management process improvement: Topics by Science.gov

Sample records for management process improvement

Business Process Reengineering in the Inventory Management to Improve Aircraft Maintenance Operations in the Indonesian Air Force

DTIC Science & Technology

2006-06-01

research will cover an overview of business process engineering (BPR) and operation management . The focus will be on the basic process of BPR, inventory...management and improvement of the process of business operation management to appropriately provide a basic model for the Indonesian Air Force in...discuss the operation management aspects of inventory management and process improvement, including Economic Order Quantity, Material Requirement
[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.
Health care managers' views on and approaches to implementing models for improving care processes.

PubMed

Andreasson, Jörgen; Eriksson, Andrea; Dellve, Lotta

2016-03-01

To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes. In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome. In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory. 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work. Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management. © 2015 John Wiley & Sons Ltd.
41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What type of records management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to...
41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What type of records management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to...
41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What type of records management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to...
41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What type of records management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to...
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.
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.
Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

PubMed

Tao, Ziqi

2015-06-01

Using methods including questionnaire-based surveys and control analysis, we analyzed the improvements in the efficiency of ICU rescue, service quality, and patients' satisfaction, in Xuzhou Central Hospital after the implementation of fine management, with an attempt to further introduce the concept of fine management and implement the brand construction. Originating in Taylor's "Theory of Scientific Management" (1982), fine management uses programmed, standardized, digitalized, and informational approaches to ensure each unit of an organization is running with great accuracy, high efficiency, strong coordination, and at sustained duration (Wang et al., Fine Management, 2007). The nature of fine management is a process that breaks up the strategy and goal, and executes it. Strategic planning takes place at every part of the process. Fine management demonstrates that everybody has a role to play in the management process, every area must be examined through the management process, and everything has to be managed (Zhang et al., The Experience of Hospital Nursing Precise Management, 2006). In other words, this kind of management theory demands all people to be involved in the entire process (Liu and Chen, Med Inf, 2007). As public hospital reform is becoming more widespread, it becomes imperative to "build a unified and efficient public hospital management system" and "improve the quality of medical services" (Guidelines on the Pilot Reform of Public Hospitals, 2010). The execution of fine management is of importance in optimizing the medical process, improving medical services and building a prestigious hospital brand.
Process safety improvement--quality and target zero.

PubMed

Van Scyoc, Karl

2008-11-15

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

PubMed

Askari, Marjan; Westerhof, Richard; Eslami, Saied; Medlock, Stephanie; de Rooij, Sophia E; Abu-Hanna, Ameen

2013-10-01

To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. We identified essential disease management related concepts and mapped them into explicit questions meant to expose areas for improvement in the respective care processes. We applied the disease management oriented questions to a process model of a comprehensive real world fall prevention and treatment program covering primary and secondary care. We relied on interviews and observations to complete the process models, which were captured in UML activity diagrams. A preliminary evaluation of the usability of our approach by gauging the experience of the modeler and an external validator was conducted, and the usefulness of the method was evaluated by gathering feedback from stakeholders at an invitational conference of 75 attendees. The process model of the fall management program was organized around the clinical tasks of case finding, risk profiling, decision making, coordination and interventions. Applying the disease management questions to the process models exposed weaknesses in the process including: absence of program ownership, under-detection of falls in primary care, and lack of efficient communication among stakeholders due to missing awareness about other stakeholders' workflow. The modelers experienced the approach as usable and the attendees of the invitational conference found the analysis results to be valid. The proposed disease management view of process modeling was usable and useful for systematically identifying areas of improvement in a fall management program. Although specifically applied to fall management, we believe our case study is characteristic of various disease management settings, suggesting the wider applicability of the approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Bridging the gap between finance and clinical operations with activity-based cost management.

PubMed

Storfjell, J L; Jessup, S

1996-12-01

Activity-based cost management (ABCM) is an exciting management tool that links financial information with operations. By determining the costs of specific activities and processes, nurse managers accurately determine true costs of services more accurately than traditional cost accounting methods, and then can target processes for improvement and monitor them for change and improvement. The authors describe the ABCM process applied to nursing management situations.
Winning performance improvement strategies--linking documentation and accounts receivable.

