence analyses (CCA). A total of 122 edible plant species were recorded, nearly 30% of them were introduced domesticated plants, 51 were wild species obtained exclusively by simple gathering and 33 were native species obtained by simple gathering and other management practices, these latter were the ones more deeply studied. People recognized variants in 21 of these latter 33 species, the variants receiving differential use, management, artificial selection and incipient domestication. The lowest values of management intensity corresponded to species under simple gathering and tolerance, mostly annual abundant plants, occasionally consumed by few people. The highest management intensity values were recorded in species with economic importance, mostly perennial with recognized variants whose management requires using tools, and which are protected by collective regulations. The regression analysis indicated significant value R² = 0.433 (P < 0.001) between risk and management indexes. CCA explained 65.5% of variation of management intensity, mainly by socio-cultural factors (32.6%), whereas ecological data explained 21.3% and the intersection of all factors 11.6%. Variation of management intensity is 67.6% explained by risk variables. Length-span of life cycle, reproductive system type, distribution, number of parts used, number of management and use forms and type of regulations were statistically significant. People manage plant resources according to the role these play in households' subsistence, the quantity available and the quality of their useful products; particularly important is the balance between resources availability and demand. Management responses to risk are also influenced by the ease to propagate or manipulate individual plants and time requiring the construction of manipulation strategies and techniques.

Ecological and socio-cultural factors influencing plant management in Náhuatl communities of the Tehuacán Valley, Mexico

PubMed Central

2013-01-01

Background Management types and their intensity may vary according to indicators such as: (1) practices complexity, (2) degree of techniques specialization, (3) occurrence and types of social regulations, (4) artificial selection intensity, (5) energy invested, (6) tools types, and (7) amounts of resources obtained. Management types of edible plants were characterized and analyzed in Náhuatl communities of the Tehuacán Valley. We expected that both natural and human pressures generate risk on plant resources availability, influencing human responses of management directed to decrease risk. We particularly hypothesized that magnitude of risk would be a direct function of human pressures favored by cultural and economic value and ecological factors such as scarcity (restricted distribution and abundance). Management practices may decrease risk of plant resources, more effectively when they are more intense; however, absence or insufficiency of management practices on endangered plants may favor loss of their populations. Understanding current management motives and their consequences on the purpose of ensuring availability of plant resources might allow us to understand similar processes occurring in the past. This issue is particularly important to be studied in the Tehuacán Valley, where archaeologists documented possible scenarios motivating origins of plant management by agriculture during prehistory. Methods Through ethnobotanical collecting, 55 semi-structured and free listing interviews we inventoried edible plant species used in five villages of Coyomeapan, Mexico. We identified: (1) native plant species whose products are obtained exclusively through simple gathering, (2) native species involving simple gathering and other management types, and (3) non-native species managed by agricultural management. We conducted in depth studies on the 33 native species managed through gathering and other types of practices. We carried out a total of 660 sessions of detailed interviews to 20 households randomly selected. We showed to people voucher specimens and photos of the sample of species chosen and documented their cultural and economic values. Spatial availability of these plant species was evaluated through vegetation sampling. Values for each cultural, economic, and ecological indicator were codified and averaged or summed and weighed according to frequency of interviewees’ responses or ecological conditions per plant species. With the standardized values of these indicators we performed a PCA and scores of the first principal component were considered as a risk index, which summarizes information of thirteen indicators of human use, demand and scarcity of each plant species. Similarly, eleven indicators of energy invested, complexity, tools and management strategies were used for performing PCA and scores of the first principal component were considered as management intensity index for each plant species. A linear regression analysis was performed to analyze the relation between risk and management intensity indexes. Amounts of variation of management data explained by ecological, cultural and economic information, as well as their risk level were analyzed through canonical correspondence analyses (CCA). Results A total of 122 edible plant species were recorded, nearly 30% of them were introduced domesticated plants, 51 were wild species obtained exclusively by simple gathering and 33 were native species obtained by simple gathering and other management practices, these latter were the ones more deeply studied. People recognized variants in 21 of these latter 33 species, the variants receiving differential use, management, artificial selection and incipient domestication. The lowest values of management intensity corresponded to species under simple gathering and tolerance, mostly annual abundant plants, occasionally consumed by few people. The highest management intensity values were recorded in species with economic importance, mostly perennial with recognized variants whose management requires using tools, and which are protected by collective regulations. The regression analysis indicated significant value R2 = 0.433 (P < 0.001) between risk and management indexes. CCA explained 65.5% of variation of management intensity, mainly by socio-cultural factors (32.6%), whereas ecological data explained 21.3% and the intersection of all factors 11.6%. Variation of management intensity is 67.6% explained by risk variables. Length-span of life cycle, reproductive system type, distribution, number of parts used, number of management and use forms and type of regulations were statistically significant. Conclusion People manage plant resources according to the role these play in households’ subsistence, the quantity available and the quality of their useful products; particularly important is the balance between resources availability and demand. Management responses to risk are also influenced by the ease to propagate or manipulate individual plants and time requiring the construction of manipulation strategies and techniques. PMID:23725379

A model for evaluating the social performance of construction waste management.

PubMed

Yuan, Hongping

2012-06-01

It has been determined by existing literature that a lot of research efforts have been made to the economic performance of construction waste management (CWM), but less attention is paid to investigation of the social performance of CWM. This study therefore attempts to develop a model for quantitatively evaluating the social performance of CWM by using a system dynamics (SD) approach. Firstly, major variables affecting the social performance of CWM are identified and a holistic system for assessing the social performance of CWM is formulated in line with feedback relationships underlying these variables. The developed system is then converted into a SD model through the software iThink. An empirical case study is finally conducted to demonstrate application of the model. Results of model validation indicate that the model is robust and reasonable to reflect the situation of the real system under study. Findings of the case study offer helpful insights into effectively promoting the social performance of CWM of the project investigated. Furthermore, the model exhibits great potential to function as an experimental platform for dynamically evaluating effects of management measures on improving the social performance of CWM of construction projects. Copyright © 2012 Elsevier Ltd. All rights reserved.

Improving educational objectives of the Industrial and Management Systems Engineering programme at Kuwait University

NASA Astrophysics Data System (ADS)

Aldowaisan, Tariq; Allahverdi, Ali

2016-05-01

This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and update of the PEOs. For each PEO an assessment process is employed where performance measures are defined along with target attainment levels. Results from assessment tools are compared with the target attainment levels to measure performance with regard to the PEOs. The assessment indicates that the results meet or exceed the target attainment levels of the PEOs' performance measures.

Disaster Risk Management and Measurement Indicators for Cultural Heritage in Taiwan

NASA Astrophysics Data System (ADS)

Yen, Y. N.; Cheng, C. F.; Cheng, H. M.

2015-08-01

Under the influence of global climate change, the risk preparedness has become a universal issue in different research fields. In the conservation of cultural heritage, disaster risk management is becoming one of the major research topics. Besides researches on the theory and mechanism of disaster risk management, the tools for the performance of site managers to protect cultural heritage is another important issue that needs development. UNESCO and ICOMOS have released some important documents on disaster risk management including its concept, identification, evaluation, mitigation, monitoring and resilience, etc. However, there is a big gap between concept and implementation in Taiwan. Presently there are 2000 monuments in Taiwan that hardly meet the modern code. First, based on international documents released, this research presents 13 disaster indicators on monuments and their environments. Next, 345 monuments in northern Taiwan are taken as examples to evaluate their risk situations with indicators designed in 2011. Some positive recommendations were given at the same time. As a result, a comparative evaluation was completed in 2012 and some key issues are found, such as too many electrical facilities, lack of efficient firefighting equipment, and a shortage of management mechanism, just to name a few. Through the improvement of the management, some major risk can be mitigated. In 2013~14, this research took 23 national monuments from the 345 monuments to evaluate their risk situations and compare the differences between national and local monuments. Results show that almost all management mechanisms in the national monuments have been established and are running well. However, problems like inappropriate electrical facilities and insufficient monitoring equipment remain. In addition, the performance of private monuments is not as good as public ones. Based on the collected information and evaluation, this research develops safety measures of heritage conservation in two aspects. One is for researchers to measure the risk of the heritage; the other is for site managers to manage the risk of their monument with ease. In conclusion, intendants of monuments in Taiwan have to develop more disaster risk management ideas to mitigate and prevent risks. In the meantime, the management and monitoring mechanisms available are helpful tools for risk mitigation. The awareness and training of the site managers are important issues for the implementation of risk prevention.

Use of Balanced Indicators as a Management Tool in Nursing1

PubMed Central

Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

2015-01-01

Objective: to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. Method: a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. Results: we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Conclusion: although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators. PMID:26625995

Analysis of collaborative communication for linguistic cues of cognitive load.

PubMed

Khawaja, M Asif; Chen, Fang; Marcus, Nadine

2012-08-01

Analyses of novel linguistic and grammatical features, extracted from transcribed speech of people working in a collaborative environment, were performed for cognitive load measurement Prior studies have attempted to assess users' cognitive load with several measures, but most of them are intrusive and disrupt normal task flow. An effective measurement of people's cognitive load can help improve their performance by deploying appropriate output and support strategies accordingly. The authors studied 33 members of bushfire management teams working collaboratively in computerized incident control rooms and involved in complex bushfire management tasks. The participants' communication was analyzed for some novel linguistic features as potential indices of cognitive load, which included sentence length, use of agreement and disagreement phrases, and use of personal pronouns, including both singular and plural pronoun types. Results showed users' different linguistic and grammatical patterns with various cognitive load levels. Specifically, with high load, people spoke more and used longer sentences, used more words that indicated disagreement with other team members, and exhibited increased use of plural personal pronouns and decreased use of singular pronouns. The article provides encouraging evidence for the use of linguistic and grammatical analysis for measuring users' cognitive load and proposes some novel features as cognitive load indices. The proposed approach may be applied to many data-intense and safety-critical task scenarios, such as emergency management departments, for example, bushfire or traffic incident management centers; air traffic control rooms; and call centers, where speech is used as part of everyday tasks.

A Comparison of the Combat Performance of Good and Poor Infantry Squad Leaders

DTIC Science & Technology

1954-09-01

56 Knowlede and skills . . . . ... 56 Communication . . . . . . . . . ........... . 59 Awareness...situation. Personnel management principles frequently indicate that when criticism is leveled 3t subordinates, this criticism should be given privately in

Indicators of waste management efficiency related to different territorial conditions

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

Passarini, Fabrizio, E-mail: fabrizio.passarini@unibo.it; Vassura, Ivano, E-mail: ivano.vassura@unibo.it; Monti, Francesco, E-mail: fmonti84@gmail.com

2011-04-15

The amount of waste produced and the control of separate collection are crucial issues for the planning of a territorial Integrated Waste Management System, enabling the allocation of each sorted waste fraction to the proper treatment and recycling processes. The present study focuses on assessing indicators of different waste management systems in areas characterized by different territorial conditions. The investigated case study concerns the municipalities of Emilia Romagna (northern Italy), which present a rather uniform socioeconomic situation, but a variety of geographic, urban and waste management characteristics. A survey of waste generation and collection rates was carried out, and correlatedmore » with the different territorial conditions, classifying the municipalities according to altitude and population density. The best environmental performances, in terms of high separate collection rate, were found on average in rural areas in the plain, while the lowest waste generation was associated with rural hill towns.« less

The pioneer projects: Economical exploration of the solar system

NASA Technical Reports Server (NTRS)

Spahr, J. R.; Hall, C. F.

1975-01-01

The interplanetary Pioneer missions are reviewed in terms of management implications and cost control. The responsibilities, organizational structure, and management practices of the Pioneer Projects are presented. The lines of authority and areas of responsibility of the principal organizational elements supporting the Pioneer missions are identified, and the methods employed for maintaining effective and timely interactions among these elements are indicated. The technical and administrative functions of the various organizational elements of the Pioneer Project Office at Ames Research Center are described in terms of their management responsibilities and interactions with other elements of the Project Office and with external organizations having Pioneer Project responsibilities. The management and control of activities prior to and during the hardware procurement phase are described to indicate the basis for obtaining visibility of the technical progress, utilization of resources, and cost performance of the contractors and other institutions supporting the Pioneer projects.

Towards a Cloud Based Smart Traffic Management Framework

NASA Astrophysics Data System (ADS)

Rahimi, M. M.; Hakimpour, F.

2017-09-01

Traffic big data has brought many opportunities for traffic management applications. However several challenges like heterogeneity, storage, management, processing and analysis of traffic big data may hinder their efficient and real-time applications. All these challenges call for well-adapted distributed framework for smart traffic management that can efficiently handle big traffic data integration, indexing, query processing, mining and analysis. In this paper, we present a novel, distributed, scalable and efficient framework for traffic management applications. The proposed cloud computing based framework can answer technical challenges for efficient and real-time storage, management, process and analyse of traffic big data. For evaluation of the framework, we have used OpenStreetMap (OSM) real trajectories and road network on a distributed environment. Our evaluation results indicate that speed of data importing to this framework exceeds 8000 records per second when the size of datasets is near to 5 million. We also evaluate performance of data retrieval in our proposed framework. The data retrieval speed exceeds 15000 records per second when the size of datasets is near to 5 million. We have also evaluated scalability and performance of our proposed framework using parallelisation of a critical pre-analysis in transportation applications. The results show that proposed framework achieves considerable performance and efficiency in traffic management applications.

Healthcare Quality Indicators for Physiotherapy Management in Hip and Knee Osteoarthritis and Rheumatoid Arthritis: A Delphi Study.

PubMed

Peter, W F; Hurkmans, E J; van der Wees, P J; Hendriks, E J M; van Bodegom-Vos, L; Vliet Vlieland, T P M

2016-12-01

The aim of the present study was to develop healthcare quality indicators (HCQIs) for the physiotherapy (PT) management of patients with hip or knee osteoarthritis (HKOA) or rheumatoid arthritis (RA) in the Netherlands. Two multidisciplinary expert panels, including patients, were instituted. A draft HCQI set was derived from recommendations included in two existing Dutch PT guidelines for HKOA and RA. The panels suggested additional topics, after which a Delphi procedure was performed. All propositions were scored for their potential to represent good-quality PT care (score range 0-9). Based on predefined rules, the Delphi panel HCQIs were discussed and selected. Lastly, every indicator was rephrased, resulting in its output consisting of a numerator and denominator, to facilitate comparisons within and among practices. After two Delphi rounds, two final sets of 17 HCQI - one for HKOA and one for RA - were composed, both containing 16 process indicators (regarding initial assessment, treatment and evaluation) and one outcome indicator. Two sets of HCQIs for PT management in HKOA and RA were developed for measuring the quality of PT care in daily clinical practice. Each indicator was formulated in a measurable way. Future research should focus on the feasibility of both indicator sets for daily clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

The Utility of Discriminant Analysis for Predicting Farmers' Intentions to Participate in Farmer-Managed Irrigation Systems in Iran

NASA Astrophysics Data System (ADS)

Zarafshani, Kiumars; Hossien Alibaygi, Amir; Afshar, Nasrin

Participatory irrigation management has been problematic in most parts of the world and Iran has been no exception. The purpose of this study was to assess farmers' intentions to participate in irrigation management based on selected variables using discriminant analysis. A survey questionnaire was used to collect information from a sample of Water Cooperatives in Javanrood Townships using stratified random sampling (n = 106). Results indicated that age, educational level, attitude towards PIM, irrigation performance, landholding size, agricultural and non-agricultural income affected farmers' intentions to participate in irrigation management.

Considering User's Access Pattern in Multimedia File Systems

NASA Astrophysics Data System (ADS)

Cho, KyoungWoon; Ryu, YeonSeung; Won, Youjip; Koh, Kern

2002-12-01

Legacy buffer cache management schemes for multimedia server are grounded at the assumption that the application sequentially accesses the multimedia file. However, user access pattern may not be sequential in some circumstances, for example, in distance learning application, where the user may exploit the VCR-like function(rewind and play) of the system and accesses the particular segments of video repeatedly in the middle of sequential playback. Such a looping reference can cause a significant performance degradation of interval-based caching algorithms. And thus an appropriate buffer cache management scheme is required in order to deliver desirable performance even under the workload that exhibits looping reference behavior. We propose Adaptive Buffer cache Management(ABM) scheme which intelligently adapts to the file access characteristics. For each opened file, ABM applies either the LRU replacement or the interval-based caching depending on the Looping Reference Indicator, which indicates that how strong temporally localized access pattern is. According to our experiment, ABM exhibits better buffer cache miss ratio than interval-based caching or LRU, especially when the workload exhibits not only sequential but also looping reference property.

Strengthening immunization in a West African country: Mali.

PubMed

Milstien, J B; Tapia, M; Sow, S O; Keita, L; Kotloff, K

2007-11-01

OBJECTIVES AND CONTEXT: This paper describes the preliminary outcomes of a collaborative capacity-building initiative performed in Mali to strengthen the immunization program. We conducted baseline assessments, training and post-training assessments in four programmatic areas: vaccine management, immunization safety, surveillance, and vaccine coverage, using adapted World Health Organization (WHO) tools. Impact assessment was done by evaluation of trainee performance, programmatic impact and sustainability. Qualitative and quantitative improvement of trainee performance was seen after the training interventions: some knowledge improvement, greater compliance with vaccine management practices and improved vaccine coverage. Deficiencies in information transfer to the periphery were identified. The program involves shared responsibility for planning, implementation and financing with national stakeholders while emphasizing the training of leaders and managers to ensure sustainability. Although short-term gains were measured, our initial assessments indicate that sustained impact will require improvements in staffing, financing and guidelines to ensure delivery of information and skills to the periphery.

Transforming cold chain performance and management in lower-income countries.

PubMed

Brison, Mike; LeTallec, Yann

2017-04-19

In many countries, one of the common factors limiting full and equitable access to effective immunization is the existence of gaps in cold chain and logistics (CCL) systems. This article focuses on the critical contribution that better management of CCL performance can make in addressing these barriers, as well as some essential practices needed to achieve and sustain these gains. These include (i) an emphasis on continuous improvement in CCL performance indicators, (ii) strong coordination and accountability across multiple stakeholders, and (iii) making the most of limited financial resources. This article is informed by the Clinton Health Access Initiative's (CHAI's) experience working with National Immunization Programs (NIPs) and immunization partners to improve the effectiveness and efficiency of CCL systems (including CCE deployment and maintenance, temperature monitoring and control, stock management and distribution) across ten Gavi-supported "focus" countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Applications of Endothermic Reaction Technology to the High Speed Civil Transport

NASA Technical Reports Server (NTRS)

Glickstein, Marvin R.; Spadaccini, Louis J.

1998-01-01

The success of strategies for controlling emissions and enhancing performance in High Speed Research applications may be Increased by more effective utilization of the heat sink afforded by the fuel in the vehicle thermal management system. This study quantifies the potential benefits associated with the use of supercritical preheating and endothermic cracking of let fuel prior to combustion to enhance the thermal management capabilities of the propulsion systems in the High Speed Civil Transport (HSCT). A fuel-cooled thermal management system, consisting of plate-fin heat exchangers and a small auxiliary compressor, is defined for the HSCT, Integrated with the engine, and an assessment of the effect on engine performance, weight, and operating cost is performed. The analysis indicates significant savings due a projected improvement in fuel economy, and the potential for additional benefit if the cycle is modified to take full advantage of all the heat sink available in the fuel.

[Municipalities Stratification for Health Performance Evaluation].

PubMed

Calvo, Maria Cristina Marino; Lacerda, Josimari Telino de; Colussi, Claudia Flemming; Schneider, Ione Jayce Ceola; Rocha, Thiago Augusto Hernandes

2016-01-01

to propose and present a stratification of Brazilian municipalities into homogeneous groups for evaluation studies of health management performance. this was a methodological study, with selected indicators which classify municipalities according to conditions that influence the health management and population size; data for the year 2010 were collected from demographic and health databases; correlation tests and factor analysis were used. seven strata were identified - Large-sized; Medium-sized with favorable, regular or unfavorable influences; and Small-sized with favorable, regular or unfavorable influences -; there was a concentration of municipalities with favorable influences in strata with better purchasing power and funding, as well as a concentration of municipalities with unfavorable influences in the North and Northeast regions. the proposed classification grouped similar municipalities regarding influential factors in health management, which allowed the identification of comparable groups of municipalities, setting up a consistent alternative to performance evaluation studies.

Predictors of Academic Performance of Seminarians in Catholic Major Seminaries in the South-West Region of Nigeria

ERIC Educational Resources Information Center

Adubale, Andrew A.; Aluede, Oyaziwo

2014-01-01

This study investigated predictors of seminarians' academic performance. The study employed a correlational research design. Two hundred and thirty two seminarians constituted the sample for the study. Bakare's modified version of student problem inventory was used to collect the data of the study. The findings indicated that time management and…

Note on evaluating safety performance of road infrastructure to motivate safety competition.

PubMed

Han, Sangjin

2016-01-01

Road infrastructures are usually developed and maintained by governments or public sectors. There is no competitor in the market of their jurisdiction. This monopolic feature discourages road authorities from improving the level of safety with proactive motivation. This study suggests how to apply a principle of competition for roads, in particular by means of performance evaluation. It first discusses why road infrastructure has been slow in safety oriented development and management in respect of its business model. Then it suggests some practical ways of how to promote road safety between road authorities, particularly by evaluating safety performance of road infrastructure. These are summarized as decision of safety performance indicators, classification of spatial boundaries, data collection, evaluation, and reporting. Some consideration points are also discussed to make safety performance evaluation on road infrastructure lead to better road safety management.

Study of microarthropod communities to assess soil quality in different managed vineyards

NASA Astrophysics Data System (ADS)

Gagnarli, Elena; Vignozzi, Nadia; Valboa, Giuseppe; Bouneb, Mabrouk; Corino, Lorenzo; Goggioli, Donatella; Guidi, Silvia; Lottero, Mariarosa; Tarchi, Franca; Simoni, Sauro

2014-05-01

Land use type influences the abundance and diversity of soil arthropods. The evaluation of the effects of different crop managements on soil quality is commonly requested; it can be pursued by means of the determination of communities' structure of edaphic fauna. The development and application of biological indices may represent an efficient mean to assess soil quality. We evaluated the effect of crop managements (organic and Integrated Pest Management-IPM) in some vineyards in Piedmont (Italy) on soil biota in relation to some physical and chemical characteristics of the soil. The study was performed in eleven sites, including seven organic and four IPM managed vineyards located in the Costigliole d'Asti area. Samplings were carried out during the winter 2011 and the spring 2012. Soil samples were collected using a cylindrical soil core sampler (3cm diameter x 30cm height): each sample was a cylindrical soil core which was equally subdivided to study arthropod communities at different depth ranges. Additional samples were collected and analyzed for the following soil physical and chemical properties: texture (sedigraph method), pH (1:2.5 soil/water), total organic carbon (TOC), total nitrogen (NT) and calcium carbonate (dry combustion by CN analyzer). The extraction of microarthropods was performed using the selector Berlese-Tullgren. All specimens were counted and determined up to the order level. The influence of soil properties and of agronomic practices on the abundance of mesofauna was evaluated by multivariate analysis (MANOVA). The biological soil quality was also defined through the determination of biotic indices such as the qualitative and quantitative QBSar (Quality Biological Soil - arthropods), and biodiversity indices such as species richness and indices of Shannon-Wiener (H') and Simpson (D). Overall, more than four thousands arthropods were collected and the highest abundance was in biological management with about 2:1 ratio (biological vs conventional/IPM management). The mites represented about 50% of the arthropodofauna recorded, collembolans 30%, and 20% other microarthropods (Blattaria, Chilopoda, Coleoptera, Diplopoda, Diplura, Diptera, Hemiptera, Hymenoptera, Isopoda, Homoptera, Pauropoda, Protura, Pseudoscopionida, Psocoptera, Symphyla, Thysanoptera). The mesofauna abundance was affected by the type of management (P=0.015) and soil texture (P=0.029). At the identification level considered, the biological indices calculated showed no substantial differences between different crop managements (H'=1.26, D=0.97 in organic vineyard, H'=1.30, D=0.89 in IPM vineyard). The analysis of microarthropod communities by QBSar, however, showed higher values in organic compared to IPM managed vineyards (QBSar 199 vs 98 in 2011 and 205 vs 188 in 2012, respectively) which are close to figures characteristic of preserved soils.

Academy of nutrition and dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in sports nutrition and dietetics.

PubMed

Steinmuller, Patricia L; Kruskall, Laura J; Karpinski, Christine A; Manore, Melinda M; Macedonio, Michele A; Meyer, Nanna L

2014-04-01

Sports nutrition and dietetics addresses relationships of nutrition with physical activity, including weight management, exercise, and physical performance. Nutrition plays a key role in the prevention and treatment of obesity and chronic disease and for maintenance of health, and the ability to engage in physical activity, sports, and other aspects of physical performance. Thus, the Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Revised 2014 Standards of Practice and Standards of Professional Performance as a resource for Registered Dietitian Nutritionists working in sports nutrition and dietetics to assess their current skill levels and to identify areas for further professional development in this emerging practice area. The revised document reflects advances in sports nutrition and dietetics practice since the original standards were published in 2009 and replaces those standards. The Standards of Practice represents the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standards can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sports nutrition and dietetics. The Standards of Practice and Standards of Professional Performance are complementary resources for Registered Dietitian Nutritionists in sports nutrition and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Generation and evaluation of an indicator of the health system's performance in maternal and reproductive health in Colombia: An ecological study.