PubMed

Braden, J H; Swadley, D

1996-01-01

When the HIM department at The University of Texas Medical Branch set out to improve documentation and accounts receivable management, it established a plan that encompassed a broad spectrum of data management process changes. The department examined and acknowledged the deficiencies in data management processes and used performance improvement tools to achieve successful results.
Improvement of radiology services based on the process management approach.

PubMed

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

2011-06-01

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

PubMed

Walley, Paul; Silvester, Kate; Mountford, Shaun

2006-01-01

The paper seeks to investigate decision-making processes within hospital improvement activity, to understand how performance measurement systems influence decisions and potentially lead to unsuccessful or unsustainable process changes. A longitudinal study over a 33-month period investigates key events, decisions and outcomes at one medium-sized hospital in the UK. Process improvement events are monitored using process control methods and by direct observation. The authors took a systems perspective of the health-care processes, ensuring that the impacts of decisions across the health-care supply chain were appropriately interpreted. The research uncovers the ways in which measurement systems disguise failed decisions and encourage managers to take a low-risk approach of "symptomatic relief" when trying to improve performance metrics. This prevents many managers from trying higher risk, sustainable process improvement changes. The behaviour of the health-care system is not understood by many managers and this leads to poor analysis of problem situations. Measurement using time-series methodologies, such as statistical process control are vital for a better understanding of the systems impact of changes. Senior managers must also be aware of the behavioural influence of similar performance measurement systems that discourage sustainable improvement. There is a risk that such experiences will tarnish the reputation of performance management as a discipline. Recommends process control measures as a way of creating an organization memory of how decisions affect performance--something that is currently lacking.
Management of local economic and ecological system of coal processing company

NASA Astrophysics Data System (ADS)

Kiseleva, T. V.; Mikhailov, V. G.; Karasev, V. A.

2016-10-01

The management issues of local ecological and economic system of coal processing company - coal processing plant - are considered in the article. The objectives of the research are the identification and the analysis of local ecological and economic system (coal processing company) performance and the proposals for improving the mechanism to support the management decision aimed at improving its environmental safety. The data on the structure of run-of-mine coal processing products are shown. The analysis of main ecological and economic indicators of coal processing enterprises, characterizing the state of its environmental safety, is done. The main result of the study is the development of proposals to improve the efficiency of local enterprise ecological and economic system management, including technical, technological and business measures. The results of the study can be recommended to industrial enterprises to improve their ecological and economic efficiency.
Defense Depot Tracy Total Quality Management Plan

DTIC Science & Technology

1989-07-01

PAGES TQM (Total Quality Management ), Depot Operations, Continuous Process Improvement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...make up our pcrceptions of Total Quality Management . Our goal is to improve those proven management processes that have brought us success while being...MANIAGEMENT F. QUALITY AUDITS OF PRODUCTS AND OPERATIONS ASSETS MANAGEMENT 00 i .......... / ~899 29 03 1 EFENSE DEPOT TACY TOTAL QUALITY MANAGEMENT PLAN
A Comparative History of Department of Defense Management Reform from 1947 to 2005

DTIC Science & Technology

2006-12-01

type of management reform agenda to improve the Department of Defense business processes and incorporate recent management ideas from the business ...introduce some type of management reform agenda to improve the Department of Defense business processes and incorporate recent management ideas...Steering Group BMMP Business Management Modernization Plan BRAC Base Realignment and Closure C3I Command, Control, Communications, and Intelligence
The clinical nurse specialist as resuscitation process manager.