PubMed

Pinzón-Flórez, Carlos Eduardo; Fernandez-Niño, Julian Alfredo; Cardenas-Cardenas, Luz Mery; Díaz-Quijano, Diana Marcela; Ruiz-Rodriguez, Myriam; Reveiz, Ludovic; Arredondo-López, Armando

2017-01-01

To generate and evaluate an indicator of the health system's performance in the area of maternal and reproductive health in Colombia. An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the states were classified according to the indicator's score. A path analysis was used to evaluate the relationship between the indicator and social determinants, with the maternal mortality ratio as the response variable. The factor analysis indicates that only one principal factor exists, namely "coverage and utilization of maternal healthcare services" (eigenvalue 4.35). The indicator performed best in the states of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander (Q4). The poorest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. The indicator's behavior was found to have an association with the unsatisfied basic needs index and women's education (β = -0.021; 95%CI -0031 to -0.01 and β 0.554; 95%CI 0.39 to 0.72, respectively). According to the path analysis, an inverse relationship exists between the proposed indicator and the behavior of the maternal mortality ratio (β = -49.34; 95%CI -77.7 to -20.9); performance was a mediating variable. The performance of the health system with respect to its management of access and coverage for maternal and reproductive health appears to function as a mediating variable between social determinants and maternal mortality in Colombia.

[Surgical procedures in 156 cases of pleural effusion. Immediate results].

PubMed

Cicero-Sabido, Raúl; Páramo-Arroyo, Rafael F; Navarro-Reynoso, Francisco Pascual; Pimentel-Ugarte, Lorenzo

2006-01-01

Pleural effusion is a common clinical entity. Proper diagnosis and management are important for successful treatment. We undertook this study to evaluate immediate results of the procedures used in a group of cases with pleural effusion. Of 2589 patients at first consultation, 787 were hospitalized and 156 had pleural effusion. Diagnostic and therapeutic procedures used were evaluated. With thoracentesis and evacuation of liquid, 23 nonneoplastic cases had resolution. Chest tube drainage with water seal was performed in 133 patients. This procedure suppressed the effusion in 109 patients, but in 24 patients another approach was necessary. In this group there were 35 neoplastic and 96 nonmalignant cases, the latter 36 were provoked by iatrogenic management. Twenty two cases of pneumothorax considered as gaseous effusion and 10 cases of chronic empyema sequelae of pleural effusions were also studied. Proportion comparison demonstrated significant differences between neoplastic and nonneoplastic effusions (p =0.001) and in cases managed with minimally invasive procedures and chest tube drainage (p =0.001). The performance of pleurodesis and thoracoscopy is discussed. In chronic cases, indications of open window thoracostomy and myoplasty are elucidated. In pleural effusion, opportune diagnosis and proper management are essential. Drainage tube can solve the majority of cases. Pneumothorax must be treated in the same way. In chronic empyema, open window thoracostomy and myoplasty are indicated. Careless patient management and poor treatment lead to iatrogenic complications.

Do technical skills correlate with non-technical skills in crisis resource management: a simulation study.

PubMed

Riem, N; Boet, S; Bould, M D; Tavares, W; Naik, V N

2012-11-01

Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. TS and NTS were significantly correlated to each other (r=0.45, P<0.05). During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.

The relationship between organizational culture and performance in acute hospitals.

PubMed

Jacobs, Rowena; Mannion, Russell; Davies, Huw T O; Harrison, Stephen; Konteh, Fred; Walshe, Kieran

2013-01-01

This paper examines the relationship between senior management team culture and organizational performance in English acute hospitals (NHS Trusts) over three time periods between 2001/2002 and 2007/2008. We use a validated culture rating instrument, the Competing Values Framework, to measure senior management team culture. Organizational performance is assessed using a wide range of routinely collected indicators. We examine the associations between organizational culture and performance using ordered probit and multinomial logit models. We find that organizational culture varies across hospitals and over time, and this variation is at least in part associated in consistent and predictable ways with a variety of organizational characteristics and routine measures of performance. Moreover, hospitals are moving towards more competitive culture archetypes which mirror the current policy context, though with a stronger blend of cultures. The study provides evidence for a relationship between culture and performance in hospital settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Construction and application of an indicator system to assess the ergonomic performance of large and medium-sized construction companies.

PubMed

Bezerra, Isabela Xavier Barbalho; de Carvalho, Ricardo José Matos

2012-01-01

This article proposes a system of indicators to evaluate the performance of companies in ergonomics for buildings. The system was developed based primarily on studies related to the performance evaluation of the construction industry and on Brazilian standards of ergonomics and work safety and had also the contribution of national and international indicators related to ergonomics, work safety, quality, sustainability, quality of work life and to organizational behavior. The indicators were named, classified and their components were assigned to compose the theoretical model SIDECE--System of Performance Indicators in Ergonomics for Building Construction (as for the Portuguese acronym), serving the major goals of ergonomics: health, safety and workers' satisfaction and production efficiency. The SIDECE is being validated along with the building construction companies in the city of Natal, Brazil, whose practical results, deriving from the application of instruments to collect field data, are under process, to be presented on the occasion of the 18th World Congress on Ergonomics. It is intended that the SIDECE be used by building construction companies as a support tool for excellence management.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects.

PubMed

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-09-27

To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades-while not inexpensive-contributed to greater system efficiency and modest savings. © Mwencha et al.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

PubMed Central

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-01-01

ABSTRACT Background: To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. Methods: We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. Results: The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Conclusion: Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades—while not inexpensive—contributed to greater system efficiency and modest savings. PMID:28877933

Capacity of English NHS hospitals to monitor quality in infection prevention and control using a new European framework: a multilevel qualitative analysis.

PubMed

Iwami, Michiyo; Ahmad, Raheelah; Castro-Sánchez, Enrique; Birgand, Gabriel; Johnson, Alan P; Holmes, Alison

2017-01-23

(1) To assess the extent to which current English national regulations/policies/guidelines and local hospital practices align with indicators suggested by a European review of effective strategies for infection prevention and control (IPC); (2) to examine the capacity of local hospitals to report on the indicators and current use of data to inform IPC management and practice. A national and local-level analysis of the 27 indicators was conducted. At the national level, documentary review of regulations/policies/guidelines was conducted. At the local level data collection comprised: (a) review of documentary sources from 14 hospitals, to determine the capacity to report performance against these indicators; (b) qualitative interviews with 3 senior managers from 5 hospitals and direct observation of hospital wards to find out if these indicators are used to improve IPC management and practice. 2 acute English National Health Service (NHS) trusts and 1 NHS foundation trust (14 hospitals). 3 senior managers from 5 hospitals for qualitative interviews. As primary outcome measures, a 'Red-Amber-Green' (RAG) rating was developed reflecting how well the indicators were included in national documents or their availability at the local organisational level. The current use of the indicators to inform IPC management and practice was also assessed. The main secondary outcome measure is any inconsistency between national and local RAG rating results. National regulations/policies/guidelines largely cover the suggested European indicators. The ability of individual hospitals to report some of the indicators at ward level varies across staff groups, which may mask required improvements. A reactive use of staffing-related indicators was observed rather than the suggested prospective strategic approach for IPC management. For effective patient safety and infection prevention in English hospitals, routine and proactive approaches need to be developed. Our approach to evaluation can be extended to other country settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evaluating the Effect of Display Realism on Natural Resource Decision Making

NASA Astrophysics Data System (ADS)

Chong, Steven S.

2018-05-01

Geographic information systems (GIS) facilitate location-based decision making. Despite the improved availability of GIS software to non-professionals, training in cartographic design has not followed suit. Prior research indicates that when presented with map choices, users are influenced by naïve realism, a preference for realistic displays cotaining irrelevant, extraneous details, leading to decreased task efficiency. This study investigated the role of naïve realism in decision making for natural resource management, a field that often employs geospatial tools. Data was collected through a GIS user ability test, a questionnaire and direct observation. Forty volunteer expert and non-expert resource managers evaluated the suitability of different sites for a land management scenario. Each participant was tested on two map display treatments containing different levels of realism - a simpler 2D display and a more complex 3D display - to compare task performance. Performance was measured by task accuracy and task completion time. User perceptions and preferences about the displays were also recorded. Display realism had an impact on performance and there were indications naïve realism was present. Users completed tasks significantly faster on the 2D display and many individuals misjudged which display they were most accurate or fastest with. The results are informative for designing information systems containing interactive maps, particularly for resource management applications. The results also suggest that the order displays were presented had a significant effect and may have implications for teaching users map-based tasks.

Models of evaluation of public joint-stock property management

NASA Astrophysics Data System (ADS)

Yakupova, N. M.; Levachkova, S.; Absalyamova, S. G.; Kvon, G.

2017-12-01

The paper deals with the models of evaluation of performance of both the management company and the individual subsidiaries on the basis of a combination of elements and multi-parameter and target approaches. The article shows that due to the power of multi-dimensional and multi-directional indicators of financial and economic activity it is necessary to assess the degree of achievement of the objectives with the use of multivariate ordinal model as a set of indicators, ordered by growth so that the maintenance of this order on a long interval of time will ensure the effective functioning of the enterprise in the long term. It is shown that these models can be regarded as the monitoring tools of implementation of strategies and guide the justification effectiveness of implementation of management decisions.

The balanced scorecard: an integrative approach to performance evaluation.

PubMed

Oliveira, J

2001-05-01

In addition to strict financial outcomes, healthcare financial managers should assess intangible assets that affect the organization's bottom line, such as clinical processes, staff skills, and patient satisfaction and loyalty. The balanced scorecard, coupled with data-warehousing capabilities, offers a way to measure an organization's performance against its strategic objectives while focusing on building capabilities to achieve these objectives. The balanced scorecard examines performance related to finance, human resources, internal processes, and customers. Because the balanced scorecard requires substantial amounts of data, it is a necessity to establish an organizational data warehouse of clinical, operational, and financial data that can be used in decision support. Because it presents indicators that managers and staff can influence directly by their actions, the balanced-scorecard approach to performance measurement encourages behavioral changes aimed at achieving corporate strategies.

Calibration of the APEX Model to Simulate Management Practice Effects on Runoff, Sediment, and Phosphorus Loss.

PubMed

Bhandari, Ammar B; Nelson, Nathan O; Sweeney, Daniel W; Baffaut, Claire; Lory, John A; Senaviratne, Anomaa; Pierzynski, Gary M; Janssen, Keith A; Barnes, Philip L

2017-11-01

Process-based computer models have been proposed as a tool to generate data for Phosphorus (P) Index assessment and development. Although models are commonly used to simulate P loss from agriculture using managements that are different from the calibration data, this use of models has not been fully tested. The objective of this study is to determine if the Agricultural Policy Environmental eXtender (APEX) model can accurately simulate runoff, sediment, total P, and dissolved P loss from 0.4 to 1.5 ha of agricultural fields with managements that are different from the calibration data. The APEX model was calibrated with field-scale data from eight different managements at two locations (management-specific models). The calibrated models were then validated, either with the same management used for calibration or with different managements. Location models were also developed by calibrating APEX with data from all managements. The management-specific models resulted in satisfactory performance when used to simulate runoff, total P, and dissolved P within their respective systems, with > 0.50, Nash-Sutcliffe efficiency > 0.30, and percent bias within ±35% for runoff and ±70% for total and dissolved P. When applied outside the calibration management, the management-specific models only met the minimum performance criteria in one-third of the tests. The location models had better model performance when applied across all managements compared with management-specific models. Our results suggest that models only be applied within the managements used for calibration and that data be included from multiple management systems for calibration when using models to assess management effects on P loss or evaluate P Indices. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Make-to-order manufacturing - new approach to management of manufacturing processes

NASA Astrophysics Data System (ADS)

Saniuk, A.; Waszkowski, R.

2016-08-01

Strategic management must now be closely linked to the management at the operational level, because only in such a situation the company can be flexible and can quickly respond to emerging opportunities and pursue ever-changing strategic objectives. In these conditions industrial enterprises seek constantly new methods, tools and solutions which help to achieve competitive advantage. They are beginning to pay more attention to cost management, economic effectiveness and performance of business processes. In the article characteristics of make-to-order systems (MTO) and needs associated with managing such systems is identified based on the literature analysis. The main aim of this article is to present the results of research related to the development of a new solution dedicated to small and medium enterprises manufacture products solely on the basis of production orders (make-to- order systems). A set of indicators to enable continuous monitoring and control of key strategic areas this type of company is proposed. A presented solution includes the main assumptions of the following concepts: the Performance Management (PM), the Balanced Scorecard (BSC) and a combination of strategic management with the implementation of operational management. The main benefits of proposed solution are to increase effectiveness of MTO manufacturing company management.

Comparison of an enhanced versus a written feedback model on the management of Medicare inpatients with venous thrombosis.

PubMed

Hayes, R; Bratzler, D; Armour, B; Moore, L; Murray, C; Stevens, B R; Radford, M; Fitzgerald, D; Elward, K; Ballard, D J

2001-03-01

A multistate randomized study conducted under the Health Care Financing Administration's (HCFA's) Health Care Quality Improvement Program (HCQIP) offered the opportunity to compare the effect of a written feedback intervention (WFI) with that of an enhanced feedback intervention (EFI) on improving the anticoagulant management of Medicare beneficiaries who present to the hospital with venous thromboembolic disease. Twenty-nine hospitals in five states were randomly assigned to receive written hospital-specific feedback (WFI) of feedback enhanced by the participation of a trained physician, quality improvement tools, and an Anticoagulant Management of Venous Thrombosis (AMVT) project liaison (EFI). Differences in the performance of five quality indicators between baseline and remeasurement were assessed. Quality managers were interviewed to determine perceptions of project implementation. No significant differences in the change from baseline to remeasurement were found between the two intervention groups. Significant improvement in one indicator and significant decline in two indicators were found for one or both groups. Yet 59% of all quality managers perceived the AMVT project as being successful to very successful, and more EFI quality managers perceived success than did WFI managers (71% versus 40%). In the majority of EFI hospitals, physician liaisons played an important role in project implementation. Study results indicated that the addition of a physician liaison, quality improvement tools, and a project liaison did not provide incremental value to hospital-specific feedback for improving quality of care. Future studies with larger sample sizes, lengthier follow-up periods, and interventions that include more of the elements shown to affect practice behavior change are needed to identify an optimal feedback model for use by external quality management organizations.

Key performance indicators to benchmark hospital information systems - a delphi study.

PubMed

Hübner-Bloder, G; Ammenwerth, E

2009-01-01

To identify the key performance indicators for hospital information systems (HIS) that can be used for HIS benchmarking. A Delphi survey with one qualitative and two quantitative rounds. Forty-four HIS experts from health care IT practice and academia participated in all three rounds. Seventy-seven performance indicators were identified and organized into eight categories: technical quality, software quality, architecture and interface quality, IT vendor quality, IT support and IT department quality, workflow support quality, IT outcome quality, and IT costs. The highest ranked indicators are related to clinical workflow support and user satisfaction. Isolated technical indicators or cost indicators were not seen as useful. The experts favored an interdisciplinary group of all the stakeholders, led by hospital management, to conduct the HIS benchmarking. They proposed benchmarking activities both in regular (annual) intervals as well as at defined events (for example after IT introduction). Most of the experts stated that in their institutions no HIS benchmarking activities are being performed at the moment. In the context of IT governance, IT benchmarking is gaining importance in the healthcare area. The found indicators reflect the view of health care IT professionals and researchers. Research is needed to further validate and operationalize key performance indicators, to provide an IT benchmarking framework, and to provide open repositories for a comparison of the HIS benchmarks of different hospitals.

Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

PubMed

Rüter, Anders; Vikstrom, Tore

2009-01-01

Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

Coliform Bacteria Monitoring in Fish Systems: Current Practices in Public Aquaria.

PubMed

Culpepper, Erin E; Clayton, Leigh A; Hadfield, Catherine A; Arnold, Jill E; Bourbon, Holly M

2016-06-01

Public aquaria evaluate coliform indicator bacteria levels in fish systems, but the purpose of testing, testing methods, and management responses are not standardized, unlike with the coliform bacteria testing for marine mammal enclosures required by the U.S. Department of Agriculture. An online survey was sent to selected aquaria to document current testing and management practices in fish systems without marine mammals. The information collected included indicator bacteria species, the size and type of systems monitored, the primary purpose of testing, sampling frequency, test methods, the criteria for interpreting results, corrective actions, and management changes to limit human exposure. Of the 25 institutions to which surveys were sent, 19 (76%) responded. Fourteen reported testing for fecal indicator bacteria in fish systems. The most commonly tested indicator species were total (86%) and fecal (79%) coliform bacteria, which were detected by means of the membrane filtration method (64%). Multiple types and sizes of systems were tested, and the guidelines for testing and corrective actions were highly variable. Only three institutions performed additional tests to confirm the identification of indicator organisms. The results from this study can be used to compare bacterial monitoring practices and protocols in fish systems, as an aid to discussions relating to the accuracy and reliability of test results, and to help implement appropriate management responses. Received August 23, 2015; accepted December 29, 2015.

Marine reserve effects on fishery profit

PubMed Central

White, Crow; Kendall, Bruce E; Gaines, Steven; Siegel, David A; Costello, Christopher

2008-01-01

Some studies suggest that fishery yields can be higher with reserves than under conventional management. However, the economic performance of fisheries depends on economic profit, not fish yield. The predictions of higher yields with reserves rely on intensive fishing pressures between reserves; the exorbitant costs of harvesting low-density populations erode profits. We incorporated this effect into a bioeconomic model to evaluate the economic performance of reserve-based management. Our results indicate that reserves can still benefit fisheries, even those targeting species that are expensive to harvest. However, in contrast to studies focused on yield, only a moderate proportion of the coast in reserves (with moderate harvest pressures outside reserves) is required to maximize profit. Furthermore, reserve area and harvest intensity can be traded off with little impact on profits, allowing for management flexibility while still providing higher profit than attainable under conventional management. Ecology Letters (2008) 11: 370–379 PMID:18205836

Managing patient deterioration: assessing teamwork and individual performance.

PubMed

Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth

2013-05-01

To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

Performance and capacity of river dykes of protection against the floods", through elaboration of performance indicators and decision aid tool in view of the patrimonial assessment of river dykes

NASA Astrophysics Data System (ADS)

Vuillet, Marc; Peyras, Laurent; Serre, Damien; Diab, Youssef

2010-05-01

France and more generally the World have to face frequent episodes of devastating floods. The human and material damages are multiplied during the failure of a protection structure. In France the length of dykes is estimated to 7500 kilometers, protecting around 15 000 to 18 000 km² and an estimated population between 1.6 to 2 millions. Regrettably, these structures are most of the time old, unidentified, badly maintained, showing signs of weaknesses on numerous occasions. The management of these dikes raises then considerable problems to the decision-makers who are in charge of guaranteeing a maximal safety to the populations at a rational and acceptable management cost. The ambition of the project "Performance and capacity in the service of river dykes of protection against the floods" is to propose to Administrator scientific methods and technical tools for the management of river dykes. These tools will be capable of estimating the capacity in the service of dykes, and to define and organize into a hierarchy the actions of inspection, maintenance and repair. Scientific objectives: • To suggest a methodology of evaluation of the performance of river dykes • To identify and to understand the causes of variability (spatial and temporal) • To analyze the relation between the quality of the data and the quality of the profile of performance • To propose a methodology of auscultation and confortation of the information The research work consists in adapting functional analysis based on safety engineering method, in order to precise the role of each rivers dyke's component in regard to the mechanisms of degradation they suffer. It will allow us to identify failure indicators and decision criteria for evaluating the performance of dykes. The criteria will be the basis to develop a multicriteria decision aid tool allowing to determine the hierarchical organization and the selection of the sections of a park of dykes of protection against the floods, according to their performances and to their capacities to the service. Then we will continue the research work to determine the best scales for analyzing spatial and temporal variability of the phenomenon, as well as to test and to improve the quality of the performance indicators. Finally, we shall synthetize and shall integrate the results into a GIS tool for the dykes asset management.

Impact of HMO mergers and acquisitions on financial performance.

PubMed

Weech-Maldonado, Robert

2002-01-01

This study examines the effect of health maintenance organization (HMO) mergers and acquisitions on financial performance, as indicated by cash flow returns, profitability ratios, and efficiency indicators. Pooled, cross-sectional files of financial performance data were created for HMO mergers occurring in the period of 1988 to 1994. The study uses a time-series design involving the analysis of pre- and post-acquisition financial performance measured over a period of four years. Change scores for the industry-adjusted financial performance measures were calculated and then evaluated using t-tests. The study showed that HMO mergers had a positive effect on financial performance and efficiency. This effect disappeared, however, after adjusting for HMO industry returns. Potential synergies arising from HMO mergers have been largely illusory. Mergers may have been a result of non-value enhancing motives or management overconfidence.

Integrating indigenous livelihood and lifestyle objectives in managing a natural resource

PubMed Central

Plagányi, Éva Elizabeth; van Putten, Ingrid; Hutton, Trevor; Deng, Roy A.; Dennis, Darren; Pascoe, Sean; Skewes, Tim; Campbell, Robert A.

2013-01-01

Evaluating the success of natural resource management approaches requires methods to measure performance against biological, economic, social, and governance objectives. In fisheries, most research has focused on industrial sectors, with the contributions to global resource use by small-scale and indigenous hunters and fishers undervalued. Globally, the small-scale fisheries sector alone employs some 38 million people who share common challenges in balancing livelihood and lifestyle choices. We used as a case study a fishery with both traditional indigenous and commercial sectors to develop a framework to bridge the gap between quantitative bio-economic models and more qualitative social analyses. For many indigenous communities, communalism rather than capitalism underlies fishers’ perspectives and aspirations, and we find there are complicated and often unanticipated trade-offs between economic and social objectives. Our results highlight that market-based management options might score highly in a capitalistic society, but have negative repercussions on community coherence and equity in societies with a strong communal ethic. There are complex trade-offs between economic indicators, such as profit, and social indicators, such as lifestyle preferences. Our approach makes explicit the “triple bottom line” sustainability objectives involving trade-offs between economic, social, and biological performance, and is thus directly applicable to most natural resource management decision-making situations. PMID:23401546

Integrating indigenous livelihood and lifestyle objectives in managing a natural resource.

PubMed

Plagányi, Éva Elizabeth; van Putten, Ingrid; Hutton, Trevor; Deng, Roy A; Dennis, Darren; Pascoe, Sean; Skewes, Tim; Campbell, Robert A

2013-02-26

Evaluating the success of natural resource management approaches requires methods to measure performance against biological, economic, social, and governance objectives. In fisheries, most research has focused on industrial sectors, with the contributions to global resource use by small-scale and indigenous hunters and fishers undervalued. Globally, the small-scale fisheries sector alone employs some 38 million people who share common challenges in balancing livelihood and lifestyle choices. We used as a case study a fishery with both traditional indigenous and commercial sectors to develop a framework to bridge the gap between quantitative bio-economic models and more qualitative social analyses. For many indigenous communities, communalism rather than capitalism underlies fishers' perspectives and aspirations, and we find there are complicated and often unanticipated trade-offs between economic and social objectives. Our results highlight that market-based management options might score highly in a capitalistic society, but have negative repercussions on community coherence and equity in societies with a strong communal ethic. There are complex trade-offs between economic indicators, such as profit, and social indicators, such as lifestyle preferences. Our approach makes explicit the "triple bottom line" sustainability objectives involving trade-offs between economic, social, and biological performance, and is thus directly applicable to most natural resource management decision-making situations.

OLEM Performance Assessment Information

EPA Pesticide Factsheets

This asset includes a variety of data sets that measure the performance of Office of Land and Emergency Management (OLEM) programs in support of the Office of the Chief Financial Officer's Annual Commitment System (ACS) and Performance Evaluation Reporting System (PERS). Information is drawn from OLEM's ACRES, RCRAInfo, CERCLIS/SEMS, ICIS, and LUST4 systems, as well as input manually by authorized individuals in OLEM's program offices. Information is reviewed by OLEM program staff prior to being pushed to ACS and entered into PERS. This data asset also pulls in certain performance information input directly by Regional Office staff into ACS. Information is managed by the Performance Assessment Tool (PAT) and displayed in the PAT Dashboard.Information in this asset include:--Government Performance and Results Act (GPRA) of 1993: Measures reported for Innovations, Partnerships and Communications Office (IPCO), the Office of Brownfields and Land Revitalization (OBLR), the Office of Emergency Management (OEM), the Office of Resource Conservation and Recovery (ORCR), the Office of Superfund Remediation and Technology Innovation (OSRTI), and the Office of Underground Storage Tanks (OUST).-- Performance and Environmental Results System (PERS): Includes OLEM's information on performance results and baselines for the EPA Annual Plan and Budget.--Key Performance Indicators: OLEM has identified five KPIs that are tracked annually.--Integrated Cleanup Initiative: A pilot pe

The spectrum of skin biopsies and excisions in a pediatric skin center.

PubMed

Theiler, Martin; Neuhaus, Kathrin; Kerl, Katrin; Weibel, Lisa

2017-12-01

Little is known about the spectrum of pediatric skin disorders requiring biopsy/excision, their indication, impact on further management, and the accuracy of clinical diagnosis. We aimed to address these questions in the patient population seen at our Swiss University referral center for Pediatric Dermatology and Plastic Surgery. All skin biopsies/excisions performed in patients aged ≤ 16 years over a period of 2 years were retrospectively analyzed. A total of 506 samples were included. The majority of biopsies/excisions (n = 413, 82%) was performed for tumors, cysts, and hamartomas and 18% for other skin conditions. Malignant tumors were found in 12 samples (2%) from four patients. In 121 (24%) patients, the histopathology had an important impact on patient management. In 80 (16%) cases, the pathology did not match with the clinical diagnosis. In 382 (75%) cases, excision was the treatment of choice. Of these, the indication for surgery was based on patient's request in 181 (47%) cases. Surgical interventions for pediatric skin disorders are performed for diagnostic and therapeutic reasons. In this cohort, histopathology was essential for treatment in one quarter of cases. Skin tumors, cysts, and hamartomas often require excision during childhood, with families' request and esthetic considerations playing an important role. What is Known: • The spectrum of pediatric skin conditions has been studied in outpatient, inpatient, and emergency settings. • In contrast, no data exist on the spectrum of pediatric skin disorders undergoing biopsy/excision specifically. What is New: • We analyze biopsies/excisions in children, focusing on diagnosis, indication, and impact on patient management. • Surgical interventions for skin disorders in children are often performed for tumors and hamartomas with esthetic considerations playing a relevant role. If used for diagnostic purposes, they are often performed to confirm or rule out severe skin disease.

A business model for managing system change through strategic financing and performance indicators: a case study.

PubMed

Armstrong, Mary I; Milch, Heidi; Curtis, Peter; Endress, Phillip

2012-06-01

This article describes how a system of care operated by a county government agency used a fiscal crisis as the opportunity to reform its children's system. A cross-system response to the crisis is outlined that includes a system of care framework coupled with a business model, inter-departmental collaboration and leadership, the use of strategic reinvestment strategies, and a quality improvement system that focuses on key indicators. Implementation of the system change is described with a specific focus on cross-system entry points, financing strategies that re-allocate funds from deep-end programs to community-based services, and management oversight through the use of performance indicators to monitor and support effectiveness. This article examines the results of the system change, including the diversion of youth from system penetration, the reduction in residential treatment bed days, the re-allocation of these savings to community-based services, and the outcomes of children who were diverted from residential care and served in the community. The article offers a number of recommendations for other communities contemplating system change.

Effects of Heart Failure and its Pharmacological Management on Sleep

PubMed Central

Jiménez, Jessica A.; Greenberg, Barry H.; Mills, Paul J.

2011-01-01

Heart failure (HF) patients have a high prevalence of disturbed sleep. Optimal pharmacological management of HF includes the use of angiotensin converting enzyme inhibitors and β-blockers, which have been associated with decreased severity of central sleep apnea, which is likely secondary to improvements in cardiac performance. There is also evidence, however, indicating that other pharmacological treatments for HF might adversely affect sleep. This brief review introduces the topic of disturbed sleep in HF and examines the extent to which its standard pharmacological management impacts sleep quality. PMID:22125571

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

PubMed

Cole, Donald C; Robson, Lynda S; Lemieux-Charles, Louise; McGuire, Wendy; Sicotte, Claude; Champagne, Francois

2005-01-01

Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Habitat heterogeneity influences restoration efficacy: Implications of a habitat-specific management regime for an invaded marsh

NASA Astrophysics Data System (ADS)

Tang, Long; Gao, Yang; Wang, Cheng-Huan; Li, Bo; Chen, Jia-Kuan; Zhao, Bin

2013-07-01

Invasive species have to be managed to prevent adverse consequences. Spartina alterniflora has invaded many marshes where salinity and inundation are often key factors affecting vegetation. The former was surface clipped twice and native Phragmites australis was planted in invaded zones to examine the effects of habitat properties on the efficacy of invader control and native restoration. The results showed that two clipping treatments almost eliminated S. alterniflora in the zones with long inundation periods of 80 h/15 d but stimulated compensatory growth of S. alterniflora in the zones with short inundation periods. Transplanted P. australis performed better over time in zones with low salinity (<10.5 psu) but performed poorly in high-salinity zones, indicating that the efficacy of invader management and native restoration activities changes significantly along habitat gradients. With a progression from the dyke to the seaward side of the studied marsh, there was a long then short then long inundation period whereas salinity increased consistently. The study indicates that the high-frequency removal of the above-ground parts of S. alterniflora should be used only in the middle tidal zones and that native vegetation should be planted in zones above the mean high water level while the others zones in the saltmarsh should be restored to mud flats. Usually, invasive plants can flourish in highly heterogeneous habitats, which can influence management efficacy by influencing the re-growth of treated invaders and the performance of restored native species. Therefore, habitat-specific management regimes for invasive species can be expected to be more efficient because of their dependence on specific habitats.

Structural and Psychological Empowerment Climates, Performance, and the Moderating Role of Shared Felt Accountability: A Managerial Perspective

ERIC Educational Resources Information Center

Wallace, J. Craig; Johnson, Paul D.; Mathe, Kimberly; Paul, Jeff

2011-01-01

The authors proposed and tested a model in which data were collected from managers (n = 539) at 116 corporate-owned quick service restaurants to assess the structural and psychological empowerment process as moderated by shared-felt accountability on indices of performance from a managerial perspective. The authors found that empowering leadership…

Understanding the Impact of Training on Performance

DTIC Science & Technology

2014-05-01

learning argue that this method encourages metacognitive activity and self -regulation of learning; which, in turn, can aid the development of adaptable...Frese, M. (2005). Self -regulation in error management training: Emotion control and metacognition as mediators of performance effects. Journal...on aptitude by treatment interactions that indicate the effectiveness of training interventions can differ depending on trainee aptitude for self

Health and safety management systems: liability or asset?

PubMed

Bennett, David

2002-01-01

Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace.

DB4US: A Decision Support System for Laboratory Information Management.

PubMed

Carmona-Cejudo, José M; Hortas, Maria Luisa; Baena-García, Manuel; Lana-Linati, Jorge; González, Carlos; Redondo, Maximino; Morales-Bueno, Rafael

2012-11-14

Until recently, laboratory automation has focused primarily on improving hardware. Future advances are concentrated on intelligent software since laboratories performing clinical diagnostic testing require improved information systems to address their data processing needs. In this paper, we propose DB4US, an application that automates information related to laboratory quality indicators information. Currently, there is a lack of ready-to-use management quality measures. This application addresses this deficiency through the extraction, consolidation, statistical analysis, and visualization of data related to the use of demographics, reagents, and turn-around times. The design and implementation issues, as well as the technologies used for the implementation of this system, are discussed in this paper. To develop a general methodology that integrates the computation of ready-to-use management quality measures and a dashboard to easily analyze the overall performance of a laboratory, as well as automatically detect anomalies or errors. The novelty of our approach lies in the application of integrated web-based dashboards as an information management system in hospital laboratories. We propose a new methodology for laboratory information management based on the extraction, consolidation, statistical analysis, and visualization of data related to demographics, reagents, and turn-around times, offering a dashboard-like user web interface to the laboratory manager. The methodology comprises a unified data warehouse that stores and consolidates multidimensional data from different data sources. The methodology is illustrated through the implementation and validation of DB4US, a novel web application based on this methodology that constructs an interface to obtain ready-to-use indicators, and offers the possibility to drill down from high-level metrics to more detailed summaries. The offered indicators are calculated beforehand so that they are ready to use when the user needs them. The design is based on a set of different parallel processes to precalculate indicators. The application displays information related to tests, requests, samples, and turn-around times. The dashboard is designed to show the set of indicators on a single screen. DB4US was deployed for the first time in the Hospital Costa del Sol in 2008. In our evaluation we show the positive impact of this methodology for laboratory professionals, since the use of our application has reduced the time needed for the elaboration of the different statistical indicators and has also provided information that has been used to optimize the usage of laboratory resources by the discovery of anomalies in the indicators. DB4US users benefit from Internet-based communication of results, since this information is available from any computer without having to install any additional software. The proposed methodology and the accompanying web application, DB4US, automates the processing of information related to laboratory quality indicators and offers a novel approach for managing laboratory-related information, benefiting from an Internet-based communication mechanism. The application of this methodology has been shown to improve the usage of time, as well as other laboratory resources.

Assessment of the waste electrical and electronic equipment management systems profile and sustainability in developed and developing European Union countries.

PubMed

Ibanescu, Dumitrita; Cailean Gavrilescu, Daniela; Teodosiu, Carmen; Fiore, Silvia

2018-03-01

The assessment of waste management systems for electrical and electronic equipment (WEEE) from developed economies (Germany, Sweden and Italy) and developing countries (Romania and Bulgaria), is discussed covering the period 2007-2014. The WEEE management systems profiles are depicted by indicators correlated to WEEE life cycle stages: collection, transportation and treatment. The sustainability of national WEEE management systems in terms of greenhouse gas emissions is presented, together with the greenhouse gas efficiency indicator that underlines the efficiency of WEEE treatment options. In the countries comparisons, the key elements are: robust versus fragile economies, the overall waste management performance and the existence/development of suitable management practices on WEEE. Over the life cycle perspective, developed economies (Germany, Sweden and Italy) manage one order of magnitude higher quantities of WEEE compared to developing countries (Romania and Bulgaria). Although prevention and reduction measures are encouraged, all WEEE quantities were larger in 2013, than in 2007. In 2007-2014, developed economies exceed the annual European collection target of 4 kg WEEE/capita, while collection is still difficult in developing countries. If collection rates are estimated in relationship with products placed on market, than similar values are registered in Sweden and Bulgaria, followed by Germany and Italy and lastly Romania. WEEE transportation shows different patterns among countries, with Italy as the greatest exporter (in 2014), while Sweden treats the WEEE nationally. WEEE reuse is a common practice in Germany, Sweden (from 2009) and Bulgaria (from 2011). By 2014, recycling was the most preferred WEEE treatment option, with the same kind of rates performance, over 80%, irrespective of the country, with efforts in each of the countries in developing special collection points, recycling facilities and support instruments. The national total and the recycling carbon footprints of WEEE are lower in 2013 than in 2007 for each country, the order in reducing the environmental impacts being: Germany, Italy, Sweden, Bulgaria and Romania. The negative values indicate savings in greenhouse gas emissions. In 2013, the GHG efficiency shows no differences of the WEEE management in the developed and developing countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Defining and Measuring Safety Climate: A Review of the Construction Industry Literature.

PubMed

Schwatka, Natalie V; Hecker, Steven; Goldenhar, Linda M

2016-06-01

Safety climate measurements can be used to proactively assess an organization's effectiveness in identifying and remediating work-related hazards, thereby reducing or preventing work-related ill health and injury. This review article focuses on construction-specific articles that developed and/or measured safety climate, assessed safety climate's relationship with other safety and health performance indicators, and/or used safety climate measures to evaluate interventions targeting one or more indicators of safety climate. Fifty-six articles met our inclusion criteria, 80% of which were published after 2008. Our findings demonstrate that researchers commonly defined safety climate as perception based, but the object of those perceptions varies widely. Within the wide range of indicators used to measure safety climate, safety policies, procedures, and practices were the most common, followed by general management commitment to safety. The most frequently used indicators should and do reflect that the prevention of work-related ill health and injury depends on both organizational and employee actions. Safety climate scores were commonly compared between groups (e.g. management and workers, different trades), and often correlated with subjective measures of safety behavior rather than measures of ill health or objective safety and health outcomes. Despite the observed limitations of current research, safety climate has been promised as a useful feature of research and practice activities to prevent work-related ill health and injury. Safety climate survey data can reveal gaps between management and employee perceptions, or between espoused and enacted policies, and trigger communication and action to narrow those gaps. The validation of safety climate with safety and health performance data offers the potential for using safety climate measures as a leading indicator of performance. We discuss these findings in relation to the related concept of safety culture and offer suggestions for future research and practice including (i) deriving a common definition of safety climate, (ii) developing and testing construction-specific indicators of safety climate, and (iii) focusing on construction-specific issues such as the transient workforce, subcontracting, work organization, and induction/acculturation processes. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Using the balanced scorecard to align strategy and performance in long-term care.

PubMed

Macdonald, M

1998-01-01

The Sisters of Charity of Ottawa Health Service (SCOHS) is a Canadian health care corporation that has adapted Kaplan and Norton's balanced scorecard to enhance strategic management and measurement in a multisite health care facility comprising long term care, continuing complex care, rehabilitative services, palliative care and ambulatory care. This article discusses how the SCOHS has incorporated the following principles into the balanced scorecard: demonstration of cause and effect; inclusion of outcomes and performance drivers; linkage to fiscal and utilization indicators; and integration of the mission and values of the organization. Examples of corporate level outcomes and performance measures are provided in the form of lead and lag indicators.

Employee self-enhancement motives and job performance behaviors: investigating the moderating effects of employee role ambiguity and managerial perceptions of employee commitment.

PubMed

Yun, Seokhwa; Takeuchi, Riki; Liu, Wei

2007-05-01

This study examined the effects of employee self-enhancement motives on job performance behaviors (organizational citizenship behaviors and task performance) and the value of these behaviors to them. The authors propose that employees display job performance behaviors in part to enhance their self-image, especially when their role is not clearly defined. They further argue that the effects of these behaviors on managerial reward recommendation decisions should be stronger when managers believe the employees to be more committed. The results from a sample of 84 working students indicate that role ambiguity moderated the effects of self-enhancement motives on job performance behaviors and that managerial perceptions of an employee's commitment moderated the effects of those organizational citizenship behaviors that are aimed at other individuals on managers' reward allocation decisions. 2007 APA, all rights reserved

Load Index Metrics for an Optimized Management of Web Services: A Systematic Evaluation

PubMed Central

Souza, Paulo S. L.; Santana, Regina H. C.; Santana, Marcos J.; Zaluska, Ed; Faical, Bruno S.; Estrella, Julio C.

2013-01-01

The lack of precision to predict service performance through load indices may lead to wrong decisions regarding the use of web services, compromising service performance and raising platform cost unnecessarily. This paper presents experimental studies to qualify the behaviour of load indices in the web service context. The experiments consider three services that generate controlled and significant server demands, four levels of workload for each service and six distinct execution scenarios. The evaluation considers three relevant perspectives: the capability for representing recent workloads, the capability for predicting near-future performance and finally stability. Eight different load indices were analysed, including the JMX Average Time index (proposed in this paper) specifically designed to address the limitations of the other indices. A systematic approach is applied to evaluate the different load indices, considering a multiple linear regression model based on the stepwise-AIC method. The results show that the load indices studied represent the workload to some extent; however, in contrast to expectations, most of them do not exhibit a coherent correlation with service performance and this can result in stability problems. The JMX Average Time index is an exception, showing a stable behaviour which is tightly-coupled to the service runtime for all executions. Load indices are used to predict the service runtime and therefore their inappropriate use can lead to decisions that will impact negatively on both service performance and execution cost. PMID:23874776

Diskectomy during Pregnancy: Case Report and Review of the Literature.

PubMed

Kanas, Michel; Kunzle, Hugo; Martins, Delio E; Kirsch, Luiz A; Puertas, Eduardo B; Wajchenberg, Marcelo

2015-04-01

Study Design Case report. Objective The purpose of this report is to discuss the management of a disk herniation during pregnancy and the indication and particularities of surgery in this situation. Methods We describe a case of diskectomy performed in a 35-year-old woman at 18 weeks of gestation. After 4 weeks of trying to manage the disk herniation with rest and medications without success, the muscle strength of the L5 right root decreased to grade 4, and the patient was not responding to intravenous analgesia. After discussion with the patient and family, a decision was made to perform the diskectomy. Results After surgery, the patient's pain lessened, and the Lasegue test became negative. Two weeks after the procedure, the patient's muscle strength was normal. In the 40th week of pregnancy, the patient gave birth without any complications. Conclusion When necessary, diskectomy can be indicated and performed during pregnancy. However, appropriate precautions must be taken. Awareness of these precautions is important for the success of the procedure and for the well-being of the mother and the newborn.

Three novel obese indicators perform better in monitoring management of metabolic syndrome in type 2 diabetes.

PubMed

Ma, Chun-Ming; Lu, Na; Wang, Rui; Liu, Xiao-Li; Lu, Qiang; Yin, Fu-Zai

2017-08-29

The present study evaluated the performance of three novel obese indicators, visceral adiposity index (VAI), lipid accumulation product (LAP) and waist circumference-triglyceride index (WTI), for identifying metabolic syndrome(MetS) in type 2 diabetes. A cross-sectional study was conducted on 711 type 2 diabetes in Qinhuangdao. The MetS was defined as the definition of Chinese Diabetes Society. Receiver operating characteristic curve analyses were performed to assess the accuracy of three obese indicators as diagnostic tests for MetS. The prevalence of MetS was 71.3%. In men, among all three obese indicators, the LAP had the highest area under curve (AUC) value (AUC = 0.894), followed by VAI (AUC = 0.860) and WTI (AUC = 0.855). In women, among all three obese indicators, the LAP had the highest AUC value (AUC = 0.906), followed by WTI (AUC = 0.887) and VAI (AUC = 0.881). However. there was no significant difference between the three obese indicators(P > 0.05). Three obese indicators were effective indicators for the screening of MetS, LAP and WTI are more simple.

A system dynamics-based environmental performance simulation of construction waste reduction management in China.

PubMed

Ding, Zhikun; Yi, Guizhen; Tam, Vivian W Y; Huang, Tengyue

2016-05-01

A huge amount of construction waste has been generated from increasingly higher number of construction activities than in the past, which has significant negative impacts on the environment if they are not properly managed. Therefore, effective construction waste management is of primary importance for future sustainable development. Based on the theory of planned behaviors, this paper develops a system dynamic model of construction waste reduction management at the construction phase to simulate the environmental benefits of construction waste reduction management. The application of the proposed model is shown using a case study in Shenzhen, China. Vensim is applied to simulate and analyze the model. The simulation results indicate that source reduction is an effective waste reduction measure which can reduce 27.05% of the total waste generation. Sorting behaviors are a premise for improving the construction waste recycling and reuse rates which account for 15.49% of the total waste generated. The environmental benefits of source reduction outweigh those of sorting behaviors. Therefore, to achieve better environmental performance of the construction waste reduction management, attention should be paid to source reduction such as low waste technologies and on-site management performance. In the meantime, sorting behaviors encouragement such as improving stakeholders' waste awareness, refining regulations, strengthening government supervision and controlling illegal dumping should be emphasized. Copyright © 2016 Elsevier Ltd. All rights reserved.

A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England

PubMed Central

2011-01-01

Background The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR. Method Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR's strategic goals, which could be reported to NIHR's leadership team on a quarterly basis via an oversight dashboard. Results Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting. Conclusions The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives. PMID:21435265

Radioactive Waste Management Complex performance assessment: Draft

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

Case, M.J.; Maheras, S.J.; McKenzie-Carter, M.A.

1990-06-01

A radiological performance assessment of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory was conducted to demonstrate compliance with appropriate radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the general public. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the general public via air, ground water, and food chain pathways. Projections of doses were made for both offsite receptors and individuals intruding onto the site after closure. In addition, uncertainty analyses were performed. Resultsmore » of calculations made using nominal data indicate that the radiological doses will be below appropriate radiological criteria throughout operations and after closure of the facility. Recommendations were made for future performance assessment calculations.« less

NREL Evaluates Performance of Fast-Charge Electric Buses

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

2016-09-16

This real-world performance evaluation is designed to enhance understanding of the overall usage and effectiveness of electric buses in transit operation and to provide unbiased technical information to other agencies interested in adding such vehicles to their fleets. Initial results indicate that the electric buses under study offer significant fuel and emissions savings. The final results will help Foothill Transit optimize the energy-saving potential of its transit fleet. NREL's performance evaluations help vehicle manufacturers fine-tune their designs and help fleet managers select fuel-efficient, low-emission vehicles that meet their bottom line and operational goals. help Foothill Transit optimize the energy-saving potentialmore » of its transit fleet. NREL's performance evaluations help vehicle manufacturers fine-tune their designs and help fleet managers select fuel-efficient, low-emission vehicles that meet their bottom line and operational goals.« less

"Nailing" the management of the ingrown great toenail.

PubMed

Block, Stan L

2014-11-01

"Nailing" the management of the severely ingrown great toenail, commonly encountered in the adolescent population, is an important tool in the pediatrician's armamentarium. I have found great toenail removal to be worthwhile, with straightforward indications; and quite rewarding for my patients in terms of time, convenience, and costs. The key to the procedure is to keep it simple. Four basic vital steps are involved: (1) operative permit and explanation; (2) performing a careful complete digital nerve block; (3) removing the entire toenail; and, importantly, (4) performing a partial chemical matricectomy--with readily available silver nitrate sticks--to prevent frequent recurrences. Copyright 2014, SLACK Incorporated.

The Development of a Quality Management Framework for Evaluating Medical Device Reprocessing Practice in Healthcare Facilities.

PubMed

Lorv, Bailey; Horodyski, Robin; Welton, Cynthia; Vail, John; Simonetto, Luca; Jokanovic, Danilo; Sharma, Richa; Mahoney, Angela Rea; Savoy-Bird, Shay; Bains, Shalu

2017-01-01

There is increasing awareness of the importance of medical device reprocessing (MDR) for the provision of safe patient care. Although industry service standards are available to guide MDR practices, there remains a lack of published key performance indicators (KPIs) and targets that are necessary to evaluate MDR quality for feedback and improvement. This article outlines the development of an initial framework that builds on established guidelines and includes service standards, KPIs and targets for evaluating MDR operations. This framework can support healthcare facilities in strengthening existing practices and enables a platform for collaboration towards better MDR performance management.

Using SCOR as a Supply Chain Management Framework for Government Agency Contract Requirements

NASA Technical Reports Server (NTRS)

Paxton, Joe

2010-01-01

Enterprise Supply Chain Management consists of: Specifying suppliers to support inter-program and inter-agency efforts. Optimizing inventory levels and locations throughout the supply chain. Executing corrective actions to improve quality and lead time issues throughout the supply chain. Processing reported data to calculate and make visible supply chain performance (provide information for decisions and actions). Ensuring the right hardware and information is provided at the right time and in the right place. Monitoring the industrial base while developing, producing, operating and retiring a system. Seeing performance deep in the supply chain that could indicate issues affecting system availability and readiness.

Towards a balanced performance measurement system in a public health care organization.

PubMed

Yuen, Peter P; Ng, Artie W

2012-01-01

This article attempts to devise an integrated performance measurement framework to assess the Hong Kong Hospital Authority (HA) management system by harnessing previous performance measurement systems. An integrated evaluative framework based on the balanced score card (BSC) was developed and applied using the case study method and longitudinal data to evaluate the HA's performance management system. The authors unveil evolving HA performance indicators (P1). Despite the HA staffs explicit quality emphasis, cost control remains the primary focus in their performance measurements. RESEARCH LHNITATIONS/IMPLICATIONS: Data used in this study are from secondary sources, disclosed mostly by HA staff. This study shows public sector staff often attach too much importance to cost control and easily measurable activities at the expense of quality and other less easily measurable attributes'. A balanced performance measurement system, linked to health targets, with a complementary budgeting process that supports pertinent resource allocation is yet to be implemented in Hong Kong's public hospitals.

7 CFR 1944.404 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... other business management or administrative ventures which indicate an ability to perform responsibility... 7 Agriculture 13 2010-01-01 2009-01-01 true Eligibility. 1944.404 Section 1944.404 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE...

PERFORMANCE OF STORMWATER RETENTION PONDS AND CONSTRUCTED WETLANDS IN REDUCING MICROBIAL CONCENTRATIONS

EPA Science Inventory

Stormwater runoff can transport high concentrations of pathogens to receiving waters. Bacteria indicator organisms, as surrogates for pathogens, are the most often reported cause of receiving water impairments. Stormwater best management practices (BMPs) are often considered ef...

Hypertension management in rural primary care facilities in Zambia: a mixed methods study.

PubMed

Yan, Lily D; Chirwa, Cindy; Chi, Benjamin H; Bosomprah, Samuel; Sindano, Ntazana; Mwanza, Moses; Musatwe, Dennis; Mulenga, Mary; Chilengi, Roma

2017-02-03

Improved primary health care is needed in developing countries to effectively manage the growing burden of hypertension. Our objective was to evaluate hypertension management in Zambian rural primary care clinics using process and outcome indicators to assess the screening, monitoring, treatment and control of high blood pressure. Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics. Clinical data were collected as part of routine patient care from an electronic medical record system, and reviewed for site performance over time according to hypertension related indicators: screening (blood pressure measurement), management (recorded diagnosis, physical exam or urinalysis), treatment (on medication), and control. Quantitative data was used to develop guides for qualitative in-depth interviews, conducted with health care providers at a proportional sample of half (20) of clinics. Qualitative data was iteratively analyzed for thematic content. From January 2011 to December 2014, 318,380 visits to 46 primary care clinics by adults aged ≥ 25 years with blood pressure measurements were included. Blood pressure measurement at vital sign screening was initially high at 89.1% overall (range: 70.1-100%), but decreased to 62.1% (range: 0-100%) by 48 months after intervention start. The majority of hypertensive patients made only one visit to the clinics (57.8%). Out of 9022 patients with at least two visits with an elevated blood pressure, only 49.3% had a chart recorded hypertension diagnosis. Process indicators for monitoring hypertension were <10% and did not improve with time. In in-depth interviews, antihypertensive medication shortages were common, with 15/20 clinics reporting hydrochlorothiazide-amiloride stockouts. Principal challenges in hypertension management included 1) equipment and personnel shortages, 2) provider belief that multiple visits were needed before official management, 3) medication stock-outs, leading to improper prescriptions and 4) poor patient visit attendance. Our findings suggest that numerous barriers stand in the way of hypertension diagnosis and management in Zambian primary health facilities. Future work should focus on performance indicator development and validation in low resource contexts, to facilitate regular and systematic data review to improve patient outcomes. ClinicalTrials.gov, Identifier NCT01942278 . Date of Registration: September 2013.

A linear regression approach to evaluate the green supply chain management impact on industrial organizational performance.