PubMed

Schneiderhahn, Mary Elizabeth; Fish, Anne Folta

2014-01-01

The purpose of this article was to describe the history and leadership dimensions of the role of resuscitation process manager and provide specific examples of how this role is implemented at a Midwest medical center. In 1992, a medical center in the Midwest needed a nurse to manage resuscitation care. This role designation meant that this nurse became central to all quality improvement efforts in resuscitation care. The role expanded as clinical resuscitation guidelines were updated and as the medical center grew. The role became known as the critical care clinical nurse specialist as resuscitation process manager. This clinical care nurse specialist was called a manager, but she had no direct line authority, so she accomplished her objectives by forming a multitude of collaborative networks. Based on a framework by Finkelman, the manager role incorporated specific leadership abilities in quality improvement: (1) coordination of medical center-wide resuscitation, (2) use of interprofessional teams, (3) integration of evidence into practice, and (4) staff coaching to develop leadership. The manager coordinates resuscitation care with the goals of prevention of arrests if possible, efficient and effective implementation of resuscitation protocols, high quality of patient and family support during and after the resuscitation event, and creation or revision of resuscitation policies for in-hospital and for ambulatory care areas. The manager designs a comprehensive set of meaningful and measurable process and outcome indicators with input from interprofessional teams. The manager engages staff in learning, reflecting on care given, and using the evidence base for resuscitation care. Finally, the manager role is a balance between leading quality improvement efforts and coaching staff to implement and sustain these quality improvement initiatives. Revisions to clinical guidelines for resuscitation care since the 1990s have resulted in medical centers developing improved resuscitation processes that require management. The manager enhances collaborative quality improvement efforts that are in line with Institute of Medicine recommendations. The role of resuscitation process manager may be of interest to medical centers striving for excellence in evidence-based resuscitation care.

Application of process improvement principles to increase the frequency of complete airway management documentation.

PubMed

McCarty, L Kelsey; Saddawi-Konefka, Daniel; Gargan, Lauren M; Driscoll, William D; Walsh, John L; Peterfreund, Robert A

2014-12-01

Process improvement in healthcare delivery settings can be difficult, even when there is consensus among clinicians about a clinical practice or desired outcome. Airway management is a medical intervention fundamental to the delivery of anesthesia care. Like other medical interventions, a detailed description of the management methods should be documented. Despite this expectation, airway documentation is often insufficient. The authors hypothesized that formal adoption of process improvement methods could be used to increase the rate of "complete" airway management documentation. The authors defined a set of criteria as a local practice standard of "complete" airway management documentation. The authors then employed selected process improvement methodologies over 13 months in three iterative and escalating phases to increase the percentage of records with complete documentation. The criteria were applied retrospectively to determine the baseline frequency of complete records, and prospectively to measure the impact of process improvements efforts over the three phases of implementation. Immediately before the initial intervention, a retrospective review of 23,011 general anesthesia cases over 6 months showed that 13.2% of patient records included complete documentation. At the conclusion of the 13-month improvement effort, documentation improved to a completion rate of 91.6% (P<0.0001). During the subsequent 21 months, the completion rate was sustained at an average of 90.7% (SD, 0.9%) across 82,571 general anesthetic records. Systematic application of process improvement methodologies can improve airway documentation and may be similarly effective in improving other areas of anesthesia clinical practice.
Improving the medical records department processes by lean management.

PubMed

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

2015-01-01

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

PubMed

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

2014-01-01

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

ERIC Educational Resources Information Center

Lamp, Sandra A.

2012-01-01

There is information available in the literature that discusses information technology (IT) governance and investment decision making from an executive-level perception, yet there is little information available that offers the perspective of process owners and process managers pertaining to their role in IT process improvement and investment…
Applying Lean Six Sigma to improve medication management.

PubMed

Nayar, Preethy; Ojha, Diptee; Fetrick, Ann; Nguyen, Anh T

2016-01-01

A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA's dual care policy; collect data and describe the current process for co-management of dual care veterans' medications; and draft recommendations to improve the current process for dual care medications co-management. Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. The findings of this project will be of value to VA providers and policy makers and health care managers who plan to apply Lean Six Sigma techniques in their organizations to improve the quality of care for their patients.
[QUIPS: quality improvement in postoperative pain management].