PubMed

Mumtaz, Ubaidullah; Ali, Yousaf; Petrillo, Antonella

2018-05-15

The increase in the environmental pollution is one of the most important topic in today's world. In this context, the industrial activities can pose a significant threat to the environment. To manage problems associate to industrial activities several methods, techniques and approaches have been developed. Green supply chain management (GSCM) is considered one of the most important "environmental management approach". In developing countries such as Pakistan the implementation of GSCM practices is still in its initial stages. Lack of knowledge about its effects on economic performance is the reason because of industries fear to implement these practices. The aim of this research is to perceive the effects of GSCM practices on organizational performance in Pakistan. In this research the GSCM practices considered are: internal practices, external practices, investment recovery and eco-design. While, the performance parameters considered are: environmental pollution, operational cost and organizational flexibility. A set of hypothesis propose the effect of each GSCM practice on the performance parameters. Factor analysis and linear regression are used to analyze the survey data of Pakistani industries, in order to authenticate these hypotheses. The findings of this research indicate a decrease in environmental pollution and operational cost with the implementation of GSCM practices, whereas organizational flexibility has not improved for Pakistani industries. These results aim to help managers regarding their decision of implementing GSCM practices in the industrial sector of Pakistan. Copyright © 2017 Elsevier B.V. All rights reserved.

A retrospective review of performance and utility of routine clinical pelvimetry.

PubMed

Blackadar, Charles S; Viera, Anthony J

2004-01-01

Some authorities have questioned the utility of performing clinical pelvimetry as part of routine prenatal care. This study determined the frequency with which clinical pelvimetry is still performed at two military hospitals and whether the results of pelvimetry influence the management of labor and delivery. We conducted a retrospective review of prenatal records at two military hospitals. One was an overseas hospital, and one was a family medicine teaching hospital in the United States. The records of 660 pregnant women were reviewed to identify documentation that pelvimetry was performed during prenatal care and whether there was evidence that the physician managing labor and delivery altered management based on pelvimetry results. Seventy percent (461) of the 660 records reviewed had all pelvimetry measurements documented as normal, or the provider had written "good for TOL (trial of labor)," "proven to XX pounds," or similar annotation that pelvimetry was normal. Nine percent (58 records) had no documentation of pelvimetry (pelvimetry section left blank). The remaining 21% (141 charts) had at least one pelvimetry measurement listed as abnormal on the initial prenatal exam. No admission note, progress note, or operative note recorded during labor and delivery made reference to clinical pelvimetry results. No abnormal pelvimetry result was referenced in follow-up visits or appeared to make any difference in mode of delivery or treatment in labor. Two women (one at each institution) had initial visit notes indicating the need to consider radiographic pelvimetry based on the results of clinical exam, but this test was not done in either case, and both women delivered vaginally. Our study indicates that clinical pelvimetry does not change management of pregnant patients. Current practice is to allow all women a trial of labor regardless of pelvimetry results. This makes the routine performance and recording of clinical pelvimetry a waste of time, a potential liability, and an unnecessary discomfort for patients.

Environmental implications of anaerobic digestion for manure management in dairy farms in Mexico: a life cycle perspective.

PubMed

Rivas-García, Pasiano; Botello-Álvarez, José E; Abel Seabra, Joaquim E; da Silva Walter, Arnaldo C; Estrada-Baltazar, Alejandro

2015-01-01

The environmental profile of milk production in Mexico was analysed for three manure management scenarios: fertilization (F), anaerobic digestion (AD) and enhanced anaerobic digestion (EAD). The study used the life cycle assessment (LCA) technique, considering a 'cradle-to-gate' approach. The assessment model was constructed using SimaPro LCA software, and the life cycle impact assessment was performed according to the ReCiPe method. Dairy farms with AD and EAD scenarios were found to exhibit, respectively, 12% and 27% less greenhouse gas emissions, 58% and 31% less terrestrial acidification, and 3% and 18% less freshwater eutrophication than the F scenario. A different trend was observed in the damage to resource availability indicator, as the F scenario presented 6% and 22% less damage than the EAD and AD scenarios, respectively. The magnitude of environmental damage from milk production in the three dairy manure management scenarios, using a general single score indicator, was 0.118, 0.107 and 0.081 Pt/L of milk for the F, AD and EAD scenarios, respectively. These results indicate that manure management systems with anaerobic digestion can improve the environmental profile of each litre of milk produced.

Surgical management of benign and indeterminate hepatic lesions in the era of laparoscopic liver surgery.

PubMed

Abu Hilal, Mohammed; Di Fabio, Francesco; Teng, Mabel Joey; Godfrey, Dean Anthony; Primrose, John Neil; Pearce, Neil William

2011-01-01

The expansion of the laparoscopic approach for the management of benign liver lesions has raised concerns regarding the risk of widening surgical indications and compromising safety. Large single-centre series focusing on laparoscopic management of benign liver lesions are sporadic. We reviewed a prospectively collected database of patients undergoing pure laparoscopic liver resection (LLR) for benign liver lesions. All cases were individually discussed at a multidisciplinary team meeting. Forty-six patients underwent 50 LLRs for benign disease. Indications for surgery were: symptomatic lesions, preoperative diagnosis of adenoma or cystadenoma, and lesions with an indeterminate diagnosis. The preoperative diagnosis was uncertain in 11 cases. Of these, histological diagnosis was hepatocellular carcinoma in one (9%) and benign lesion in 10 patients (91%). Thirteen patients (28%) required major hepatectomy. Three patients (7%) developed postoperative complications. Mortality was nil. The median postoperative hospital stay following major and minor hepatectomy was 4 and 3 days, respectively. The laparoscopic approach represents a safe option for the management of benign and indeterminate liver lesions, even when major hepatectomy is required. LLR should be only performed in specialized centres to ensure safety and strict adherence to orthodox surgical indication. Copyright © 2011 S. Karger AG, Basel.

Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala.

PubMed

Hernández, Alison R; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel

2015-10-08

Mid-level health workers are on the front-lines in underserved areas in many LMICs, and their performance is critical for improving the health of vulnerable populations. However, improving performance in low-resource settings is complex and highly dependent on the organizational context of local health systems. This study aims to examine the views of actors from different levels of a regional health system in Guatemala on actions to support the performance of auxiliary nurses, a cadre of mid-level health workers with a prominent role in public sector service delivery. A concept mapping study was carried out to develop an integrated view on organizational support and identify locally relevant strategies for strengthening performance. A total of 93 regional and district managers, and primary and secondary care health workers participated in generating ideas on actions needed to support auxiliary nurses' performance. Ideas were consolidated into 30 action items, which were structured through sorting and rating exercises, involving a total of 135 of managers and health workers. Maps depicting participants' integrated views on domains of action and dynamics in sub-groups' interests were generated using a sequence of multivariate statistical analyses, and interpreted by regional managers. The combined input of health system actors provided a multi-faceted view of actions needed to support performance, which were organized in six domains, including: Communication and coordination, Tools to orient work, Organizational climate of support, Motivation through recognition, Professional development and Skills development. The nature of relationships across hierarchical levels was identified as a cross-cutting theme. Pattern matching and go-zone maps indicated directions for action based on areas of consensus and difference across sub-groups of actors. This study indicates that auxiliary nurses' performance is interconnected with the performance of other health system actors who require support, including managers and community-level collaborators. Organizational climate is critical for making auxiliary nurses feel supported, and greater attention to improving the quality of hierarchical relationships is needed in LMIC settings. The participatory nature of the concept-mapping process enabled health system actors to collaborate in co-production of context-specific knowledge needed to guide efforts to strengthen performance in a vulnerable region.

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

PubMed

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

2013-01-01

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

Fire danger index efficiency as a function of fuel moisture and fire behavior.

PubMed

Torres, Fillipe Tamiozzo Pereira; Romeiro, Joyce Machado Nunes; Santos, Ana Carolina de Albuquerque; de Oliveira Neto, Ricardo Rodrigues; Lima, Gumercindo Souza; Zanuncio, José Cola

2018-08-01

Assessment of the performance of forest fire hazard indices is important for prevention and management strategies, such as planning prescribed burnings, public notifications and firefighting resource allocation. The objective of this study was to evaluate the performance of fire hazard indices considering fire behavior variables and susceptibility expressed by the moisture of combustible material. Controlled burns were carried out at different times and information related to meteorological conditions, characteristics of combustible material and fire behavior variables were recorded. All variables analyzed (fire behavior and fuel moisture content) can be explained by the prediction indices. The Brazilian EVAP/P showed the best performance, both at predicting moisture content of the fuel material and fire behavior variables, and the Canadian system showed the best performance to predicting the rate of spread. The coherence of the correlations between the indices and the variables analyzed makes the methodology, which can be applied anywhere, important for decision-making in regions with no records or with only unreliable forest fire data. Copyright © 2018 Elsevier B.V. All rights reserved.

Financial gains and risks in pay-for-performance bonus algorithms.

PubMed

Cromwell, Jerry; Drozd, Edward M; Smith, Kevin; Trisolini, Michael

2007-01-01

Considerable attention has been given to evidence-based process indicators associated with quality of care, while much less attention has been given to the structure and key parameters of the various pay-for-performance (P4P) bonus and penalty arrangements using such measures. In this article we develop a general model of quality payment arrangements and discuss the advantages and disadvantages of the key parameters. We then conduct simulation analyses of four general P4P payment algorithms by varying seven parameters, including indicator weights, indicator intercorrelation, degree of uncertainty regarding intervention effectiveness, and initial baseline rates. Bonuses averaged over several indicators appear insensitive to weighting, correlation, and the number of indicators. The bonuses are sensitive to disease manager perceptions of intervention effectiveness, facing challenging targets, and the use of actual-to-target quality levels versus rates of improvement over baseline.

Strategic planning in Brazilian protected areas: Uses and adjustments.

PubMed

Barreto, Cristiane Gomes; Drummond, José Augusto L

2017-09-15

Management plans for protected areas commonly use strategic planning tools in their drafting. It is proposed that the adequate use of the instruments of planning and management of protected areas can improve their strategic competitiveness, providing greater financial and administrative independence, enabling them to be economically sustainable organizations. This study evaluated the application of concepts and strategy formulation, strategy principles and competitiveness, organizational diagnosis, strategic maps, scenarios, and other strategic planning instruments used for conservation management in Brazil. 25 management plans of 25 different protected areas were selected and studied, with special attention to the indicators used in each plan. Results indicate that there is a high suitability for the application of SP tools to the universe of protected areas, although management plans did not take full advantage of these tools. We also found that the broader use of these tools did not guarantee greater managerial effectiveness. We suggest that other governance variables beyond planning strategies must be improved, to ensure a better performance of protected areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical Implications From an Exploratory Study of Postural Management of Breech Presentation

PubMed Central

Founds, Sandra A.

2013-01-01

The results from an exploratory study of the effectiveness of maternal knee-chest posture for producing cephalic version of breech presentation are shown. Methods are briefly described and clinical implications are presented. Among 25 women, fewer who performed the maternal knee-chest postural intervention experienced fetal cephalic version than women in the control group who did nothing to influence breech presentation. Despite limitations of the underpowered findings, trends in the data may indicate that parity and gestational age were potentially relevant covariates of version. Postural management is not an evidence-based practice. This exploratory study indicates that maternal knee-chest posture may work opposite to the expected direction, but the small sample size precludes generalizations about efficacy of knee-chest postural management. At least one adequately powered trial that controls for parity and gestational age is needed to determine whether knee-chest postural management results in no effect, a small, or small to moderate clinically significant effect. PMID:16814225

Endoscopic endonasal approach for the treatment of anterior skull base tumours.

PubMed

López, Fernando; Suárez, Vanessa; Costales, María; Rodrigo, Juan P; Suárez, Carlos; Llorente, José Luis

2012-01-01

The increasing expertise of transnasal endoscopic surgery has recently expanded its indications to include the management of tumours affecting the skull base. We report our experience with endoscopic management of these tumours, emphasising the indications and surgical technique used. A retrospective analysis was performed of patients treated by an endoscopic endonasal approach (EEA) in our department from 2004 until 2011. Sixty-three patients were analysed. We performed an endoscopic craniofacial resection in 32 patients (51%), an expanded EEA in 22 (35%), a transclival approach in 6 (9%) and a transpterygoid approach in 3 (5%). The most frequent benign tumour was nasopharyngeal angiofibroma (24%), while adenocarcinoma (30%) was the most common among malignancies. Mean follow-up was 26 months (range: 6 to 84 months). The complication rate was 5% and resection was complete in 56 cases (89%). The 5-year overall-survival was 71% in patients with malignant tumours and the effectiveness was 100% in benign tumours. Our results support that endoscopic surgery, when properly planned, represents a valid alternative to standard surgical approaches for the management of skull base tumours. Copyright © 2012 Elsevier España, S.L. All rights reserved.

What Factors Influence Employee Service Recovery Performance and What Are the Consequences in Health Care?

PubMed

Nadiri, Halil; Tanova, Cem

2016-01-01

We analyzed the extent to which the service recovery performance of frontline employees in private health care institutions is influenced by employee perceptions of manager attitudes toward service quality, workplace support, and manager fairness and organizational commitment. We also examined the relationship of service recovery performance to employee job satisfaction and turnover intentions. Partial least square path modeling of data from 178 frontline employees in private health care institutions in North Cyprus was utilized. Although empowerment and role clarity were positively related to service recovery performance, perceived managerial attitudes toward hospital customer service, teamwork, and customer service-oriented training as indicators of workplace support were not related to frontline employees' service recovery performance. Organizational justice was related to affective commitment, which in turn was related to service recovery performance. Although service recovery performance was not related to employee turnover intentions, it was related to job satisfaction. Managerial implications of these study findings are presented in the light of the cognitive evaluation theory. Health services differ from other service organizations in the way that intrinsic and extrinsic rewards influence the service recovery efforts of frontline employees. To ensure high quality services, managers should focus on intrinsic rewards, empower and give more autonomy to staff.

Quality-Based Supply Management Indicators

DTIC Science & Technology

1993-09-01

Dixon and others, 1990:72; Williams, 1982:458-461; Szilagyi and Wallace , 1980:336-337). Conclusion #4. The characteristics o- customer focus and...December 1989). Szilagyi , Andrew D., Jr. and Marc J. Wallace , Jr. Organizational Behavior and Performance. Santa Monica CA: Goodyear Publishing Co., Inc

Managerial Perceptions Regarding Salary Increase Criteria

ERIC Educational Resources Information Center

Dyer, Lee; And Others

1976-01-01

Results of study indicate that managers feel job performance should be most important determinant of salary increases for themselves and for subordinates; that organizations do not place sufficient emphasis on this criterion; and that job satisfaction is affected to some degree by this perception. (RW)

Approaches for assessing temperament in calves post-weaning

USDA-ARS?s Scientific Manuscript database

Cattle undergo routine management, which may cause anxiety with potential to impact well-being and performance. Our objectives were to develop procedures to reliably evaluate calf behavior indicative of stress, and determine whether behaviors change under repeated handling. A factorial design of 2...

The effects of Crew Resource Mangement (CRM) training in airline maintenance: Results following three years' experience

NASA Technical Reports Server (NTRS)

Taylor, J. C.; Robertson, M. M.

1995-01-01

This report describes three years' evaluation of the effects of one airline's Crew Resources Management (CRM) training operation for maintenance. This evaluation focuses on the post-training attitudes of maintenance managers' and technical support professionals, their reported behaviors, and the safety, efficiency and dependable maintenance performance of their units. The results reveal a strong positive effect of the training. The overall program represents the use of CRM training as a long-term commitment to improving performance through effective communication at all levels in airline maintenance operations. The initial findings described in our previous progress reports are reinforced and elaborated here. The current results benefit from the entire pre-post training survey, which now represents total attendance of all managers and staff professionals. Additionally there are now full results from the two-month, six-month, and 12-month follow-up questionnaires, together with as many as 33 months of post-training performance data, using several indicators. In this present report, we examine participants' attitudes, their reported behaviors following the training, the performance of their work units, and the relationships among these variables. Attitudes include those measured immediately before and after the training as well as participants' attitudes months after their training. Performance includes measures, by work units, of on-time flight departures, on-schedule maintenance releases, occupational and aircraft safety, and efficient labor costs. We report changes in these performance measures following training, as well their relationships with the training participants' attitudes. Highlights of results from this training program include increased safety and improved costs associated with positive attitudes about the use of more assertive communication, and the improved management of stress. Improved on-time performance is also related to those improved attitudes, as well as favorable attitudes about participative management.

[Indicators of communication and degree of professional integration in healthcare].

PubMed

Mola, Ernesto; Maggio, Anna; Vantaggiato, Lucia

2009-01-01

According to the chronic care model, improving the management of chronic illness requires efficient communication between health care professionals and the creation of a web of integrated healthcare The aim of this study was to identify an efficient methodology for evaluating the degree of professional integration through indicators related to communication between healthcare professionals. The following types of indicators were identified:-structure indicators to evaluate the presence of prerequisites necessary for implementing the procedures -functional indicators to quantitatively evaluate the use of communications instruments-performance indicators Defining specific indicators may be an appropriate methodology for evaluating the degree of integration and communication between health professionals, available for a bargaining system of incentives.

Confirmatory Factor Analysis of the Bases of Leader Power: First-Order Factor Model and Its Invariance Across Groups.

PubMed

Rahim, M A; Magner, N R

1996-10-01

Confirmatory factor analyses of data (from five samples: N = 308 accountants and finance professionals, N = 578 management and non-management employees, and N = 588 employed management students in the U.S.; N = 728 management and non-management employees in S. Korea, N = 250 management and non-management bank employees in Bangladesh) on the 29 items of the Rahim Leader Power Inventory were performed with LISREL 7. The results provided support for the convergent and discriminant validities of the subscales measuring the five bases of leader power (coercive, reward, legitimate, expert, and referent), and the invariance of factor pattern and factor loadings across organizational levels and the three American samples. Additional analysis indicated that leader power profiles differed across the three national cultures represented in the study.

IDD Info: a software to manage surveillance data of Iodine Deficiency Disorders.

PubMed

Liu, Peng; Teng, Bai-Jun; Zhang, Shu-Bin; Su, Xiao-Hui; Yu, Jun; Liu, Shou-Jun

2011-08-01

IDD info, a new software for managing survey data of Iodine Deficiency Disorders (IDD), is presented in this paper. IDD Info aims to create IDD project databases, process, analyze various national or regional surveillance data and form final report. It has series measures of choosing database from existing ones, revising it, choosing indicators from pool to establish database and adding indicators to pool. It also provides simple tools to scan one database and compare two databases, to set IDD standard parameters, to analyze data by single indicator and multi-indicators, and finally to form typeset report with content customized. IDD Info was developed using Chinese national IDD surveillance data of 2005. Its validity was evaluated by comparing with survey report given by China CDC. The IDD Info is a professional analysis tool, which succeeds in speeding IDD data analysis up to about 14.28% with respect to standard reference routines. It consequently enhances analysis performance and user compliance. IDD Info is a practical and accurate means of managing the multifarious IDD surveillance data that can be widely used by non-statisticians in national and regional IDD surveillance. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A mapping review of international guidance on the management and care of amyotrophic lateral sclerosis (ALS).

PubMed

Janssens, Astrid I W A; Ruytings, Marijke; Al-Chalabi, Ammar; Chio, Adriano; Hardiman, Orla; Mcdermott, Christopher J; Meyer, Thomas; Mora, Gabriele; Van Damme, Philip; Van Den Berg, Leonard H; Vanhaecht, Kris; Winkler, Andrea S; Sermeus, Walter

2016-01-01

Management of ALS is suboptimal. Consequently, quality improvement interventions are needed to improve ALS care. An evidence-based insight into how patients should be managed is essential when developing quality improvement interventions. Therefore, this study aimed to map, categorize and summarize international guidance on the management and care of ALS and to identify gaps in this guidance by means of a mapping review. Literature was searched for clinical practice guidelines, quality indicators and evidence-based clinical summaries. A content analysis and meta-synthesis of the included literature was performed. Interventions and outcomes used in the management and care of ALS were identified and categorized. Furthermore, the amount of guidance underpinning these interventions and outcomes was analysed. Six clinical practice guidelines, one set of quality indicators and three evidence-based clinical summaries were identified. The results demonstrated that certain domains in ALS care, mainly disease-specific domains such as breathing and swallowing, are extensively addressed in the literature whereas other subjects, such as care coordination, receive little attention. In conclusion, this mapping review provides a scientific basis for targeting and developing the clinical content of a quality improvement intervention for the management of ALS.

Management of acute and chronic ankle instability.

PubMed

Maffulli, Nicola; Ferran, Nicholas A

2008-10-01

Acute lateral ankle ligament injuries are common. If left untreated, they can result in chronic instability. Nonsurgical measures, including functional rehabilitation, are the management methods of choice for acute injuries, with surgical intervention reserved for high-demand athletes. Chronic lateral ankle instability is multifactorial. Failed nonsurgical management after appropriate rehabilitation is an indication for surgery. Of the many surgical options available, anatomic repair of the anterior talofibular and calcaneofibular ligaments is recommended when the quality of the ruptured ligaments permits. Anatomic reconstruction with autograft or allograft should be performed when the ruptured ligaments are attenuated. Ankle arthroscopy is an important adjunct to ligamentous repair and should be performed at the time of repair to identify and address intra-articular conditions associated with chronic ankle instability. Tenodesis procedures are not recommended because they may disturb ankle and hindfoot biomechanics.

Use of echocardiography in outpatients with chest pain and normal resting electrocardiograms referred to Mayo Clinic Rochester.

PubMed

Gibbons, Raymond J; Carryer, Damita; Liu, Hongfang; Brady, Peter A; Askew, John Wells; Hodge, David; Ammash, Naser; Ebbert, Jon O; Roger, Veronique L

2018-02-01

To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). There are scant data to indicate how often Class III recommendations are ignored in clinical practice. We searched electronically all medical records of referral outpatients seen at Mayo Clinic Rochester from January 1, 2010, through December 31, 2013, to identify patients with stable chest pain and known or suspected coronary artery disease who underwent resting echocardiography and had normal resting ECGs and no other indication for echocardiography. Of the 15,529 referral outpatients who were evaluated at Mayo Clinic Rochester with chest pain, 3976 (25.6%) had resting echocardiograms. Eight hundred seventy of these 3976 patients (21.9%) had normal resting ECGs. Six hundred nineteen of these 870 patients (71.1%) had other indications for echocardiography. The remaining 251 patients (6.3% of all echocardiograms and 1.6% of all patients) had normal resting ECGs and no other indication for echocardiography. Two hundred thirty-nine of these 251 patients (95.2%) had normal echocardiograms. Of the 12 abnormal echocardiograms, only 4 led to any change in clinical management. Sixty-one of these 251 echocardiograms (24.3%) were "preordered" before the provider (physicians, nurses, physician assistants) visit. Echocardiograms were performed in 1 in 4 referral outpatients with chest pain seen at Mayo Clinic Rochester. However, only 1 in 16 of these echocardiograms was performed in violation of the class III recommendation in the American College of Cardiology Foundation/American Heart Association guidelines for the management of stable angina. These unnecessary echocardiograms were almost always normal, and had little impact on clinical management. The rate of unnecessary echocardiograms could be decreased by eliminating preordering. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluating sustainable water quality management in the U.S.: Urban, Agricultural, and Environmental Protection Practices

NASA Astrophysics Data System (ADS)

van Oel, P. R.; Alfredo, K. A.; Russo, T. A.

2015-12-01

Sustainable water management typically emphasizes water resource quantity, with focus directed at availability and use practices. When attention is placed on sustainable water quality management, the holistic, cross-sector perspective inherent to sustainability is often lost. Proper water quality management is a critical component of sustainable development practices. However, sustainable development definitions and metrics related to water quality resilience and management are often not well defined; water quality is often buried in large indicator sets used for analysis, and the policy regulating management practices create sector specific burdens for ensuring adequate water quality. In this research, we investigated the methods by which water quality is evaluated through internationally applied indicators and incorporated into the larger idea of "sustainability." We also dissect policy's role in the distribution of responsibility with regard to water quality management in the United States through evaluation of three broad sectors: urban, agriculture, and environmental water quality. Our research concludes that despite a growing intention to use a single system approach for urban, agricultural, and environmental water quality management, one does not yet exist and is even hindered by our current policies and regulations. As policy continues to lead in determining water quality and defining contamination limits, new regulation must reconcile the disparity in requirements for the contaminators and those performing end-of-pipe treatment. Just as the sustainable development indicators we researched tried to integrate environmental, economic, and social aspects without skewing focus to one of these three categories, policy cannot continue to regulate a single sector of society without considering impacts to the entire watershed and/or region. Unequal distribution of the water pollution burden creates disjointed economic growth, infrastructure development, and policy enactment across the sectors preventing a holistic approach to water quality management and, thus, rendering our system unsustainable.

A 7-Step Strategy for the Implementation of Worksite Lifestyle Interventions: Helpful or Not?

PubMed

Wierenga, Debbie; Engbers, Luuk H; Van Empelen, Pepjin; van Mechelen, Willem

2016-05-01

The aim of this study was to evaluate the use of and adherence to a 7-step strategy for the development, implementation, and continuation of a comprehensive, multicomponent lifestyle program. Strategy use and adherence was assessed with 12 performance indicators. Data were collected by combining onsite monitoring with semi-structured interviews at baseline and follow-up (6, 12, and 18 months). Not all performance indicators were met so partial strategy adherence was obtained. The strategy could be improved on the following aspects: support among management, project structure, adaptation to needs of employees, planning, and maintenance. The results of this evaluation indicate that strategy adherence facilitated structured development and implementation. On the basis of the qualitative data, this study suggests that when improvements will be made on both the content and performance, the 7-step strategy could be an effective tool to successfully implement a multicomponent WHPP.

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model.

PubMed

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective.

Characteristics of health plans that treat psychiatric patients.