PubMed

Meissner, Winfried

2011-01-01

Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. Outcome improved in four of the six hospitals. Process indicators, such as routine pain documentation, were only poorly correlated with outcomes. To date, more than 130 German hospitals use QUIPS as a routine quality management tool. An EC-funded parallel project disseminates the concept internationally. QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine. Copyright © 2011. Published by Elsevier GmbH.
TQM (Total Quality Management) SPARC (Special Process Action Review Committees) Handbook

DTIC Science & Technology

1989-08-01

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

PubMed Central

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

2015-01-01

Background: Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. Aims: The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. Materials and Methods: This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. Statistical Analysis Used: The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. Results: The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. Conclusion: The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. Originality/Value: The study represents one of the few attempts trying to eliminate wastes in the MRD. PMID:26097862
41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) FEDERAL MANAGEMENT REGULATION ADMINISTRATIVE PROGRAMS 193-CREATION, MAINTENANCE, AND USE OF RECORDS § 102... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What type of records management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...
How Implementation of TQM and the Development of a Process Improvement Model, Within a Forward Support Battalion, Can Improve Preparation of the Material Condition Status Report (DA Form 2406)

DTIC Science & Technology

1990-12-01

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

DTIC Science & Technology

1989-07-01

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

NASA Technical Reports Server (NTRS)

Shay, Kathy

1993-01-01

By concentrating on defining and improving specific Configuration Management (CM) functions, processes, procedures, personnel selection/development, and tools, internal and external customers received improved CM services. Job performance within the section increased in both satisfaction and output. Participation in achieving major improvements has led to the delivery of consistent quality CM products as well as significant decreases in every measured CM metrics category.
Managing clinical integration in integrated delivery systems: a framework for action.

PubMed

Young, D W; Barrett, D

1997-01-01

An integrated delivery system (IDS) in healthcare must coordinate patient care across multiple functions, activities, and operating units. To achieve this clinical integration, senior management confronts many challenges. This paper uses a cross-functional-process (CFP) framework to discuss these challenges. There are ten CFPs that fall into three categories: planning processes (strategy formulation, program adaptation, budget formulation), organizational processes (authority and influence, client management, conflict resolution, motivation, and cultural maintenance), and measurement and reporting processes (financial and programmatic). Each process typically spans several functional units. Senior management must consider how to improve both the functioning of each CFP, as well as its "fit" with the other nine. The result can be greater clinical integration, improved cost management, and more coordinated care for enrollees.
Supplier Relationship Management at Army Life Cycle Management Commands: Gap Analysis of Best Practices

DTIC Science & Technology

2012-01-01

307–308) define kaizen as “continuous, incremental improvement of an activity to create more value with less muda.” They define muda as “any activity...approaches, kaizen events, Six Sigma, total quality management (TQM) for continuous improvement, kaikaku,6 process reengineering for discontinuous...them fix problems and develop capabilities. These efforts may include kaizen (i.e., continuous, incremental improvement) events, process mapping, work
Implementation of Integrated System Fault Management Capability

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Schmalzel, John; Morris, Jon; Smith, Harvey; Turowski, Mark

2008-01-01

Fault Management to support rocket engine test mission with highly reliable and accurate measurements; while improving availability and lifecycle costs. CORE ELEMENTS: Architecture, taxonomy, and ontology (ATO) for DIaK management. Intelligent Sensor Processes; Intelligent Element Processes; Intelligent Controllers; Intelligent Subsystem Processes; Intelligent System Processes; Intelligent Component Processes.
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
Experimental application of Business Process Management technology to manage clinical pathways: a pediatric kidney transplantation follow up case.

PubMed

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

2017-11-03

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

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1992-01-01

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

NASA Astrophysics Data System (ADS)

Raiman, Laura B.

1992-12-01

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

NASA Technical Reports Server (NTRS)

Raftery, Michael; Carter-Journet, Katrina

2013-01-01

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

A ten-step process to develop case management plans.

PubMed

Tahan, Hussein A

2002-01-01

The use of case management plans has contained cost and improved quality of care successfully. However, the process of developing these plans remains a great challenge for healthcare executives, in this article, the author presents the answer to this challenge by discussing a 10-step formal process that administrators of patient care services and case managers can adapt to their institutions. It also can be used by interdisciplinary team members as a practical guide to develop a specific case management plan. This process is applicable to any care setting (acute, ambulatory, long term, and home care), diagnosis, or procedure. It is particularly important for those organizations that currently do not have a deliberate and systematic process to develop case management plans and are struggling with how to improve the efficiency and productivity of interdisciplinary teams charged with developing case management plans.
Daily Management System of the Henry Ford Production System: QTIPS to Focus Continuous Improvements at the Level of the Work.