PubMed

Zarin, D A; West, J C; Pincus, H A; Tanielian, T L

1999-01-01

Nationally representative data regarding the organizational, financial, and procedural features of health plans in which psychiatric patients receive treatment indicate that fewer privately insured, Medicaid, and Medicare managed care enrollees receive care from a psychiatrist than is true for "nonmanaged" enrollees. Financial considerations were reported to adversely affect treatment for one-third of all patients. Although utilization management techniques and financial/resource constraints commonly applied to patients in both managed and nonmanaged plans, performance-based incentives were rare in nonmanaged plans. The traditional health plan categories provide limited information to identify salient plan characteristics and guide policy decisions regarding the provision of care.

The use KPI's to determine the waste in production process

NASA Astrophysics Data System (ADS)

Borsos, G.; Iacob, C. C.; Calefariu, G.

2016-11-01

In theory and practice of management is well-known Lean approach about forms of waste from production processes (Muda) and the method VSM (Value Stream Map), one of the most effective methods for determining the activities generating value within industrial companies. It is also obvious concern of the specialists for performance measurement regardless of purview of the organizations. The literature review has shown that the link between performance indicators and the objectives of the companies is researched in detail. However, the correlation between indicators and the forms of waste that generate deviations from the setpoints is rather nature practical and it depends on the talent and managerial skills of those directing production processes. The paper presents the results of a applied study, performed by the authors, through which it was has sought to will create a system of performance indicators specific to manufacturing activity that to be a useful tool to quantify the losses and to determining ways to improve default losses.

Review of recycling performance indicators: a study on collection rate in Taiwan.

PubMed

Wen, Lihchyi; Lin, Chun-Hsu; Lee, Soo-Cheol

2009-08-01

The Taiwan Environmental Protection Administration (Taiwan EPA) launched a national Extended Producer Responsibility (EPR) system after integrating eight private recycling organizations in 1998. After that, the environmental performance of the EPR system brought a lot of attention to policy makers. Many studies show positive environmental effects of the EPR system in Taiwan. However, there are controversial questions remained, such as whether the performance indicators used are the right choice to estimate the environmental effects of the recycling policy? Can those estimated results really reflect the performance of the system? This paper would therefore like to more accurately evaluate the performance indicators of the EPR system based on data observed over the past decade in Taiwan. In the process of evaluating the performance indicators, we have found that the collection rates for durable goods are often ignored in countries that pursue a zero waste policy. This may affect the actual recycling outcome and resource direction targeted by producers. However, in order for the collection rate to be adopted as a policy indicator, how to estimate the amounts of retired or waste products during a period is critical. In this paper, we estimate the collection rate for electrical and electronic waste by using the survival analysis and ownership data analysis approaches. We also provide a comparison of both approaches and put forward suggestions for directions in the future in solid waste management.

Doctors or technicians: assessing quality of medical education

PubMed Central

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products. PMID:23745059

Doctors or technicians: assessing quality of medical education.

PubMed

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.

Managing the environmental impacts of land transport: integrating environmental analysis with urban planning.

PubMed

Irving, Paul; Moncrieff, Ian

2004-12-01

Ecological systems have limits or thresholds that vary by pollutant type, emissions sources and the sensitivity of a given location. Human health can also indicate sensitivity. Good environmental management requires any problem to be defined to obtain efficient and effective solutions. Cities are where transport activities, effects and resource management decisions are often most focussed. The New Zealand Ministry of Transport has developed two environmental management tools. The Vehicle Fleet Model (VFM) is a predictive database of the environmental performance of the New Zealand traffic fleet (and rail fleet). It calculates indices of local air quality, stormwater, and greenhouse gases emissions. The second is an analytical process based on Environmental Capacity Analysis (ECA). Information on local traffic is combined with environmental performance data from the Vehicle Fleet Model. This can be integrated within a live, geo-spatially defined analysis of the overall environmental effects within a defined local area. Variations in urban form and activity (traffic and other) that contribute to environmental effects can be tracked. This enables analysis of a range of mitigation strategies that may contribute, now or in the future, to maintaining environmental thresholds or meeting targets. A case study of the application of this approach was conducted within Waitakere City. The focus was on improving the understanding of the relative significance of stormwater contaminants derived from land transport.

The relationship among the resiliency practices in supply chain, financial performance, and competitive advantage in manufacturing firms in Indonesia and Sierra Leone

NASA Astrophysics Data System (ADS)

Musa, I.; Nyoman Pujawan, I.

2018-04-01

Current supply chain management (SCM) has become a potentially treasured way of safeguarding competitive advantage and improving organizational performance since competition is no longer between organizations, but among supply chains. This research conceptualizes and develops four resiliency practices (Flexibility, Redundancy, Collaboration and Agility) and tests the relationships between organizations’ financial performance and competitive advantage in manufacturing firms. The study involves manufacturing firms in Indonesia and Sierra Leone. The study used stratified random sampling to pick a sample size of 95 manufacturing firms, which represented different industrial sectors. The respondents were mainly managers of different manufacturing companies. The relationships proposed in the conceptual framework were tested using correlation analysis. The results indicate that higher levels of resilience practices in manufacturing firms can lead to enhanced competitive advantage and improved financial performance.

Development of a model to assess environmental performance, concerning HSE-MS principles.

PubMed

Abbaspour, M; Hosseinzadeh Lotfi, F; Karbassi, A R; Roayaei, E; Nikoomaram, H

2010-06-01

The main objective of the present study was to develop a valid and appropriate model to evaluate companies' efficiency and environmental performance, concerning health, safety, and environmental management system principles. The proposed model overcomes the shortcomings of the previous models developed in this area. This model has been designed on the basis of a mathematical method known as Data Envelopment Analysis (DEA). In order to differentiate high-performing companies from weak ones, one of DEA nonradial models named as enhanced Russell graph efficiency measure has been applied. Since some of the environmental performance indicators cannot be controlled by companies' managers, it was necessary to develop the model in a way that it could be applied when discretionary and/or nondiscretionary factors were involved. The model, then, has been modified on a real case that comprised 12 oil and gas general contractors. The results showed the relative efficiency, inefficiency sources, and the rank of contractors.

Case management: key to access, quality, and financial success.

PubMed

Smith, Alison P

2003-01-01

Several strategic, organizational, and operational variables drive successful case management programs. Organizational goals and accountability for support by administrative and medical staff leaders set the stage for a comprehensive program. The integration of utilization review, discharge planning, and other functions into the role of the case manager improves productivity and continuity. Choosing a model for assigning patients, a variable unique to the institution, should be carefully considered. Regardless of the power of strategic goals or the creative selection of a model, daily practices that promote daily review and communication will reveal all of the opportunities for improved performance. Complications are avoided one patient at a time and patients deserve vigilance. Length of stay is shortened 1 day at a time and we can no longer afford to miss these opportunities. In the period of high census, an unnecessary day for one patient at the end of his/her stay may mean another patient being diverted to another hospital away from his/her physician and past medical records. Creating constructive physician partnerships and cooperative relationships with postacute care providers can bring a case management program to higher level of performance. While many organizations have employees called "case managers," fewer have a comprehensive approach that has the potential to drive so many important indicators of performance.

Management of heart transplant recipients: reference for primary care physicians.

PubMed

Kansara, Pranav; Kobashigawa, Jon A

2012-07-01

Heart transplantation is the treatment of choice for a select group of patients with end-stage heart failure. Survival rates have increased and complication rates have decreased due to better immunosuppressive agents, improvement in organ procurement and surgical technique, and overall increase in experience for performing heart transplantation. Involvement from primary care physicians is very important to optimize postoperative management of heart transplant recipients. In this article, we discuss the indications for heart transplantation, physiology of the denervated heart, the standard postoperative care of adult heart transplant recipients, and long-term complications. Primary care physicians must play an increasing role in the management of heart transplant recipients in the age of managed care and increasing survival rates.

Attitudes and expectations of producers to the use of a microcomputer-based management information system to monitor dairy herd performance

PubMed Central

Lissemore, Kerry D.; Leslie, Ken E.; Martin, S. Wayne; Menzies, Paula I.; Meek, Alan H.

1992-01-01

The attitudes and expectations of producers toward the use of a microcomputer-based herd management information system were assessed. The study was conducted over a two-year period, beginning in January 1986, and was operated as a bureau service. The implementation and use of the program are described elsewhere. Pre- and posttrial questionnaires were administered to assess producer attitudes. We found that the monthly analysis reports were used in the management of the dairy farms and were found to be a useful management tool. The majority of producers indicated a willingness to pay, on average, $6.86/cow/year for such a service. PMID:17423946

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

PubMed

Sampurno, Fanny; Zheng, Jia; Di Stefano, Lydia; Millar, Jeremy L; Foster, Claire; Fuedea, Ferran; Higano, Celestia; Hulan, Hartwig; Mark, Stephen; Moore, Caroline; Richardson, Alison; Sullivan, Frank; Wenger, Neil S; Wittmann, Daniela; Evans, Sue

2018-03-01

We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicted by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater. The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes. We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A simplified method of performance indicators development for epidemiological surveillance networks--application to the RESAPATH surveillance network.

PubMed

Sorbe, A; Chazel, M; Gay, E; Haenni, M; Madec, J-Y; Hendrikx, P

2011-06-01

Develop and calculate performance indicators allows to continuously follow the operation of an epidemiological surveillance network. This is an internal evaluation method, implemented by the coordinators in collaboration with all the actors of the network. Its purpose is to detect weak points in order to optimize management. A method for the development of performance indicators of epidemiological surveillance networks was developed in 2004 and was applied to several networks. Its implementation requires a thorough description of the network environment and all its activities to define priority indicators. Since this method is considered to be complex, our objective consisted in developing a simplified approach and applying it to an epidemiological surveillance network. We applied the initial method to a theoretical network model to obtain a list of generic indicators that can be adapted to any surveillance network. We obtained a list of 25 generic performance indicators, intended to be reformulated and described according to the specificities of each network. It was used to develop performance indicators for RESAPATH, an epidemiological surveillance network of antimicrobial resistance in pathogenic bacteria of animal origin in France. This application allowed us to validate the simplified method, its value in terms of practical implementation, and its level of user acceptance. Its ease of use and speed of application compared to the initial method argue in favor of its use on broader scale. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2012 CFR

2012-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2011 CFR

2011-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2013 CFR

2013-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2014 CFR

2014-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

Using KPIs To Anchor Strategic Choices.

ERIC Educational Resources Information Center

Rowley, Daniel James

1997-01-01

Colleges and universities should approach strategic change by establishing three kinds of key performance indicators (KPIs): mandated (state-mandates or other imposed objectives); management (determined by the administration); and derived (from the special intentions of institutional units). By assembling the three kinds of KPIs, the strategic…

Maximizing Service Provider Relationships: Best Practices through Blended Management.

ERIC Educational Resources Information Center

Scherrens, Maurice W.

This book examines the institutional movement toward outsourcing support services, focusing on the development of outcome-oriented performance indicators and continuous self-assessment. Using 125 "lessons" based on support service theories, philosophies, and practices at George Mason University (Virginia), which collectively are termed…

The Management of Change

ERIC Educational Resources Information Center

Hersey, Paul; Blanchard, Kenneth H.

1972-01-01

Second of three articles cites research indicating employee productivity is usually higher under employee-centered" supervisors who keep a loose rein than under job-centered" ones who exercise close supervision. Since high expectations lead to increasingly high performance, and vice versa, authors suggest ways to turn around low-producing…

A computerized system to monitor resilience indicators in organizations.

PubMed

de Carvalho, Paulo Victor Rodrigues; de Souza, Alan Pinheiro; Gomes, Jose Orlando

2012-01-01

The concepts developed by resilience engineering allow the understanding and monitoring the functioning of organizations and, particularly, to map the role of human activities, in success or in failure, enabling a better comprehension about how people make decisions in unexpected situations. The capture of information about human activities in the various organization levels gives managers a deeper real-time understanding of what is influencing the people performance, providing awareness of the factors that influence positively or negatively the organizational goals initially projected. The monitoring is important because the correct functioning of complex systems depends on the knowledge that people have to perform their activities and how the system environment provides tools that actually support the human performance. Therefore, organizations should look forward through precursors in operating signals to identify possible problems or solutions in the structure of tasks and activities, safety, quality, schedule, rework, and maintenance. We apply the concepts of resilience engineering to understand the organization by the analysis of cognitive tasks and activities. The aim is the development of a computerized system to monitor human activities to produce indicators to access system resilience. The validation of the approach was made in a real organization and the results show the successful applicability of the system. Based on findings obtained after the experiment of the system in a real organization, and managers and workers opinions, it was possible to show that the use of system provided an anticipated (real-time) perception about how activities are effectively being performed, allowing managers and workers to make decisions more consistent with daily problems, and also to anticipate solutions to cope with unexpected situations.

On the Potential of Surfers to Monitor Environmental Indicators in the Coastal Zone.

PubMed

Brewin, Robert J W; de Mora, Lee; Jackson, Thomas; Brewin, Thomas G; Shutler, Jamie

2015-01-01

The social and economic benefits of the coastal zone make it one of the most treasured environments on our planet. Yet it is vulnerable to increasing anthropogenic pressure and climate change. Coastal management aims to mitigate these pressures while augmenting the socio-economic benefits the coastal region has to offer. However, coastal management is challenged by inadequate sampling of key environmental indicators, partly due to issues relating to cost of data collection. Here, we investigate the use of recreational surfers as platforms to improve sampling coverage of environmental indicators in the coastal zone. We equipped a recreational surfer, based in the south west United Kingdom (UK), with a temperature sensor and Global Positioning System (GPS) device that they used when surfing for a period of one year (85 surfing sessions). The temperature sensor was used to derive estimates of sea-surface temperature (SST), an important environmental indicator, and the GPS device used to provide sample location and to extract information on surfer performance. SST data acquired by the surfer were compared with data from an oceanographic station in the south west UK and with satellite observations. Our results demonstrate: (i) high-quality SST data can be acquired by surfers using low cost sensors; and (ii) GPS data can provide information on surfing performance that may help motivate data collection by surfers. Using recent estimates of the UK surfing population, and frequency of surfer participation, we speculate around 40 million measurements on environmental indicators per year could be acquired at the UK coastline by surfers. This quantity of data is likely to enhance coastal monitoring and aid UK coastal management. Considering surfing is a world-wide sport, our results have global implications and the approach could be expanded to other popular marine recreational activities for coastal monitoring of environmental indicators.

On the Potential of Surfers to Monitor Environmental Indicators in the Coastal Zone

PubMed Central

Brewin, Robert J. W.; de Mora, Lee; Jackson, Thomas; Brewin, Thomas G.; Shutler, Jamie

2015-01-01

The social and economic benefits of the coastal zone make it one of the most treasured environments on our planet. Yet it is vulnerable to increasing anthropogenic pressure and climate change. Coastal management aims to mitigate these pressures while augmenting the socio-economic benefits the coastal region has to offer. However, coastal management is challenged by inadequate sampling of key environmental indicators, partly due to issues relating to cost of data collection. Here, we investigate the use of recreational surfers as platforms to improve sampling coverage of environmental indicators in the coastal zone. We equipped a recreational surfer, based in the south west United Kingdom (UK), with a temperature sensor and Global Positioning System (GPS) device that they used when surfing for a period of one year (85 surfing sessions). The temperature sensor was used to derive estimates of sea-surface temperature (SST), an important environmental indicator, and the GPS device used to provide sample location and to extract information on surfer performance. SST data acquired by the surfer were compared with data from an oceanographic station in the south west UK and with satellite observations. Our results demonstrate: (i) high-quality SST data can be acquired by surfers using low cost sensors; and (ii) GPS data can provide information on surfing performance that may help motivate data collection by surfers. Using recent estimates of the UK surfing population, and frequency of surfer participation, we speculate around 40 million measurements on environmental indicators per year could be acquired at the UK coastline by surfers. This quantity of data is likely to enhance coastal monitoring and aid UK coastal management. Considering surfing is a world-wide sport, our results have global implications and the approach could be expanded to other popular marine recreational activities for coastal monitoring of environmental indicators. PMID:26154173

Cost and efficiency of disaster waste disposal: A case study of the Great East Japan Earthquake.

PubMed

Sasao, Toshiaki

2016-12-01

This paper analyzes the cost and efficiency of waste disposal associated with the Great East Japan Earthquake. The following two analyses were performed: (1) a popular parametric approach, which is an ordinary least squares (OLS) method to estimate the factors that affect the disposal costs; (2) a non-parametric approach, which is a two-stage data envelopment analysis (DEA) to analyze the efficiency of each municipality and clarify the best performance of the disaster waste management. Our results indicate that a higher recycling rate of disaster waste and a larger amount of tsunami sediments decrease the average disposal costs. Our results also indicate that area-wide management increases the average cost. In addition, the efficiency scores were observed to vary widely by municipality, and more temporary incinerators and secondary waste stocks improve the efficiency scores. However, it is likely that the radioactive contamination from the Fukushima Daiichi nuclear power station influenced the results. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modeling the prediction of business intelligence system effectiveness.

PubMed

Weng, Sung-Shun; Yang, Ming-Hsien; Koo, Tian-Lih; Hsiao, Pei-I

2016-01-01

Although business intelligence (BI) technologies are continually evolving, the capability to apply BI technologies has become an indispensable resource for enterprises running in today's complex, uncertain and dynamic business environment. This study performed pioneering work by constructing models and rules for the prediction of business intelligence system effectiveness (BISE) in relation to the implementation of BI solutions. For enterprises, effectively managing critical attributes that determine BISE to develop prediction models with a set of rules for self-evaluation of the effectiveness of BI solutions is necessary to improve BI implementation and ensure its success. The main study findings identified the critical prediction indicators of BISE that are important to forecasting BI performance and highlighted five classification and prediction rules of BISE derived from decision tree structures, as well as a refined regression prediction model with four critical prediction indicators constructed by logistic regression analysis that can enable enterprises to improve BISE while effectively managing BI solution implementation and catering to academics to whom theory is important.

Improving integrated waste management at the regional level: the case of Lombardia.

PubMed

Rigamonti, Lucia; Falbo, Alida; Grosso, Mario

2013-09-01

The article summarises the main results of the 'Gestione Rifiuti in Lombardia: Analisi del ciclo di vita' (Waste management in Lombardia region: Life cycle assessment; GERLA) project. Life cycle assessment (LCA) has been selected by Regione Lombardia as a strategic decision support tool in the drafting of its new waste management programme. The goal was to use the life cycle thinking approach to assess the current regional situation and thus to give useful strategic indications for the future waste management. The first phase of the study consisted of the LCA of the current management of municipal waste in the Lombardia region (reference year: 2009). The interpretation of such results has allowed the definition of four possible waste management scenarios for the year 2020, with the final goal being to improve the environmental performance of the regional system. The results showed that the current integrated waste management of Lombardia region is already characterised by good energy and environmental performances. However, there is still room for further improvement: actions based, on the one hand, on a further increase in recycling rates and, on the other hand, on a series of technological modifications, especially in food waste and residual waste management, can be undertaken to improve the overall system.

DB4US: A Decision Support System for Laboratory Information Management

PubMed Central

Hortas, Maria Luisa; Baena-García, Manuel; Lana-Linati, Jorge; González, Carlos; Redondo, Maximino; Morales-Bueno, Rafael

2012-01-01

Background Until recently, laboratory automation has focused primarily on improving hardware. Future advances are concentrated on intelligent software since laboratories performing clinical diagnostic testing require improved information systems to address their data processing needs. In this paper, we propose DB4US, an application that automates information related to laboratory quality indicators information. Currently, there is a lack of ready-to-use management quality measures. This application addresses this deficiency through the extraction, consolidation, statistical analysis, and visualization of data related to the use of demographics, reagents, and turn-around times. The design and implementation issues, as well as the technologies used for the implementation of this system, are discussed in this paper. Objective To develop a general methodology that integrates the computation of ready-to-use management quality measures and a dashboard to easily analyze the overall performance of a laboratory, as well as automatically detect anomalies or errors. The novelty of our approach lies in the application of integrated web-based dashboards as an information management system in hospital laboratories. Methods We propose a new methodology for laboratory information management based on the extraction, consolidation, statistical analysis, and visualization of data related to demographics, reagents, and turn-around times, offering a dashboard-like user web interface to the laboratory manager. The methodology comprises a unified data warehouse that stores and consolidates multidimensional data from different data sources. The methodology is illustrated through the implementation and validation of DB4US, a novel web application based on this methodology that constructs an interface to obtain ready-to-use indicators, and offers the possibility to drill down from high-level metrics to more detailed summaries. The offered indicators are calculated beforehand so that they are ready to use when the user needs them. The design is based on a set of different parallel processes to precalculate indicators. The application displays information related to tests, requests, samples, and turn-around times. The dashboard is designed to show the set of indicators on a single screen. Results DB4US was deployed for the first time in the Hospital Costa del Sol in 2008. In our evaluation we show the positive impact of this methodology for laboratory professionals, since the use of our application has reduced the time needed for the elaboration of the different statistical indicators and has also provided information that has been used to optimize the usage of laboratory resources by the discovery of anomalies in the indicators. DB4US users benefit from Internet-based communication of results, since this information is available from any computer without having to install any additional software. Conclusions The proposed methodology and the accompanying web application, DB4US, automates the processing of information related to laboratory quality indicators and offers a novel approach for managing laboratory-related information, benefiting from an Internet-based communication mechanism. The application of this methodology has been shown to improve the usage of time, as well as other laboratory resources. PMID:23608745

New thinking on how to link executive pay with performance.

PubMed

Rappaport, A

1999-01-01

As the stock market began its ascent in the mid-1990s, executive pay--always the subject of heated debate--mounted along with it. That's because among the largest U.S. companies, stock options now account for more than half of total CEO compensation and about 30% of senior operating managers' pay. One problem became particularly clear during the bull market's astonishing run: even below-average performers reap huge gains from stock options when the market is rising rapidly. The author proposes steps to close the gap between existing compensation practices and those needed to promote higher levels of achievement at all levels of the corporation. For top managers, he recommends replacing conventional stock options with options that are tied to a market or peer index. Below-average performers would not be rewarded under such plans; superior performers could, depending on the way plans were structured, receive even more. He notes that managers at the business unit level should not be judged on the company's stock price--over which they have little control--and advocates an approach that accurately measures the value added by each unit. Finally, he suggests how certain indicators of value can be used to measure the contribution of frontline managers and employees. The concept of pay for performance has gained wide acceptance, but the link between incentive pay and superior performance is still too weak. Reforms must be adopted at all levels of the organization. Shareholders will applaud changes in pay schemes that motivate companies to deliver more value.

Organizational performance and regulatory compliance as measured by clinical pertinence indicators before and after implementation of Anesthesia Information Management System (AIMS).

PubMed

Choi, Clark K; Saberito, Darlene; Tyagaraj, Changa; Tyagaraj, Kalpana

2014-01-01

Previous studies have suggested that electronic medical records (EMR) can lead to a greater reduction of medical errors and better adherence to regulatory compliance than paper medical records (PMR). In order to assess the organizational performance and regulatory compliance, we tracked different clinical pertinence indicators (CPI) in our anesthesia information management system (AIMS) for 5 years. These indicators comprised of the protocols from the Surgical Care Improvement Project (SCIP), elements of performance (EP) from The Joint Commission (TJC), and guidelines from the Centers for Medicare and Medicaid Services (CMS). A comprehensive AIMS was initiated and the CPI were collected from October 5, 2009 to December 31, 2010 (EMR period) and from January 1, 2006 to October 4, 2009 (PMR period). Fourteen CPI were found to be common between the EMR and PMR periods. Based on the statistical analysis of the 14 common CPI, there was a significant increase (p < 0.001) in overall compliance after the introduction of EMR compared to the PMR period. The increase in overall compliance was significantly progressive (p = 0.013) from year to year over 2006 and 2010. Of the 14 CPI, Documentation of a) medication doses, and b) monitoring of postoperative physiological status, mental status, and pain scores showed significant improvement (p < 0.001) during the EMR period compared to the PMR period.

The interns' learning assessment in obstetrics and gynecology department of Zahedan University of Medical Sciences.

PubMed

Roudbari, Masoud; Yaghmaei, Minoo

2007-09-01

One of the aims of management priorities in medical universities is the evaluation of learning in educational departments in order to prevent educational retardation and to improve the quality of education. The aim of this study was to evaluate the interns' learning in the obstetrics and gynecology (O&G) department at Zahedan University of Medical Sciences (ZUMS). The study was performed in ZUMS, Iran, in 2002-2003 on all interns at the O&G department, including 30 men and 40 women. For data collection, a questionnaire was used and included some questions regarding the common emergencies and diseases in O&G, together with different learning indicators such as reading, observation, hearing, management, and the capability of management. The data were analyzed using descriptive statistics, tables, t test, and chi-square test using the SPSS software. The mean percentages of learning indicators of observation, bedside teaching, supervised management, and personal management in the common emergencies and diseases of O&G in male interns were significantly lower than those in female interns. Also, the mean percentages of managing capabilities were 12% and 70.5% in common emergencies and 14.2% and 59.3% in common diseases for male and female interns, respectively. The chi-square test showed a significant difference between the mean percentages of the managing capabilities in male and female interns for the majority of the common emergencies and diseases. Also, the chi-square test revealed a significant relationship between the learning indicators and the interns' managing capabilities for common emergencies and diseases. Some learning indicators in the male interns were very low. This needs urgent improvement of the learning quality in the O&G department, especially for the male interns, particularly those who are supposed to work in the deprived areas of the country after graduation in the public service.

Value-based management of design reuse

NASA Astrophysics Data System (ADS)

Carballo, Juan Antonio; Cohn, David L.; Belluomini, Wendy; Montoye, Robert K.

2003-06-01

Effective design reuse in electronic products has the potential to provide very large cost savings, substantial time-to-market reduction, and extra sources of revenue. Unfortunately, critical reuse opportunities are often missed because, although they provide clear value to the corporation, they may not benefit the business performance of an internal organization. It is therefore crucial to provide tools to help reuse partners participate in a reuse transaction when the transaction provides value to the corporation as a whole. Value-based Reuse Management (VRM) addresses this challenge by (a) ensuring that all parties can quickly assess the business performance impact of a reuse opportunity, and (b) encouraging high-value reuse opportunities by supplying value-based rewards to potential parties. In this paper we introduce the Value-Based Reuse Management approach and we describe key results on electronic designs that demonstrate its advantages. Our results indicate that Value-Based Reuse Management has the potential to significantly increase the success probability of high-value electronic design reuse.

Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

PubMed

Steele, Ian H; Thrower, Natasha; Noroian, Paul; Saleh, Fabian M

2018-01-01

Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety. © 2017 American Academy of Forensic Sciences.

Surgical Management of Rib Fractures: Strategies and Literature Review.

PubMed

de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H

2014-06-01

Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

PubMed Central

Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

2017-01-01

Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications.

PubMed

Letoublon, Christian; Morra, Irene; Chen, Yao; Monnin, Valerie; Voirin, David; Arvieux, Catherine

2011-05-01

The objective was to clarify the role of hepatic arterial embolization (AE) in the management of blunt hepatic trauma. Retrospective observational study of 183 patients with blunt hepatic trauma admitted to a trauma referral center over a 9-year period. The charts of 29 patients (16%) who underwent hepatic angiography were reviewed for demographics, injury specific data, management strategy, angiographic indication, efficacy and complications of embolization, and outcome. AE was performed in 23 (79%) of the patients requiring angiography. Thirteen patients managed conservatively underwent emergency embolization after preliminary computed tomography scan. Six had postoperative embolization after damage control laparotomy and four had delayed embolization. Arterial bleeding was controlled in all the cases. Sixteen patients (70%) had one or more liver-related complications; temporary biliary leak (n=11), intra-abdominal hypertension (n=14), inflammatory peritonitis (n=3), hepatic necrosis (n=3), gallbladder infarction (n=2), and compressive subcapsular hematoma (n=1). Unrecognized hepatic necrosis could have contributed to the late posttraumatic death of one patient. AE is a key element in modern management of high-grade liver injuries. Two principal indications exist in the acute postinjury phase: primary hemostatic control in hemodynamically stable or stabilized patients with radiologic computed tomography evidence of active arterial bleeding and adjunctive hemostatic control in patients with uncontrolled suspected arterial bleeding despite emergency laparotomy. Successful management of injuries of grade III upward often entails a combined angiographic and surgical approach. Awareness of the ischemic complications due to angioembolization is important.

The impact of manufacturing complexity drivers on performance-a preliminary study

NASA Astrophysics Data System (ADS)

Huah Leang, Suh; Mahmood, Wan Hasrulnizzam Wan; Rahman, Muhamad Arfauz A.

2018-03-01

Manufacturing systems, in pursuit of cost, time and flexibility optimisation are becoming more and more complex, exhibiting a dynamic and nonlinear behaviour. Unpredictability is a distinct characteristic of such behaviour and effects production planning significantly. Therefore, this study was undertaken to investigate the priority level and current achievement of manufacturing performance in Malaysia’s manufacturing industry and the complexity drivers on manufacturing productivity performance. The results showed that Malaysia’s manufacturing industry prioritised product quality and they managed to achieve a good on time delivery performance. However, for other manufacturing performance, there was a difference where the current achievement of manufacturing performances in Malaysia’s manufacturing industry is slightly lower than the priority given to them. The strong correlation of significant value for priority status was observed between efficient production levelling (finished goods) and finish product management while the strong correlation of significant value for current achievement was minimised the number of workstation and factory transportation system. This indicates that complexity drivers have an impact towards manufacturing performance. Consequently, it is necessary to identify complexity drivers to achieve well manufacturing performance.

Variability of Hormonal Stress Markers Collected from a Managed Dolphin Population

DTIC Science & Technology

2012-09-30

production and subsequent cortisol and aldosterone release, a condition that is physiologically similar to Addison’s disease. The long-term impact of this...phone: (858) 546-7090 Award Number: N000141110436 http://www.nmmf.org/ LONG-TERM GOALS Quantifying physiological indicators of stress in...cortisol and aldosterone in this species (Houser et al., 2011). Parallel processing of serum catecholamines will be performed via high-performance

Coordination strategies of crew management

NASA Technical Reports Server (NTRS)

Conley, Sharon; Cano, Yvonne; Bryant, Don

1991-01-01

An exploratory study that describes and contrasts two three-person flight crews performing in a B-727 simulator is presented. This study specifically attempts to delineate crew communication patterns accounting for measured differences in performance across routine and nonroutine flight patterns. The communication patterns in the two crews evaluated indicated different modes of coordination, i.e., standardization in the less effective crew and planning/mutual adjustment in the more effective crew.

Megacity Indicator System for Disaster Risk Management in Istanbul (MegaIST)

NASA Astrophysics Data System (ADS)

Yahya Menteşe, Emin; Kılıç, Osman; Baş, Mahmut; Khazai, Bijan; Ergün Konukcu, Betul; Emre Basmacı, Ahmet

2017-04-01

Decision makers need tools to understand the priorities and to set up benchmarks and track progress in their disaster risk reduction activities, so that they can justify their decisions and investments. In this regard, Megacity Indicator System for Disaster Risk Management (MegaIST), is developed in order to be used in disaster risk management studies, for decision makers and managers to establish right strategies and proper risk reduction actions, enhance resource management and investment decisions, set priorities, monitor progress in DRM and validate decisions taken with the aim of helping disaster oriented urban redevelopment, inform investors about risk profile of the city and providing a basis for dissemination and sharing of risk components with related stakeholders; by Directorate of Earthquake and Ground Research of Istanbul Metropolitan Municipality (IMM). MegaIST achieves these goals by analyzing the earthquake risk in three separate but complementary sub-categories consisting of "urban seismic risk, coping capacity and disaster risk management index" in an integrated way. MegaIST model fosters its analyses by presenting the outputs in a simple and user friendly format benefiting from GIS technology that ensures the adoptability of the model's use. Urban seismic risk analysis includes two components, namely; Physical Risk and Social Vulnerability Analysis. Physical risk analysis is based on the possible physical losses (such as building damage, casualties etc.) due to an earthquake while social vulnerability is considered as a factor that increases the results of the physical losses in correlation with the level of education, health, economic status and disaster awareness/preparedness of society. Coping capacity analysis is carried out with the aim of understanding the readiness of the Municipality to respond and recover from a disaster in Istanbul can be defined both in terms of the Municipality's operational capacities - the capacity of the Municipality in terms of the demand on its resources to respond to emergencies and restore services - as well as functional capacities - the policies and planning measures at the Municipality which lead to reduction of risk and protection of people. Disaster Risk Management Index (DRMI) is used as "control system" within the conceptual framework of MegaIST. This index has been developed to understand impact of corporate governance and enforcement structures and policies on total Urban Seismic Risk and in order to make the performance evaluation. Also, DRMI is composed of macro indicators that are developed in order to monitor progress in reducing disaster risk management of institution. They are presented in four broad indicator groups: Legal and Institutional Requirements, Risk Reduction Implementation and Preparedness Activities, Readiness to Respond and Recover, and Strategy and Coordination. As a result; in MegaIST, with the identification and analysis of physical and social vulnerabilities along with coping capacity and disaster risk management performance indicators; an integrated and analytical decision support system has been established to enhance DRM process and reach to a disaster resilient urban environment.

Evaluating health service quality: using importance performance analysis.

PubMed

Izadi, Azar; Jahani, Younes; Rafiei, Sima; Masoud, Ali; Vali, Leila

2017-08-14

Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item's importance from the patients' perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly. Findings Findings revealed a significant gap between service importance and performance. From the patients' viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively). Practical implications Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction. Originality/value The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.

Development of a system of indicators for sustainable port management.

PubMed

Peris-Mora, E; Diez Orejas, J M; Subirats, A; Ibáñez, S; Alvarez, P

2005-12-01

The 1998 project ECOPORT, "Towards A Sustainable Transport Network", developed by the Valencia Port Authority (VPA), established the bases for implementing an Environmental Management System (EMS) in industrial harbours. The use of data and information shall always be required to develop an efficient EMS. The objective of the present research (INDAPORT) study is to propose a system of sustainable environmental management indicators to be used by any port authorities. All activities performed within a port area are analysed for any potential environmental impacts and risks. An environmental analysis of port activities has been carried out with the objective of designing the indicators system. Twenty-one corresponding activities have been identified for large industrial ports. Subsequently, the same methodology developed to date will be later applied to other Spanish and European ports. The study has been developed by using an original system and a methodology, which simultaneously use stage diagrams and systemic models (material and energy flow charts). Multi-criteria analysis techniques were used to evaluate potential impacts (identification of factors and evaluation of impacts).

Reconciling Biodiversity Conservation and Timber Production in Mixed Uneven-Aged Mountain Forests: Identification of Ecological Intensification Pathways.

PubMed

Lafond, Valentine; Cordonnier, Thomas; Courbaud, Benoît

2015-11-01

Mixed uneven-aged forests are considered favorable to the provision of multiple ecosystem services and to the conciliation of timber production and biodiversity conservation. However, some forest managers now plan to increase the intensity of thinning and harvesting operations in these forests. Retention measures or gap creation are considered to compensate potential negative impacts on biodiversity. Our objectives were to assess the effect of these management practices on timber production and biodiversity conservation and identify potential compensating effects between these practices, using the concept of ecological intensification as a framework. We performed a simulation study coupling Samsara2, a simulation model designed for spruce-fir uneven-aged mountain forests, an uneven-aged silviculture algorithm, and biodiversity models. We analyzed the effect of parameters related to uneven-aged management practices on timber production, biodiversity, and sustainability indicators. Our study confirmed that the indicators responded differently to management practices, leading to trade-offs situations. Increasing management intensity had negative impacts on several biodiversity indicators, which could be partly compensated by the positive effect of retention measures targeting large trees, non-dominant species, and deadwood. The impact of gap creation was more mitigated, with a positive effect on the diversity of tree sizes and deadwood but a negative impact on the spruce-fir mixing balance and on the diversity of the understory layer. Through the analysis of compensating effects, we finally revealed the existence of possible ecological intensification pathways, i.e., the possibility to increase management intensity while maintaining biodiversity through the promotion of nature-based management principles (gap creation and retention measures).

Generation and evaluation of an indicator of the health system’s performance in maternal and reproductive health in Colombia: An ecological study

PubMed Central

Pinzón-Flórez, Carlos Eduardo; Fernandez-Niño, Julian Alfredo; Cardenas-Cardenas, Luz Mery; Díaz-Quijano, Diana Marcela; Ruiz-Rodriguez, Myriam; Reveiz, Ludovic; Arredondo-López, Armando

2017-01-01

Objective To generate and evaluate an indicator of the health system’s performance in the area of maternal and reproductive health in Colombia. Materials and methods An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the states were classified according to the indicator’s score. A path analysis was used to evaluate the relationship between the indicator and social determinants, with the maternal mortality ratio as the response variable. Results The factor analysis indicates that only one principal factor exists, namely "coverage and utilization of maternal healthcare services" (eigenvalue 4.35). The indicator performed best in the states of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander (Q4). The poorest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. The indicator’s behavior was found to have an association with the unsatisfied basic needs index and women’s education (β = -0.021; 95%CI -0031 to -0.01 and β 0.554; 95%CI 0.39 to 0.72, respectively). According to the path analysis, an inverse relationship exists between the proposed indicator and the behavior of the maternal mortality ratio (β = -49.34; 95%CI -77.7 to -20.9); performance was a mediating variable. Discussion The performance of the health system with respect to its management of access and coverage for maternal and reproductive health appears to function as a mediating variable between social determinants and maternal mortality in Colombia. PMID:28854236

Performance of health workers in the management of seriously sick children at a Kenyan tertiary hospital: before and after a training intervention.

PubMed

Irimu, Grace W; Gathara, David; Zurovac, Dejan; Kihara, Harrison; Maina, Christopher; Mwangi, Julius; Mbori-Ngacha, Dorothy; Todd, Jim; Greene, Alexandra; English, Mike

2012-01-01

Implementation of WHO case management guidelines for serious common childhood illnesses remains a challenge in hospitals in low-income countries. The impact of locally adapted clinical practice guidelines (CPGs) on the quality-of-care of patients in tertiary hospitals has rarely been evaluated. We conducted, in Kenyatta National Hospital, an uncontrolled before and after study with an attempt to explore intervention dose-effect relationships, as CPGs were disseminated and training was progressively implemented. The emergency triage, assessment and treatment plus admission care (ETAT+) training and locally adapted CPGs targeted common, serious childhood illnesses. We compared performance in the pre-intervention (2005) and post-intervention periods (2009) using quality indicators for three diseases: pneumonia, dehydration and severe malnutrition. The indicators spanned four domains in the continuum of care namely assessment, classification, treatment, and follow-up care in the initial 48 hours of admission. In the pre-intervention period patients' care was largely inconsistent with the guidelines, with nine of the 15 key indicators having performance of below 10%. The intervention produced a marked improvement in guideline adherence with an absolute effect size of over 20% observed in seven of the 15 key indicators; three of which had an effect size of over 50%. However, for all the five indicators that required sustained team effort performance continued to be poor, at less than 10%, in the post-intervention period. Data from the five-year period (2005-09) suggest some dose dependency though the adoption rate of the best-practices varied across diseases and over time. Active dissemination of locally adapted clinical guidelines for common serious childhood illnesses can achieve a significant impact on documented clinical practices, particularly for tasks that rely on competence of individual clinicians. However, more attention must be given to broader implementation strategies that also target institutional and organisational aspects of service delivery to further enhance quality-of-care.

Investigating Interruptions: Implications for Flightdeck Performance

NASA Technical Reports Server (NTRS)

Latorella, Kara A.

1999-01-01

A fundamental aspect of multiple task management is attending to new stimuli and integrating associated task requirements into an ongoing task set; this is "interruption management" (IM). Anecdotal evidence and field studies indicate the frequency and consequences of interruptions, however experimental investigations of mechanisms influencing IM are scarce. Interruptions on commercial flightdecks are numerous, of various forms, and have been cited as contributing factors in many aviation incident and accident reports. This research grounds an experimental investigation of flightdeck interruptions in a proposed IM stage model. This model organizes basic research, identifies influencing mechanisms, and suggests appropriate dependent measures for IM. Fourteen airline pilots participated in a flightdeck simulation experiment to investigate the general effects of performing an interrupting task and interrupted procedure, and the effects of specific task factors: (1) modality; (2) embeddedness, or goal-level, of an interruption; (3) strength of association, or coupling-strength, between interrupted tasks; (4) semantic similarity; and (5) environmental stress. General effects of interruptions were extremely robust. All individual task factors significantly affected interruption management, except "similarity." Results extend the Interruption Management model, and are interpreted for their implications for interrupted flightdeck performance and intervention strategies for mitigating their effects on the flightdeck.

The Design of a High Performance Earth Imagery and Raster Data Management and Processing Platform

NASA Astrophysics Data System (ADS)

Xie, Qingyun

2016-06-01

This paper summarizes the general requirements and specific characteristics of both geospatial raster database management system and raster data processing platform from a domain-specific perspective as well as from a computing point of view. It also discusses the need of tight integration between the database system and the processing system. These requirements resulted in Oracle Spatial GeoRaster, a global scale and high performance earth imagery and raster data management and processing platform. The rationale, design, implementation, and benefits of Oracle Spatial GeoRaster are described. Basically, as a database management system, GeoRaster defines an integrated raster data model, supports image compression, data manipulation, general and spatial indices, content and context based queries and updates, versioning, concurrency, security, replication, standby, backup and recovery, multitenancy, and ETL. It provides high scalability using computer and storage clustering. As a raster data processing platform, GeoRaster provides basic operations, image processing, raster analytics, and data distribution featuring high performance computing (HPC). Specifically, HPC features include locality computing, concurrent processing, parallel processing, and in-memory computing. In addition, the APIs and the plug-in architecture are discussed.

The occupational safety and health scorecard--a business case example for strategic management.

PubMed

Köper, Birgit; Möller, Klaus; Zwetsloot, Gerard

2009-12-01

Human resources and health issues are crucial in terms of corporate competitiveness. However, systematic, continuous and strategically aligned occupational safety and health (OSH) management is scarcely applied in companies. One major reason for this could be the lack of generally accepted and standardised OSH control methods. Our objective was thus to conceptualize a method by which qualitative factors such as human resources and OSH aspects contribute to the performance or value-added layer of an organization. We developed a business case based on the well-known and accepted Balanced Scorecard approach, which we adapted and applied to the management of OSH issues. The concept was implemented in the course of a comprehensive case study at a German automobile manufacturer. We gathered health as well as finance data in order to test which health-related indicators had an impact on financial performance. The demonstration of, and reporting on, how the promotion of workplace health contributes strategically to the organization is crucial for both health and human resource managers. Based on multivariate regression analyses, our main finding was that the Balanced Scorecard approach is an adequate means to control OSH issues in terms of strategic health management. Our analyses demonstrated that health-related interventions contribute significantly to performance aspects such as quality, productivity, absenteeism, and cost reduction. Therefore, the financial impact of health-related aspects / interventions could be demonstrated by means of the OSH scorecard. The availability and quality of health data within the context of overall corporate performance data needs to be improved in order to bridge OSH-related and performance issues of an organization.

Managing adaptively for multifunctionality in agricultural systems

USGS Publications Warehouse

Hodbod, Jennifer; Barreteau, Olivier; Allen, Craig R.; Magda, Danièle

2016-01-01

The critical importance of agricultural systems for food security and as a dominant global landcover requires management that considers the full dimensions of system functions at appropriate scales, i.e. multifunctionality. We propose that adaptive management is the most suitable management approach for such goals, given its ability to reduce uncertainty over time and support multiple objectives within a system, for multiple actors. As such, adaptive management may be the most appropriate method for sustainably intensifying production whilst increasing the quantity and quality of ecosystem services. However, the current assessment of performance of agricultural systems doesn’t reward ecosystem service provision. Therefore, we present an overview of the ecosystem functions agricultural systems should and could provide, coupled with a revised definition for assessing the performance of agricultural systems from a multifunctional perspective that, when all satisfied, would create adaptive agricultural systems that can increase production whilst ensuring food security and the quantity and quality of ecosystem services. The outcome of this high level of performance is the capacity to respond to multiple shocks without collapse, equity and triple bottom line sustainability. Through the assessment of case studies, we find that alternatives to industrialized agricultural systems incorporate more functional goals, but that there are mixed findings as to whether these goals translate into positive measurable outcomes. We suggest that an adaptive management perspective would support the implementation of a systematic analysis of the social, ecological and economic trade-offs occurring within such systems, particularly between ecosystem services and functions, in order to provide suitable and comparable assessments. We also identify indicators to monitor performance at multiple scales in agricultural systems which can be used within an adaptive management framework to increase resilience at multiple scales.

Managing adaptively for multifunctionality in agricultural systems.

PubMed

Hodbod, Jennifer; Barreteau, Olivier; Allen, Craig; Magda, Danièle

2016-12-01

The critical importance of agricultural systems for food security and as a dominant global landcover requires management that considers the full dimensions of system functions at appropriate scales, i.e. multifunctionality. We propose that adaptive management is the most suitable management approach for such goals, given its ability to reduce uncertainty over time and support multiple objectives within a system, for multiple actors. As such, adaptive management may be the most appropriate method for sustainably intensifying production whilst increasing the quantity and quality of ecosystem services. However, the current assessment of performance of agricultural systems doesn't reward ecosystem service provision. Therefore, we present an overview of the ecosystem functions agricultural systems should and could provide, coupled with a revised definition for assessing the performance of agricultural systems from a multifunctional perspective that, when all satisfied, would create adaptive agricultural systems that can increase production whilst ensuring food security and the quantity and quality of ecosystem services. The outcome of this high level of performance is the capacity to respond to multiple shocks without collapse, equity and triple bottom line sustainability. Through the assessment of case studies, we find that alternatives to industrialized agricultural systems incorporate more functional goals, but that there are mixed findings as to whether these goals translate into positive measurable outcomes. We suggest that an adaptive management perspective would support the implementation of a systematic analysis of the social, ecological and economic trade-offs occurring within such systems, particularly between ecosystem services and functions, in order to provide suitable and comparable assessments. We also identify indicators to monitor performance at multiple scales in agricultural systems which can be used within an adaptive management framework to increase resilience at multiple scales. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Surgical treatment of blunt liver trauma, indications for surgery and results].

PubMed

Morales Uribe, Carlos H; López, Carolina Arenas; Cote, Juan Camilo Correa; Franco, Sebastián Tobón; Saldarriaga, Maria Fernanda; Mosquera, Jackson; Villegas Lanau, María I

2014-01-01

The liver is the most frequently injured organ in blunt abdominal trauma. Patients that are hemodynamically unstable must undergo inmmediate surgical treatment. There are 2 surgical approaches for these patients; Anatomical Liver resection or non-anatomic liver resection. Around 80-90% of patients are candidates for non-operative management. -Several risk factors have been studied to select the patients most suited for a non operative management. We performed a retrospective study based on a prospective database. We searched for risk factors related to immediate surgical management and failed non-operative management. We also described the surgical procedures that were undertaken in this cohort of patients and their outcomes and complications. During the study period 117 patients presented with blunt liver trauma. 19 patients (16.2%) required a laparotomy during the initial 24h after their admission. There were 11 deaths (58%) amongst these patients. Peri-hepatic packing and suturing were the most common procedures performed. A RTS Score<7.8 (RR: 7.3; IC 95%: 1.8-30.1), and ISS Score >20 (RR 2,5 IC 95%: 1.0-6.7), and associated intra-abdominal injuries (RR: 2.95; IC 95%: 1.25-6.92) were risk factors for immediate surgery. In 98 (83.7%) patients a non-operative management was performed. 7 patients had a failed non-operative management. The need for immediate surgical management is related to the presence of associated intra-abdominal injuries, and the ISS and RTS scores. In this series the most frequently performed procedure for blunt liver trauma was peri-hepatic packing. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

[Potential for the survey of quality indicators based on a national emergency department registry : A systematic literature search].

PubMed

Hörster, A C; Kulla, M; Brammen, D; Lefering, R

2018-06-01

Emergency department processes are often key for successful treatment. Therefore, collection of quality indicators is demanded. A basis for the collection is systematic, electronic documentation. The development of paper-based documentation into an electronic and interoperable national emergency registry is-besides the establishment of quality management for emergency departments-a target of the AKTIN project. The objective of this research is identification of internationally applied quality indicators. For the investigation of the current status of quality management in emergency departments based on quality indicators, a systematic literature search of the database PubMed, the Cochrane Library and the internet was performed. Of the 170 internationally applied quality indicators, 25 with at least two references are identified. A total of 10 quality indicators are ascertainable by the data set. An enlargement of the data set will enable the collection of seven further quality indicators. The implementation of data of care behind the emergency processes will provide eight additional quality indicators. This work was able to show that the potential of a national emergency registry for the establishment of quality indicators corresponds with the international systems taken into consideration and could provide a comparable collection of quality indicators.

The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.

PubMed

Tu, Jack V; Maclagan, Laura C; Ko, Dennis T; Atzema, Clare L; Booth, Gillian L; Johnston, Sharon; Tu, Karen; Lee, Douglas S; Bierman, Arlene; Hall, Ruth; Bhatia, R Sacha; Gershon, Andrea S; Tobe, Sheldon W; Sanmartin, Claudia; Liu, Peter; Chu, Anna

2017-04-25

High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care. We used a 2-stage modified Delphi panel process to rate potential indicators, which were identified from the literature and national cardiovascular organizations. The top-rated indicators were pilot tested to determine their measurement feasibility with the use of data routinely collected in the Canadian health care system. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes. The indicators reflect the major cardiovascular risk factors including smoking, obesity, hypertension, diabetes, dyslipidemia and atrial fibrillation. All indicators were determined to be amenable to measurement with the use of population-based administrative (physician claims, hospital admission, laboratory, medication), survey or electronic medical record databases. The Cardiovascular Health in Ambulatory Care Research Team indicators of primary prevention performance provide a framework for the measurement of cardiovascular primary prevention efforts in Canada. The indicators may be used by clinicians, researchers and policy-makers interested in measuring and improving the prevention of cardiovascular disease in ambulatory care settings. Copyright 2017, Joule Inc. or its licensors.

Essential Concepts in Modern Health Services

PubMed Central

El Taguri, A

2008-01-01

Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

Ethnic disparities in coronary heart disease management and pay for performance in the UK.

PubMed

Millett, Christopher; Gray, Jeremy; Wall, Martin; Majeed, Azeem

2009-01-01

Few pay for performance schemes have been subject to rigorous evaluation, and their impact on disparities in chronic disease management is uncertain. To examine disparities in coronary heart disease management and intermediate clinical outcomes within a multiethnic population before and after the introduction of a major pay for performance initiative in April 2004. Comparison of two cross-sectional surveys using electronic general practice records. Thirty-two family practices in south London, United Kingdom (UK). Two thousand eight hundred and ninety-one individuals with coronary heart disease registered with participating practices in 2003 and 3,101 in 2005. Percentage achievement by ethnic group of quality indicators in the management of coronary heart disease The proportion of patients reaching national treatment targets increased significantly for blood pressure (51.2% to 58.9%) and total cholesterol (65.7% to 73.8%) after the implementation of a major pay for performance initiative in April 2004. Improvements in blood pressure control were greater in the black group compared to whites, with disparities evident at baseline being attenuated (black 54.8% vs. white 58.3% reaching target in 2005). Lower recording of blood pressure in the south Asian group evident in 2003 was attenuated in 2005. Statin prescribing remained significantly lower (p < 0.001) in the black group compared with the south Asian and white groups after the implementation of pay for performance (black 74.8%, south Asian 83.8%, white 80.2% in 2005). The introduction of pay for performance incentives in UK primary care has been associated with better and more equitable management of coronary heart disease across ethnic groups.