PubMed

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

2015-07-01

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

PubMed

Glickman, Seth W; Baggett, Kelvin A; Krubert, Christopher G; Peterson, Eric D; Schulman, Kevin A

2007-12-01

Although agreement about the need for quality improvement in health care is almost universal, the means of achieving effective improvement in overall care is not well understood. Avedis Donabedian developed the structure-process-outcome framework in which to think about quality-improvement efforts. There is now a robust evidence-base in the quality-improvement literature on process and outcomes, but structure has received considerably less attention. The health-care field would benefit from expanding the current interpretation of structure to include broader perspectives on organizational attributes as primary determinants of process change and quality improvement. We highlight and discuss the following key elements of organizational attributes from a management perspective: (i) executive management, including senior leadership and board responsibilities (ii) culture, (iii) organizational design, (iv) incentive structures and (v) information management and technology. We discuss the relevant contributions from the business and medical literature for each element, and provide this framework as a roadmap for future research in an effort to develop the optimal definition of 'structure' for transforming quality-improvement initiatives.
Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

PubMed

Joshi, M S; Bernard, D B

1999-08-01

In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The challenge is to provide leadership support, to reward and recognize best practice performers, and to emphasize the use of data for feedback and improvement. As these processes are implemented successfully, and evidence of improved outcomes is documented, it is likely that this approach will be more widely embraced and that organizationwide performance improvement will increase significantly. Health care has traditionally invested extraordinary resources in developing best practice approaches, including guidelines, education programs, or other tangible products and services. Comparatively little time, effort, and resources have been targeted to implementation and use, the stage at which most efforts fail. CQI's emphasis on data, rapid diffusion of innovative programs, and rapid cycle improvements enhance the implementation and effectiveness of disease management.
A Prototype for the Support of Integrated Software Process Development and Improvement

NASA Astrophysics Data System (ADS)

Porrawatpreyakorn, Nalinpat; Quirchmayr, Gerald; Chutimaskul, Wichian

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

NASA Astrophysics Data System (ADS)

Carlsson, Sven; Schönström, Mikael

Commentators on contemporary themes of strategic management and firm competitiveness stress that a firm's competitive advantage flows from its unique knowledge and how it manages knowledge, and for many firms their ability to create, share, exchange, and use knowledge have a major impact on their competitiveness (Nonaka & Teece 2001). In software development, knowledge management (KM) plays an increasingly important role. It has been argued that the KM-field is an important source for creating new perspectives on the software development process (Iivari 2000). Several Software Process Improvement (SPI) approaches stress the importance of managing knowledge and experiences as a way for improving software processes (Ahem et al. 2001). Another SPI-trend is the use of ideas from process management like in the Capability Maturity Model (CMM). Unfortunately, little research on the effects of the use of process management ideas in SPI exists. Given the influx of process management ideas to SPI, the impact of these ideas should be addressed.
Leadership and Quality Management: An Analysis of Three Key Features of the Greek Education System

ERIC Educational Resources Information Center

Saiti, Anna

2012-01-01

Purpose: This paper aims to investigate whether educational leadership in Greece implements the values of total quality management and contributes to the improvement of the educational process, and to offer proposals for a framework of total quality management that would contribute to an improvement in the overall quality of the education process.…
The six critical attributes of the next generation of quality management software systems.