Applying the balanced scorecard to local public health performance measurement: deliberations and decisions

PubMed Central

Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

2009-01-01

Background All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Discussion Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? Summary An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process. PMID:19426508

Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

PubMed

Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

2009-05-08

All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

Evaluating the soil physical quality under long-term field experiments in Southern Italy

NASA Astrophysics Data System (ADS)

Castellini, Mirko; Stellacci, Anna Maria; Iovino, Massimo; Rinaldi, Michele; Ventrella, Domenico

2017-04-01

Long-term field experiments performed in experimental farms are important research tools to assess the soil physical quality (SPQ) given that relatively stable conditions can be expected in these soils. However, different SPQ indicators may sometimes provide redundant or conflicting results, making difficult an SPQ evaluation (Castellini et al., 2014). As a consequence, it is necessary to apply appropriate statistical procedures to obtain a minimum set of key indicators. The study was carried out at the Experimental Farm of CREA-SCA (Foggia) in two long-term field experiments performed on durum wheat. The first long-term experiment is aiming at evaluating the effects of two residue management systems (burning, B or soil incorporation of crop residues, I) while the second at comparing the effect of tillage (conventional tillage, CT) and sod-seeding (direct drilling, DD). In order to take into account both optimal and non-optimal soil conditions, five SPQ indicators were monitored at 5-6 sampling dates during the crop season (i.e., between November and June): soil bulk density (BD), macroporosity (PMAC), air capacity (AC), plant available water capacity (PAWC) and relative field capacity (RFC). Two additional data sets, collected on DD plot in different cropping seasons and in Sicilian soils differing for texture, depth and land use (N=140), were also used with the aim to check the correlation among indicators. Impact of soil management was assessed by comparing SPQ evaluated under different management systems with optimal reference values reported in literature. Two techniques of multivariate analysis (principal component analysis, PCA and stepwise discriminant analysis, SDA) were applied to select the most suitable indicator to facilitate the judgment on SPQ. Regardless of the considered management system, sampling date or auxiliary data set, correlation matrices always showed significant negative relationships between RFC and AC. Decreasing RFC at increasing AC is expected as both indicators depends on soil water contents at saturation and field capacity. Our results reinforce the suggestion that one of the two indicators can be neglected (Cullotta et al., 2016) even if further investigations are necessary to choose the most accurate and/or widely applicable indicator since different optimal ranges were suggested in literature. A positive significant correlation was also generally found between PMAC and AC. PCA analysis identified RFC and AC as the main indicators that explain most of the data variation. When the data collected at the different sampling dates were pooled together, in both experiments the first principal component explained the highest proportion of total variance (67.9% and 81.5%, respectively for residue management and tillage) and RFC showed the highest loadings, followed by AC and PMAC. SDA provided consistent results and RFC was selected as the main variable to assess the effects of tillage. Conversely, the residue management had no effect on SPQ as indicated by negligible differences between indicators. Finally, our results suggest that RFC always reached optimal and steady values between April and June. *The work was supported by the projects "STRATEGA, Sperimentazione e TRAsferimento di TEcniche innovative di aGricoltura conservativA", financed by Regione Puglia - Servizio Agricoltura, and "DESERT, Low-cost water desalination and sensor technology compact module" financed by ERANET-WATERWORKS 2014. References Castellini, M., M. Niedda, M. Pirastru, and D. Ventrella. 2014. Temporal changes of soil physical quality under two residue management systems. Soil Use Management. 30:423-434. doi:10.1111/sum.12137 Cullotta, S., V. Bagarello, G. Baiamonte, G. Gugliuzza, M. Iovino, D.S. La Mela Veca, F. Maetzke, V. Palmeri, and S. Sferlazza. 2016. Comparing Different Methods to Determine Soil Physical Quality in a Mediterranean Forest and Pasture Land. Soil Sci. Soc. Am. J. 80:1038-1056. doi:10.2136/sssaj2015.12.0447

Prevalence of Invalid Performance on Baseline Testing for Sport-Related Concussion by Age and Validity Indicator.

PubMed

Abeare, Christopher A; Messa, Isabelle; Zuccato, Brandon G; Merker, Bradley; Erdodi, Laszlo

2018-03-12

Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator. This retrospective, cross-sectional study included data collected between January 1, 2012, and December 31, 2016, from a clinical referral center in the Midwestern United States. Participants included 7897 consecutively tested, equivalently proportioned male and female athletes aged 10 to 21 years, who completed baseline neurocognitive testing for the purpose of concussion management. Baseline assessment was conducted with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT), a computerized neurocognitive test designed for assessment of concussion. Base rates of failure on published ImPACT validity indicators were compared within and across age groups. Hypotheses were developed after data collection but prior to analyses. Of the 7897 study participants, 4086 (51.7%) were male, mean (SD) age was 14.71 (1.78) years, 7820 (99.0%) were primarily English speaking, and the mean (SD) educational level was 8.79 (1.68) years. The base rate of failure ranged from 6.4% to 47.6% across individual indicators. Most of the sample (55.7%) failed at least 1 of 4 validity indicators. The base rate of failure varied considerably across age groups (117 of 140 [83.6%] for those aged 10 years to 14 of 48 [29.2%] for those aged 21 years), representing a risk ratio of 2.86 (95% CI, 2.60-3.16; P < .001). The results for base rate of failure were surprisingly high overall and varied widely depending on the specific validity indicator and the age of the examinee. The strong age association, with 3 of 4 participants aged 10 to 12 years failing validity indicators, suggests that the clinical interpretation and utility of baseline testing in this age group is questionable. These findings underscore the need for close scrutiny of performance validity indicators on baseline testing across age groups.

Graduate capabilities for health service managers: reconfiguring health management education @UNSW.

PubMed

Meyer, Lois D; Hodgkinson, Alan R; Knight, Rosemary; Ho, Maria Theresa; di Corpo, Sophie K; Bhalla, Sonal

2007-08-01

The Master of Health Administration program at UNSW was extensively revised in 2006 to ensure that it effectively meets the challenging and dynamic environment of health service managers in local and global health contexts. This paper describes the innovative approach to the redesign of the health management program within the Faculty of Medicine. It outlines the method and considerations undertaken, particularly in identifying and embedding new graduate capabilities within the program. The paper concludes that using an outcomes-based approach and engaging with key stakeholders provides opportunity to identify and promote critical capabilities needed by managers to support the challenges confronting health services, including workforce flexibility. Further research is required on how such curriculum initiatives might impact on the performance of health service managers, but initial indications are that the health industry recognises the need and value of this approach.

77 FR 59902 - Western Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... Assignment of Rapporteurs. 3. Status of the 110th SSC Meeting Recommendations. 4. Report from the Pacific... Sustainability Foundation (ISSF) Research. C. Tracking the Changes of Economic Performance Indicators for the... Set Swordfish Fishery. E. American Samoa and Hawaii Longline Quarterly Reports. F. International...

Implementation uncertainty when using recreational hunting to manage carnivores

PubMed Central

Bischof, Richard; Nilsen, Erlend B; Brøseth, Henrik; Männil, Peep; Ozoliņš, Jaānis; Linnell, John D C; Bode, Michael

2012-01-01

1. Wildlife managers often rely on resource users, such as recreational or commercial hunters, to achieve management goals. The use of hunters to control wildlife populations is especially common for predators and ungulates, but managers cannot assume that hunters will always fill annual quotas set by the authorities. It has been advocated that resource management models should account for uncertainty in how harvest rules are realized, requiring that this implementation uncertainty be estimated. 2. We used a survival analysis framework and long-term harvest data from large carnivore management systems in three countries (Estonia, Latvia and Norway) involving four species (brown bear, grey wolf, Eurasian lynx and wolverine) to estimate the performance of hunters with respect to harvest goals set by managers. 3. Variation in hunter quota-filling performance was substantial, ranging from 40% for wolverine in Norway to nearly 100% for lynx in Latvia. Seasonal and regional variation was also high within country–species pairs. We detected a positive relationship between the instantaneous potential to fill a quota slot and the relative availability of the target species for both wolverine and lynx in Norway. 4. Survivor curves and hazards – with survival time measured as the time from the start of a season until a quota slot is filled – can indicate the extent to which managers can influence harvest through adjustments of season duration and quota limits. 5. Synthesis and applications. We investigated seven systems where authorities use recreational hunting to manage large carnivore populations. The variation and magnitude of deviation from harvest goals was substantial, underlining the need to incorporate implementation uncertainty into resource management models and decisions-making. We illustrate how survival analysis can be used by managers to estimate the performance of resource users with respect to achieving harvest goals set by managers. The findings in this study come at an opportune time given the growing popularity of management strategy evaluation (MSE) models in fisheries and a push towards incorporating MSE into terrestrial harvest management. PMID:23197878

Cystoscopic suture removal by Holmium-YAG laser after Burch procedure

PubMed Central

Karaşahin, Emre Kazım; Esin, Sertaç; Alanbay, İbrahim; Ercan, Mutlu Cihangir; Mutlu, Erol; Başer, İskender; Basal, Şeref

2011-01-01

Burch colposuspension remains one of the successful operations performed for stress incontinence. Accidental suturing of the bladder wall during the procedure or subsequent erosion may lead to lower urinary tract symptoms. Diagnosis and management of these sutures indicate precise evaluation for which a 70 degree cystoscope is used. In selected cases, Holmium-YAG laser may enable us to manage long-standing, encrustated neglected sutures. Here we would like to report successful removal of intravesical sutures using the Holmium-YAG laser. PMID:24591960

Herd monitoring to optimise fertility in the dairy cow: making the most of herd records, metabolic profiling and ultrasonography (research into practice).

PubMed

Smith, R F; Oultram, J; Dobson, H

2014-05-01

Fertility performance is intrinsically linked to the quality of the animal environment, overall management and nutrition. This review describes the use of dairy herd records, metabolic profiles and ultrasonographic findings at veterinary fertility examinations to monitor and manage dairy herd fertility. After calving, a cow has to overcome a series of physiological hurdles before establishing a pregnancy. The selection of timely key performance indicators (KPIs) that monitor specific events in the postpartum and service periods is vital to correctly identify problems and their potential causes that hopefully can be rectified. Cumulative sum charts are the timeliest monitors of efficiency of detection of oestrus, insemination outcome and relationship between postpartum events and fertility, with the point of inflection indicating when a change took place. Other KPIs use data from specific cohorts, adding an inherent delay to when change is indicated. Metabolic profiles and milk constituent data allow monitoring of nutritional adequacy and developments to offer new possibilities of on-farm systems for regular measurements of milk constituents (including progesterone) and energy status. Examination of the reproductive tract can be used to indicate individual and herd fertility status but the currently available detail is under used. Recent advances in ultrasonography can improve the diagnosis of reproductive tract pathophysiology still further but the clinical use of these methods in veterinary practice needs further evaluation. Development of new KPIs to exploit research findings are needed to ensure this knowledge is used to improve on-farm performance.

Self-management model in the scheduling of successive appointments in rheumatology.

PubMed

Castro Corredor, David; Cuadra Díaz, José Luis; Mateos Rodríguez, Javier José; Anino Fernández, Joaquín; Mínguez Sánchez, María Dolores; de Lara Simón, Isabel María; Tébar, María Ángeles; Añó, Encarnación; Sanz, María Dolores; Ballester, María Nieves

2018-01-08

The rheumatology service of Ciudad Real Hospital, located in an autonomous community of that same name that is nearly in the center of Spain, implemented a self-management model of successive appointments more than 10 years ago. Since then, the physicians of the department schedule follow-up visits for their patients depending on the disease, its course and ancillary tests. The purpose of this study is to evaluate and compare the self-management model for successive appointments in the rheumatology service of Ciudad Real Hospital versus the model of external appointment management implemented in 8 of the hospital's 15 medical services. A comparative and multivariate analysis was performed to identify variables with statistically significant differences, in terms of activity and/or performance indicators and quality perceived by users. The comparison involved the self-management model for successive appointments employed in the rheumatology service of Ciudad Real Hospital and the model for external appointment management used in 8 hospital medical services between January 1 and May 31, 2016. In a database with more than 100,000 records of appointments involving the set of services included in the study, the mean waiting time and the numbers of non-appearances and rescheduling of follow-up visits in the rheumatology department were significantly lower than in the other services. The number of individuals treated in outpatient rheumatology services was 7,768, and a total of 280 patients were surveyed (response rate 63.21%). They showed great overall satisfaction, and the incidence rate of claims was low. Our results show that the self-management model of scheduling appointments has better results in terms of activity indicators and in quality perceived by users, despite the intense activity. Thus, this study could be fundamental for decision making in the management of health care organizations. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving.

PubMed

Shaw, W S; Feuerstein, M; Lincoln, A E; Miller, V I; Wood, P M

2001-08-01

A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.

Linking Governance to Sustainable Management Outcomes: Applying Dynamic Indicator Profiles to River Basin Organization Case Studies around the World.

NASA Astrophysics Data System (ADS)

Wei, Y.; Bouckaert, F. W.

2017-12-01

Institutional best practice for integrated river basin management advocates the river basin organisation (RBO) model as pivotal to achieve sustainable management outcomes and stakeholder engagement. The model has been widely practiced in transboundary settings and is increasingly adopted at national scales, though its effectiveness remains poorly studied. A meta-analysis of four river basins has been conducted to assess governance models and linking it to evaluation of biophysical management outcomes. The analysis is based on a Theory of Change framework, and includes functional dynamic governance indicator profiles, coupled to sustainable ecosystem management outcome profiles. The governance and outcome profiles, informed by context specific indicators, demand that targets for setting objectives are required in multiple dimensions, and trajectory outlines are a useful tool to track progress along the journey mapped out by the Theory of Change framework. Priorities, trade-offs and objectives vary in each basin, but the diagnostics tool allows comparison between basins in their capacity to reach targets through successive evaluations. The distance between capacity and target scores determines how program planning should be prioritized and resources allocated for implementation; this is a dynamic process requiring regular evaluations and adaptive management. The findings of this study provide a conceptual framework for combining dimensions of integrated water management principles that bridge tensions between (i) stakeholder engagement and participatory management (bottom-up approach) using localized knowledge and (ii) decision-making, control-and-command, system-scale, accountable and equitable management (top-down approach).The notion of adaptive management is broadened to include whole-of-program learnings, rather than single hypothesis based learning adjustments. This triple loop learning combines exploitative methods refinement with explorative evaluation of underlying paradigms. The significance of these findings suggests that in order to achieve effective management outcomes, a framework is required that combines governance performance with evaluations of bio-physical outcomes.

Focused use of drug screening in overdose patients increases impact on management.

PubMed

Erdmann, Andreas; Werner, Dominique; Hugli, Olivier; Yersin, Bertrand

2015-01-01

Drug poisoning is a common cause for attendance in the emergency department. Several toxicology centres suggest performing urinary drug screens, even though they rarely influence patient management. Measuring the impact on patient management, in a University Emergency Department with approximately 40 000 admissions annually, of a rapid urinary drug screening test using specifically focused indications. Drug screening was restricted to patients having a first psychotic episode or cases demonstrating respiratory failure, coma, seizures, a sympathomimetic toxidrome, severe opiate overdose necessitating naloxone, hypotension, ventricular arrhythmia, acquired long QT or QRS >100 ms, and high-degree heart block. Retrospective analysis of Triage® TOX drug screen tests performed between September 2009 and November 2011, and between January 2013 and March 2014. A total of 262 patients were included, mean age 35 ± 14.6 (standard deviation) years, 63% men; 29% poisoning with alcohol, and 2.3% deaths. Indications for testing were as follows: 34% were first psychotic episodes; 20% had acute respiratory failure; 16% coma; 8% seizures; 8% sympathomimetic toxidromes; 7% severe opioid toxidromes; 4% hypotension; 3% ventricular arrhythmias or acquired long QT intervals on electrocardiogram. A total of 78% of the tests were positive (median two substances, maximum five). The test resulted in drug-specific therapy in 6.1%, drug specific diagnostic tests in 13.3 %, prolonged monitoring in 10.7% of methadone-positive tests, and psychiatric admission in 4.2%. Overall, 34.3% tests influenced patient management. In contrast to previous studies showing modest effects of toxicological testing, restricted use of rapid urinary drug testing increases the impact on management of suspected overdose patients in the ED.

[Monitoring evaluation system for high-specialty hospitals].

PubMed

Fajardo Dolci, Germán; Aguirre Gas, Héctor G; Robledo Galván, Héctor

2011-01-01

Hospital evaluation is a fundamental process to identify medical units' objective compliance, to analyze efficiency of resource use and allocation, institutional values and mission alignment, patient safety and quality standards, contributions to research and medical education, and the degree of coordination among medical units and the health system as a whole. We propose an evaluation system for highly specialized regional hospitals through the monitoring of performance indicators. The following are established as base thematic elements in the construction of indicators: safe facilities and equipment, financial situation, human resources management, policy management, organizational climate, clinical activity, quality and patient safety, continuity of care, patients' and providers' rights and obligations, teaching, research, social responsibility, coordination mechanisms. Monitoring refers to the planned and systematic evaluation of valid and reliable indicators, aimed at identifying problems and opportunity areas. Moreover, evaluation is a powerful tool to strengthen decision-making and accountability in medical units.

Managing serious clinical deterioration in a tertiary hospital in Hong Kong: from indicators development to multiple measures in reducing the rates.

PubMed

Ho, Jasperine Ka Yee; Lee, Quinnie; Lam, Jaden Chun Ho; Tang, Kam Shing

2017-06-01

Timely detection and management of acutely deteriorating patients can save lives. Tuen Mun Hospital (TMH), a 1800-bed acute tertiary hospital serving more than 1.06 million populations in Hong Kong, is exploring to quantitatively monitor serious clinical deterioration (SCD) and uses it to guide patient care improvement initiatives. Literature review on definition and measurement of SCD was conducted. Monthly SCD rates of TMH were first calculated according to the published methodology and benchmarked against those of international centres. A refined composite clinical indicator good for local use was compiled. In the second phase, p-control charts of SCD have been plotted based on cumulative data. TMH's performance was comparable with that of international centres. SCD on p-control charts has been plotting since January 2013. There were peaks in all 4 SCD rates during the winter surge period in 2013-2014. In the third phase, multiple measures have been taking to reduce the SCD rates including targeting the 3 main factors of winter surge situation. We are delighted to observe that the pattern did not repeat in the rate of cardiac arrest without do not attempt cardiopulmonary resuscitation (DNACPR) and rate of death without DNACPR in the same period in 2014-2015. SCD becomes a clinical governance tool to monitor the performance of clinical teams in treating acutely deteriorating patients in TMH. Any abnormal patterns or indications of special cause variations in the control charts would alert leaders to look for root causes of special cause variations and manage accordingly. We hope that this project will extend to corporate level and become a sustainable clinical indicator to guide audits, quality improvement initiatives and strategic planning. © 2016 John Wiley & Sons, Ltd.

Ankle instability.

PubMed

Ferran, Nicholas A; Oliva, Francesco; Maffulli, Nicola

2009-06-01

Acute ankle sprains are common, and if inadequately treated may result in chronic instability. Lateral ankle injuries are most common, with deltoid injuries rare and associated with ankle fractures/dislocation. Medial ankle instability is rare. Functional management of acute lateral ankle sprains is the treatment of choice, with acute ligament repair reserved for athletes. Chronic lateral ankle instability is initially managed conservatively, however, failure of rehabilitation is an indication for surgical management. Nonanatomic tenodesis reconstructions have poor long-term results, sacrifice peroneal tendons, and disrupt normal ankle and hindfoot biomechanics. Anatomic repair of the anterior talofibular and calcaneofibular ligaments is recommended when the quality of the ruptured ligaments permits. Anatomic reconstruction with autograft or allograft should be performed when ligaments are attenuated. The role of arthroscopic reconstruction is evolving. Ankle arthroscopy should be performed at the time of repair or reconstruction and should address any other intra-articular causes of pain.

Assessment of the municipal solid waste management system in Accra, Ghana: A 'Wasteaware' benchmark indicator approach.

PubMed

Oduro-Appiah, Kwaku; Scheinberg, Anne; Mensah, Anthony; Afful, Abraham; Boadu, Henry Kofi; de Vries, Nanne

2017-11-01

This article assesses the performance of the city of Accra, Ghana, in municipal solid waste management as defined by the integrated sustainable waste management framework. The article reports on a participatory process to socialise the Wasteaware benchmark indicators and apply them to an upgraded set of data and information. The process has engaged 24 key stakeholders for 9 months, to diagram the flow of materials and benchmark three physical components and three governance aspects of the city's municipal solid waste management system. The results indicate that Accra is well below some other lower middle-income cities regarding sustainable modernisation of solid waste services. Collection coverage and capture of 75% and 53%, respectively, are a disappointing result, despite (or perhaps because of) 20 years of formal private sector involvement in service delivery. A total of 62% of municipal solid waste continues to be disposed of in controlled landfills and the reported recycling rate of 5% indicates both a lack of good measurement and a lack of interest in diverting waste from disposal. Drains, illegal dumps and beaches are choked with discarded bottles and plastic packaging. The quality of collection, disposal and recycling score between low and medium on the Wasteaware indicators, and the scores for user inclusivity, financial sustainability and local institutional coherence are low. The analysis suggests that waste and recycling would improve through greater provider inclusivity, especially the recognition and integration of the informal sector, and interventions that respond to user needs for more inclusive decision-making.

Assessment of Primary Health Care in the Treatment of Tuberculosis in a Brazilian Locality of the International Triple Frontier.

PubMed

Silva-Sobrinho, Reinaldo Antonio; Wysocki, Anneliese Domingues; Scatena, Lúcia Marina; Pinto, Erika Simone Galvão; Beraldo, Aline Ale; Andrade, Rubia Laine Paula; Zilly, Adriana; Munhak da Silva, Rosane Meire; Gomes, Michela Prestes; Mayer, Paulo César Morales; Ruffino-Netto, Antonio; Villa, Tereza Cristina Scatena

2017-01-01

To evaluate the performance of Primary Health Care (PHC) in treatment of TB patients in a triple international border municipality. The present study was an evaluative survey of cross-sectional and quantitative approach conducted with 225 PHC healthcare professionals. Data was collected through a structured and validated instrument, which provided five indicators of "structure" and four indicators of "process" classified as unsatisfactory, regular or satisfactory. The "structure" component was unsatisfactory for the indicator of professionals involved in TB care and training, and regular for the indicator of connection between the units and other levels of care. The "process" component was regular for the indicators of TB information, directly observed treatment and reference and counter reference on TB, and unsatisfactory for external actions on TB control. The "structure" and "process" components points out some weaknesses in terms of management and organization of human resources. Low frequency of training and the turnover influenced the involvement of professionals. Elements of "structure" and "process" show the need for investing in the PHC team and improving the clinical management of cases.

Review of recycling performance indicators: A study on collection rate in Taiwan

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

Wen Lihchyi; Lin Chunhsu; Lee, Soo-cheol

2009-08-15

The Taiwan Environmental Protection Administration (Taiwan EPA) launched a national Extended Producer Responsibility (EPR) system after integrating eight private recycling organizations in 1998. After that, the environmental performance of the EPR system brought a lot of attention to policy makers. Many studies show positive environmental effects of the EPR system in Taiwan. However, there are controversial questions remained, such as whether the performance indicators used are the right choice to estimate the environmental effects of the recycling policy? Can those estimated results really reflect the performance of the system? This paper would therefore like to more accurately evaluate the performancemore » indicators of the EPR system based on data observed over the past decade in Taiwan. In the process of evaluating the performance indicators, we have found that the collection rates for durable goods are often ignored in countries that pursue a zero waste policy. This may affect the actual recycling outcome and resource direction targeted by producers. However, in order for the collection rate to be adopted as a policy indicator, how to estimate the amounts of retired or waste products during a period is critical. In this paper, we estimate the collection rate for electrical and electronic waste by using the survival analysis and ownership data analysis approaches. We also provide a comparison of both approaches and put forward suggestions for directions in the future in solid waste management.« less

The role of work-related and personal factors in diabetes self-management.

PubMed

Weijman, Iris; Ros, Wynand J G; Rutten, Guy E H M; Schaufeli, Wilmar B; Schabracq, Marc J; Winnubst, Jacques A M

2005-10-01

The aim of this study was to investigate how factors in the workplace and personal factors are related to the frequency with which people with diabetes perform self-management activities and the degree to which they do or do not experience the performing of self-management activities as a burden. Two hundred and ninety-two employees with insulin-treated diabetes completed questionnaires on socio-demographic and illness-related background variables, work experience, diabetes self-efficacy, social support outside of work, coping styles and self-management activities. The results indicate that employees who reported a high workload were more likely to perceive injecting insulin as a burden. The level of social support was positively related to the frequency of dietary self-management in type 2 diabetes and negatively related to the sense of being burdened by dietary self-management in type 1 diabetes. With respect to personal factors, we found that a diabetes avoidance coping style was associated particularly with infrequent blood glucose monitoring and a high sense of being burdened by blood glucose monitoring. Individuals with a low level of self-efficacy were more likely to perceive all types of self-management activities as a burden. These results may guide health professionals when counseling individuals with diabetes.

Impact of yoga way of life on organizational performance

PubMed Central

Adhia, Hasmukh; Nagendra, HR; Mahadevan, B

2010-01-01

Background: Organizational performance can be attributed to a number of factors. However, there are certain organizational factors, the presence or absence of which can determine the success or failure of the organization. There are different ways in which organizations try to improve their performance by working on such factors. In the research presented in this article, an attempt is made to find out whether adoption of the Yoga Way of Life by managers can have a positive impact on such organizational performance indicators. Aims: To measure effect of yoga way of life on five different indicators through an empirical study. Materials and Methods: The five indicators are job satisfaction, job involvement, goal orientation, affective organizational commitment and organizational citizenship behavior. Statistics Analysis: Pre- and post-data was measured using self-reported questionnaire. Independent T-test (Paired) and Pearson’s correlation test were conducted using SPSS. Results and Conclusion: The results of the study show that Yoga has a significant positive impact on four out of five of these indicators. Only job involvement does not show significant improvement. The construct used for measuring job involvement had a Chronbach alpha of 0.613, which is an indicator of moderate reliability, which could be the main reason for not getting positive result. PMID:21170231

42: DESIGNING A DASHBOARD FOR EVALUATION THE BUSINESS-IT ALIGNMENT STRATEGIES IN HOSPITALS ORGANIZATIONS

PubMed Central

piri, Zakieh; Raef, Behnaz; moftian, Nazila; dehghani, Mohamad; khara, Rouhallah

2017-01-01

Background and aims Business-IT Alignment Evaluation is One of the most important issues that managers should monitor and make decisions about it. Dashboard software combines data and graphical indicators to deliver at-a-glance summaries of information for users to view the state of their business and quickly respond. The aim of this study was to design a dashboard to assess the business-IT alignment strategies for hospitals organizations in Tehran University of Medical Sciences. Methods This is a functional-developmental study. Initially, we searched related databases (PubMed and ProQuest) to determine the key performance indicators of business-IT alignment for selecting the best model for dashboard designing. After selecting the Luftman model, the key indicators were extracted for designing the dashboard model. In the next stage, an electronic questionnaire was designed based on extracted indicators. This questionnaire sends to Hospital managers and IT administrators. Collected data were analyzed by Excel 2015 and displayed in dashboard page. Results The number of key performance indicators was 39. After recognition the technical requirements the dashboard was designed in Excel. The overall business-IT alignment rate in hospitals was 3.12. Amir-aalam hospital has the highest business-IT alignment rate (3.55) and vali-asr hospital has the lowest business-IT alignment rat (2.80). Conclusion Using dashboard software improves the alignment and reduces the time and energy compared with doing this process manually.

The Quality Movements in Higher Education in the United States.

ERIC Educational Resources Information Center

Miller, Richard I.

1996-01-01

Discussion of various quality control strategies in American higher education looks at and compares Total Quality Management (TQM), outcomes assessment, Deming's 14 points, the Malcolm Baldrige National Quality Award, the ISO 9000 series, restructuring, reengineering, and performance indicators. It is suggested that colleges and universities will…

Problems in air traffic management. V., Identification and potential aptitude test measures for selection of tower air traffic controller trainees.

DOT National Transportation Integrated Search

1965-07-01

A study of over 200 Terminal Air Traffic Control Specialists indicated that their training performance could be well predicted by a composite of four aptitude tests measuring: numerical ability, non-verbal abstract reasoning, ability to solve simplif...

Enabling Process Improvement and Control in Higher Education Management

ERIC Educational Resources Information Center

Bell, Gary; Warwick, Jon; Kennedy, Mike

2009-01-01

The emergence of "managerialism" in the governance and direction of UK higher education (HE) institutions has been led by government demands for greater accountability in the quality and cost of universities. There is emerging anecdotal evidence indicating that the estimation performance of HE spreadsheets and regression models are poor.…

Managing Volunteer Performance: The Role of the Feedback Environment.

ERIC Educational Resources Information Center

Paull, Megan

2000-01-01

Volunteers (n=85) in Australian organizations who responded to a survey indicated that they received both positive and negative feedback from supervisors and coworkers. The feedback environment facilitated or hindered its effectiveness. Effectiveness was enhanced by an organizational culture that was supportive and open and development of…

Networks: A Route to Improving Performance in Manufacturing SMEs

ERIC Educational Resources Information Center

Coleman, J.

2003-01-01

Perceived as important contributors to economic growth, network and cluster groups are currently receiving much attention. The same may be said of SMEs. But practical and theoretical perspectives indicate that SMEs, and particularly the owner-managers, place little value on networks and have only limited networking resources. Consequently, they do…

A Multi-Objective Method to Align Human Resource Allocation with University Strategy

ERIC Educational Resources Information Center

Bouillard, Philippe

2016-01-01

Universities are currently under considerable pressure to reach their stakeholders' expectations. Management tools that use strategic plans, key performance indicators and quality assurance methods are increasingly deployed. This paper aims to demonstrate how resource allocation can be aligned with institutional strategic plans with a very simple…

Towards more sustainable management of European food waste: Methodological approach and numerical application.

PubMed

Manfredi, Simone; Cristobal, Jorge

2016-09-01

Trying to respond to the latest policy needs, the work presented in this article aims at developing a life-cycle based framework methodology to quantitatively evaluate the environmental and economic sustainability of European food waste management options. The methodology is structured into six steps aimed at defining boundaries and scope of the evaluation, evaluating environmental and economic impacts and identifying best performing options. The methodology is able to accommodate additional assessment criteria, for example the social dimension of sustainability, thus moving towards a comprehensive sustainability assessment framework. A numerical case study is also developed to provide an example of application of the proposed methodology to an average European context. Different options for food waste treatment are compared, including landfilling, composting, anaerobic digestion and incineration. The environmental dimension is evaluated with the software EASETECH, while the economic assessment is conducted based on different indicators expressing the costs associated with food waste management. Results show that the proposed methodology allows for a straightforward identification of the most sustainable options for food waste, thus can provide factual support to decision/policy making. However, it was also observed that results markedly depend on a number of user-defined assumptions, for example on the choice of the indicators to express the environmental and economic performance. © The Author(s) 2016.

[Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?].

PubMed

Lorenzen, J; Habermann, C; Utler, C; Grzyska, U; Weber, C; Adam, G; Koops, A

2009-10-01

To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000. Georg Thieme Verlag KG Stuttgart-New York.

Optimizing Input/Output Using Adaptive File System Policies

NASA Technical Reports Server (NTRS)

Madhyastha, Tara M.; Elford, Christopher L.; Reed, Daniel A.

1996-01-01

Parallel input/output characterization studies and experiments with flexible resource management algorithms indicate that adaptivity is crucial to file system performance. In this paper we propose an automatic technique for selecting and refining file system policies based on application access patterns and execution environment. An automatic classification framework allows the file system to select appropriate caching and pre-fetching policies, while performance sensors provide feedback used to tune policy parameters for specific system environments. To illustrate the potential performance improvements possible using adaptive file system policies, we present results from experiments involving classification-based and performance-based steering.

Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study.

PubMed

Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

2018-01-01

In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses. Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%-100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation. Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care. © 2017 John Wiley & Sons Ltd.

Development of an estuarine assessment scheme for the management of a highly urbanised catchment/estuary system, Sydney estuary, Australia.

PubMed

Birch, G F; Gunns, T J; Chapman, D; Harrison, D

2016-05-01

As coastal populations increase, considerable pressures are exerted on estuarine environments. Recently, there has been a trend towards the development and use of estuarine assessment schemes as a decision support tool in the management of these environments. These schemes offer a method by which complex environmental data is converted into a readily understandable and communicable format for informed decision making and effective distribution of limited management resources. Reliability and effectiveness of these schemes are often limited due to a complex assessment framework, poor data management and use of ineffective environmental indicators. The current scheme aims to improve reliability in the reporting of estuarine condition by including a concise assessment framework, employing high-value indicators and, in a unique approach, employing fuzzy logic in indicator evaluation. Using Sydney estuary as a case study, each of the 15 sub-catchment/sub-estuary systems were assessed using the current scheme. Results identified that poor sediment quality was a significant issue in Blackwattle/Rozelle Bay, Iron Cove and Hen and Chicken Bay while poor water quality was of particular concern in Duck River, Homebush Bay and the Parramatta River. Overall results of the assessment scheme were used to prioritise the management of each sub-catchment/sub-estuary assessed with Blackwattle/Rozelle Bay, Homebush Bay, Iron Cove and Duck River considered to be in need of a high priority management response. A report card format, using letter grades, was employed to convey the results of the assessment in a readily understood manner to estuarine managers and members of the public. Letter grades also provide benchmarking and performance monitoring ability, allowing estuarine managers to set improvement targets and assesses the effectiveness of management strategies. The current assessment scheme provides an effective, integrated and consistent assessment of estuarine health and provides an effective decision support tool to maximise the efficient distribution of limited management resources.

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model

PubMed Central

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective. PMID:23555104

Impact of star performance ratings in English acute hospital trusts.

PubMed

Mannion, Russell; Davies, Huw; Marshall, Martin

2005-01-01

To explore some of the impacts of star performance ratings in acute hospital trusts in England. A multiple case study design was used which incorporated purposeful sampling of 'low' and 'high' performing trusts using the star rating system. In each case study site, data collection comprised semi-structured interviews and documentary analysis. Between eight and 12 senior managers and senior clinicians were interviewed in each organisation. There was a general view that the star ratings as presently constituted did not represent a rounded or balanced scorecard of their own organisation's performance and a widespread belief that the information used to calculate the ratings was often incomplete and inaccurate. The star ratings were viewed by some managers as useful, in that they gave added weight to their trust's modernisation agenda. In addition to driving beneficial change, the ratings were also sometimes reported to have inadvertently induced a range of unintended and dysfunctional consequences, including tunnel vision and a distortion of clinical priorities, bullying and intimidation, erosion of public trust and reduced staff morale, and ghettoisation. Set in the context of an international body of research, this study highlights some important gaps in knowledge and failings in current policy and practice. In particular, the many dysfunctional consequences of publishing star ratings indicate a need for a re-examination of performance management policies.

Performance and Practice Guideline for the Use of Neoadjuvant Systemic Therapy in the Management of Breast Cancer.

PubMed

Holmes, Dennis; Colfry, A; Czerniecki, Brian; Dickson-Witmer, Diana; Francisco Espinel, C; Feldman, Elizabeth; Gallagher, Kristalyn; Greenup, Rachel; Herrmann, Virginia; Kuerer, Henry; Malik, Manmeet; Manahan, Eric; O'Neill, Jennifer; Patel, Mita; Sebastian, Molly; Wheeler, Amanda; Kass, Rena

2015-10-01

The American Society of Breast Surgeons (ASBrS) sought to provide an evidence-based guideline on the use of neoadjuvant systemic therapy (NST) in the management of clinical stage II and III invasive breast cancer. A comprehensive nonsystematic review was performed of selected peer-reviewed literature published since 2000. The Education Committee of the ASBrS convened to develop guideline recommendations. A performance and practice guideline was prepared to outline the baseline assessment and perioperative management of patients with clinical stage II-III breast cancer under consideration for NST. Preoperative or NST is emerging as an important initial strategy for the management of invasive breast cancer. From the surgeon's perspective, the primary goal of NST is to increase the resectability of locally advanced breast cancer, increase the feasibility of breast-conserving surgery and sentinel node biopsy, and decrease surgical morbidity. To ensure optimal patient selection and efficient patient care, the guideline recommends: (1) baseline breast and axillary imaging; (2) minimally invasive biopsies of breast and axillary lesions; (3) determination of tumor biomarkers; (4) systemic staging; (5) care coordination, including referrals to medical oncology, radiation oncology, plastic surgery, social work, and genetic counseling, if indicated; (6) initiation of NST; (7) post-NST breast and axillary imaging; and (8) decision for surgery based on extent of disease at presentation, patient choice, clinical response to NST, and genetic testing results, if performed.

American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer.

PubMed

Stack, Brendan C; Ferris, Robert L; Goldenberg, David; Haymart, Megan; Shaha, Ashok; Sheth, Sheila; Sosa, Julie Ann; Tufano, Ralph P

2012-05-01

Cervical lymph node metastases from differentiated thyroid cancer (DTC) are common. Thirty to eighty percent of patients with papillary thyroid cancer harbor lymph node metastases, with the central neck being the most common compartment involved. The goals of this study were to: (1) identify appropriate methods for determining metastatic DTC in the lateral neck and (2) address the extent of lymph node dissection for the lateral neck necessary to control nodal disease balanced against known risks of surgery. A literature review followed by formulation of a consensus statement was performed. Four proposals regarding management of the lateral neck are made for consideration by organizations developing management guidelines for patients with thyroid nodules and DTC including the next iteration of management guidelines developed by the American Thyroid Association (ATA). Metastases to lateral neck nodes must be considered in the evaluation of the newly diagnosed thyroid cancer patient and for surveillance of the previously treated DTC patient. Lateral neck lymph nodes are a significant consideration in the surgical management of patients with DTC. When current guidelines formulated by the ATA and by other international medical societies are followed, initial evaluation of the DTC patient with ultrasound (or other modalities when indicated) will help to identify lateral neck lymph nodes of concern. These findings should be addressed using fine-needle aspiration biopsy. A comprehensive neck dissection of at least nodal levels IIa, III, IV, and Vb should be performed when indicated to optimize disease control.

Empirical Analysis of Human Capital, Learning Culture, and Knowledge Management as Antecedents to Organizational Performance: Theoretical and Practical Implications for Logistics Readiness Officer Force Development

DTIC Science & Technology

2014-03-27

Much of the DoD’s force shaping problems in the active duty military stem from the way in which it chose to absorb the force reductions at the end...indicated the need for more joint oriented education and training to help them in the performance of their primary duties. CLL 016 (Joint Logistics... CLL 054 (Joint Task Force Port Opening) and CLL 055 (Joint Deployment and Distribution Performance Metrics Framework) all received high potential

Diagnosis of poor safety culture as a major shortcoming in OHSAS 18001-certified companies.

PubMed

Ghahramani, Abolfazl

2017-04-07

The evaluation of safety performance in occupational health and safety assessment series (OHSAS) 18001-certified companies provides useful information about the quality of the management system. A certified organization should employ an adequate level of safety management and a positive safety culture to achieve a satisfactory safety performance. The present study conducted in six manufacturing companies: three OHSAS 18001-certified, and three non-certified to assess occupational health and safety (OHS) as well as OHSAS 18001 practices. The certified companies had a better OHS practices compared with the non-certified companies. The certified companies slightly differed in OHS and OHSAS 18001 practices and one of the certified companies had the highest activity rates for both practices. The results indicated that the implemented management systems have not developed and been maintained appropriately in the certified companies. The in-depth analysis of the collected evidence revealed shortcomings in safety culture improvement in the certified companies. This study highlights the importance of safety culture to continuously improve the quality of OHSAS 18001 and to properly perform OHS/OHSAS 18001 practices in the certified companies.

Diagnosis of poor safety culture as a major shortcoming in OHSAS 18001-certified companies

PubMed Central

GHAHRAMANI, Abolfazl

2016-01-01

The evaluation of safety performance in occupational health and safety assessment series (OHSAS) 18001-certified companies provides useful information about the quality of the management system. A certified organization should employ an adequate level of safety management and a positive safety culture to achieve a satisfactory safety performance. The present study conducted in six manufacturing companies: three OHSAS 18001-certified, and three non-certified to assess occupational health and safety (OHS) as well as OHSAS 18001 practices. The certified companies had a better OHS practices compared with the non-certified companies. The certified companies slightly differed in OHS and OHSAS 18001 practices and one of the certified companies had the highest activity rates for both practices. The results indicated that the implemented management systems have not developed and been maintained appropriately in the certified companies. The in-depth analysis of the collected evidence revealed shortcomings in safety culture improvement in the certified companies. This study highlights the importance of safety culture to continuously improve the quality of OHSAS 18001 and to properly perform OHS/OHSAS 18001 practices in the certified companies. PMID:28025422

A Personalized Self-Management Rehabilitation System for Stroke Survivors: A Quantitative Gait Analysis Using a Smart Insole

PubMed Central

Parker, Jack; McCullagh, Paul; Zheng, Huiru; Nugent, Chris; Black, Norman David; Mawson, Susan

2016-01-01

Background In the United Kingdom, stroke is the single largest cause of adult disability and results in a cost to the economy of £8.9 billion per annum. Service needs are currently not being met; therefore, initiatives that focus on patient-centered care that promote long-term self-management for chronic conditions should be at the forefront of service redesign. The use of innovative technologies and the ability to apply these effectively to promote behavior change are paramount in meeting the current challenges. Objective Our objective was to gain a deeper insight into the impact of innovative technologies in support of home-based, self-managed rehabilitation for stroke survivors. An intervention of daily walks can assist with improving lower limb motor function, and this can be measured by using technology. This paper focuses on assessing the usage of self-management technologies on poststroke survivors while undergoing rehabilitation at home. Methods A realist evaluation of a personalized self-management rehabilitation system was undertaken in the homes of stroke survivors (N=5) over a period of approximately two months. Context, mechanisms, and outcomes were developed and explored using theories relating to motor recovery. Participants were encouraged to self-manage their daily walking activity; this was achieved through goal setting and motivational feedback. Gait data were collected and analyzed to produce metrics such as speed, heel strikes, and symmetry. This was achieved using a “smart insole” to facilitate measurement of walking activities in a free-living, nonrestrictive environment. Results Initial findings indicated that 4 out of 5 participants performed better during the second half of the evaluation. Performance increase was evident through improved heel strikes on participants’ affected limb. Additionally, increase in performance in relation to speed was also evident for all 5 participants. A common strategy emerged across all but one participant as symmetry performance was sacrificed in favor of improved heel strikes. This paper evaluates compliance and intensity of use. Conclusion Our findings suggested that 4 out of the 5 participants improved their ability to heel strike on their affected limb. All participants showed improvements in their speed of gait measured in steps per minute with an average increase of 9.8% during the rehabilitation program. Performance in relation to symmetry showed an 8.5% average decline across participants, although 1 participant improved by 4%. Context, mechanism, and outcomes indicated that dual motor learning and compensatory strategies were deployed by the participants. PMID:28582260

Practice variability in the management of complex febrile seizures by pediatric emergency physicians and fellows.

PubMed

Sales, Justin W; Bulloch, Blake; Hostetler, Mark A

2011-05-01

Febrile seizures are the most common type of childhood seizure and are categorized as simple or complex. Complex febrile seizures (CFSs) are defined as events that are focal, prolonged (> 15 minutes), or recurrent. The management of CFS is poorly defined. The objective of this study was to determine the degree of variability in the emergency department evaluation of children with CFSs. An online survey questionnaire was developed and sent to physicians identified via the listserv of the emergency medicine section of the American Academy of Pediatrics and the pediatric emergency medicine discussion list. The questionnaire consisted of five hypothetical case vignettes describing children under 5 years of age presenting with a CFS. Following review of the first four vignettes, participants were asked if they would (1) obtain blood and urine for evaluation; (2) perform a lumbar puncture; (3) perform neurologic imaging while the child was in the emergency department; (4) admit the child to the hospital; or (5) discharge with follow-up as an outpatient, with either the primary care provider or a neurologist. The final vignette determined if antiepileptic medication would be prescribed by the physician on discharge. Of the 353 physicians who participated, 293 (83%) were pediatric emergency medicine attending physicians and 60 (17%) were pediatric emergency medicine fellows. Overall, 54% of participants indicated that they would obtain blood for evaluation, 62% would obtain urine, 34% would perform a lumbar puncture, and 36% would perform neurologic imaging. The overall hypothetical admission rate for the case vignettes was 42%. This study indicates that extensive variability exists in the emergency department approach to patients with CFS. Our findings suggest that optimal management for CFS remains unclear and support the potential benefit of future prospective studies on this subject.

Examining the impact of succession management practices on organizational performance: A national study of U.S. hospitals.

PubMed

Groves, Kevin S

2017-08-03

Spearheaded by the industry's transition from volume- to value-based care, the health care reform movement has spurred both unprecedented challenges and opportunities for developing more effective and sustainable health care delivery organizations. Whereas the formidable challenges of leading hospitals and health systems have been widely discussed, including reimbursement degradation, the rapidly aging workforce, and the imminent wave of executive retirements, the opportunity to leverage succession management and talent development capabilities to overcome these challenges has been largely overlooked. To address this key research and practice need, this multiphase study develops and validates an assessment of succession management practices for health care organizations. Utilizing data collected from two national samples of hospital organizations, the results provide a 32-item succession management assessment comprising seven distinct sets of succession management practices. The results indicate that succession management practices are strongly associated with multiple hospital performance metrics, including patient satisfaction and Medicare Spending per Beneficiary, leadership bench strength, and internal/external placement rate for executive level positions. The author concludes this article with a discussion of several practical implications for health care executives and boards, including employing the succession management assessment for diagnosing development opportunities, benchmarking succession planning and talent development practices against similar hospitals or health systems, and elevating the profile of succession management as a strategic priority in today's increasingly uncertain health care landscape.

CO-CD base management model of Universitas Terbuka community service program

NASA Astrophysics Data System (ADS)

Kridasakti, S. W.; Sudirah; Siregar, H.

2018-03-01

These studies were to respond whether the UT social-aid management had been executed under CO-CD principles (Ife J. 1995) and what CO-CD base community service management model can be built. The goals of these evaluational studies were UT social-aid managerial performance profile (2011-2013) and CO-CD management model development. The methods used were Survey and FGD. For data collection were involving the UT officers, the counterparts, and the documents. The analysis used combination between the Performance Analysis (Irawan P., 2003) and the CIPP (Stuffelbeam, D, L., & Shinkfield, A, J., 1985). The findings showed that the quantitative targeting in program completion was credible in achievement (85%). However, the “qulitative targeting” of the management goals was indicating far from a good-stage (≤5.0_Interval-Force: 1-10 Scale). The “Gap” was due to the absent of socialization_needs-analysis_maintenance_release factors on the UT social-service grand-policy. The trial of CO-CD Base Management Model had been imposed to the community that turned out to be very effective to self-help, and the ensuing SOP had been successfully defined. Conclusion, ‘CO-CD Principles’ were not designed in UT community service programs management. However, if efficiency and effectivity likely to be achieved, the SOP of ‘CO-CD Base Management Model has to be adopted.

Linking management effectiveness indicators to observed effects of protected areas on fire occurrence in the Amazon rainforest.

PubMed

Nolte, Christoph; Agrawal, Arun

2013-02-01

Management-effectiveness scores are used widely by donors and implementers of conservation projects to prioritize, track, and evaluate investments in protected areas. However, there is little evidence that these scores actually reflect the capacity of protected areas to deliver conservation outcomes. We examined the relation between indicators of management effectiveness in protected areas and the effectiveness of protected areas in reducing fire occurrence in the Amazon rainforest. We used data collected with the Management Effectiveness Tracking Tool (METT) scorecard, adopted by some of the world's largest conservation organizations to track management characteristics believed to be crucial for protected-area effectiveness. We used the occurrence of forest fires from 2000 through 2010 as a measure of the effect of protected areas on undesired land-cover change in the Amazon basin. We used matching to compare the estimated effect of protected areas with low versus high METT scores on fire occurrence. We also estimated effects of individual protected areas on fire occurrence and explored the relation between these effects and METT scores. The relations between METT scores and effects of protected areas on fire occurrence were weak. Protected areas with higher METT scores in 2005 did not seem to have performed better than protected areas with lower METT scores at reducing fire occurrence over the last 10 years. Further research into the relations between management-effectiveness indicators and conservation outcomes in protected areas seems necessary, and our results show that the careful application of matching methods can be a suitable method for that purpose. ©2012 Society for Conservation Biology.

An Evaluation of the Performance Diagnostic Checklist-Human Services (PDC-HS) Across Domains.

PubMed

Wilder, David A; Lipschultz, Joshua; Gehrman, Chana

2018-06-01

The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to assess the environmental variables that contribute to poor employee performance in human service settings. Although the PDC-HS has been shown to effectively identify variables contributing to problematic performance, interventions based on only two of the four PDC-HS domains have been evaluated to date. In addition, the extent to which PDC-HS-indicated interventions are more effective than nonindicated interventions for two domains remains unclear. In the current study, we administered the PDC-HS to supervisors to assess the variables contributing to infrequent teaching of verbal operants and use of a timer by therapists at a center-based autism treatment program. Each of the four PDC-HS domains was identified as contributing to poor performance for at least one therapist. We then evaluated PDC-HS-indicated interventions for each domain. In addition, to assess the predictive validity of the tool, we evaluated various nonindicated interventions prior to implementing a PDC-HS-indicated intervention for two of the four domains. Results suggest that the PDC-HS-indicated interventions were effective across all four domains and were more effective than the nonindicated interventions for the two domains for which they were evaluated. Results are discussed in terms of the utility of the PDC-HS to identify appropriate interventions to manage therapist performance in human service settings.

Evolution of a residue laboratory network and the management tools for monitoring its performance.

PubMed

Lins, E S; Conceição, E S; Mauricio, A De Q

2012-01-01

Since 2005 the National Residue & Contaminants Control Plan (NRCCP) in Brazil has been considerably enhanced, increasing the number of samples, substances and species monitored, and also the analytical detection capability. The Brazilian laboratory network was forced to improve its quality standards in order to comply with the NRCP's own evolution. Many aspects such as the limits of quantification (LOQs), the quality management systems within the laboratories and appropriate method validation are in continuous improvement, generating new scenarios and demands. Thus, efficient management mechanisms for monitoring network performance and its adherence to the established goals and guidelines are required. Performance indicators associated to computerised information systems arise as a powerful tool to monitor the laboratories' activity, making use of different parameters to describe this activity on a day-to-day basis. One of these parameters is related to turnaround times, and this factor is highly affected by the way each laboratory organises its management system, as well as the regulatory requirements. In this paper a global view is presented of the turnaround times related to the type of analysis, laboratory, number of samples per year, type of matrix, country region and period of the year, all these data being collected from a computerised system called SISRES. This information gives a solid background to management measures aiming at the improvement of the service offered by the laboratory network.