PubMed

Clark, Kathleen

2011-07-01

Driven by both the need to meet regulatory requirements and a genuine desire to drive improved quality, quality management systems encompassing standard operating procedure, corrective and preventative actions and related processes have existed for many years, both in paper and electronic form. The impact of quality management systems on 'actual' quality, however, is often reported as far less than desired. A quality management software system that moves beyond formal forms-driven processes to include a true closed loop design, manage disparate processes across the enterprise, provide support for collaborative processes and deliver insight into the overall state of control has the potential to close the gap between simply accomplishing regulatory compliance and delivering measurable improvements in quality and efficiency.
The association between effectiveness of the management processes and quality of health services from the perspective of the managers in the university hospitals of Ahvaz, Iran

PubMed Central

Faraji-Khiavi, F; Ghobadian, S; Moradi-Joo, E

2015-01-01

Background and Objective: Knowledge management is introduced as a key element of quality improvement in organizations. There was no such research in university hospitals of Ahvaz. This study aimed to determine the association between the effectiveness of the processes of knowledge management and the health services quality from the managers’ view in the educational hospitals of Ahvaz city. Materials and Methods: in this correlational and research, the research population consisted of 120 managers from hospitals in University of Medical Sciences Ahvaz. Due to the limited population, the census was run. Three questionnaires were used for data collection: Demographic characteristics, the effectiveness of knowledge management processes and the quality of medical services. To analyze the data, the Spearman association analysis, The Kruskal-Wallis, the Mann–Whitney U test, were used in SPSS. Results: estimation of average scoring of the effectiveness of knowledge management processes and its components were relatively appropriate. Quality of medical services was estimated as relatively appropriate. Relationship of quality of health services with the effectiveness of knowledge management processes showed a medium and positive correlation (p < 0.001). Managers with different genders showed significant differences in knowledge development and transfer (P = 0.003). Conclusion: a significant and positive association was observed between the effectiveness of knowledge management processes and health care quality. To improve the health care quality in university hospitals, managers should pay more attention to develop the cultures of innovation, encourage teamwork, and improve communication and creative thinking in the knowledge management context PMID:28316735
Near-miss incident management in the chemical process industry.

PubMed

Phimister, James R; Oktem, Ulku; Kleindorfer, Paul R; Kunreuther, Howard

2003-06-01

This article provides a systematic framework for the analysis and improvement of near-miss programs in the chemical process industries. Near-miss programs improve corporate environmental, health, and safety (EHS) performance through the identification and management of near misses. Based on more than 100 interviews at 20 chemical and pharmaceutical facilities, a seven-stage framework has been developed and is presented herein. The framework enables sites to analyze their own near-miss programs, identify weak management links, and implement systemwide improvements.
Improving bed turnover time with a bed management system.

PubMed

Tortorella, Frank; Ukanowicz, Donna; Douglas-Ntagha, Pamela; Ray, Robert; Triller, Maureen

2013-01-01

Efficient patient throughput requires a high degree of coordination and communication. Opportunities abound to improve the patient experience by eliminating waste from the process and improving communication among the multiple disciplines involved in facilitating patient flow. In this article, we demonstrate how an interdisciplinary team at a large tertiary cancer center implemented an electronic bed management system to improve the bed turnover component of the patient throughput process.
[Medical record management and risk management processes. State of the art and new normative guidelines about the organization and the management of the sanitary documentation in the National Health System or Hospital Trusts].

PubMed

Spolaore, P; Murolo, G; Sommavilla, M

2003-01-01

Recent health care reforms, the start of accreditation processes of health institutions, and the introduction also in the health system of risk management concepts and instruments, borrowed from the enterprise culture and the emphasis put on the protection of privacy, render evident the need and the urgency to define and to implement improvement processes of the organization and management of the medical documentation in the hospital with the aim of facilitation in fulfilment of regional and local health authorities policies about protection of the safety and improvement of quality of care. Currently the normative context that disciplines the management of medical records inside the hospital appears somewhat fragmentary, incomplete and however not able to clearly orientate health operators with the aim of a correct application of the enforced norms in the respect of the interests of the user and of local health authority. In this job we individuate the critical steps in the various phases of management process of the clinical folder and propose a new model of regulations, with the purpose to improve and to simplify the management processes and the modalities of compilation, conservation and release to entitled people of all clinical documentation.
Preparing systems engineering and computing science students in disciplined methods, quantitative, and advanced statistical techniques to improve process performance

NASA Astrophysics Data System (ADS)

McCray, Wilmon Wil L., Jr.

The research was prompted by a need to conduct a study that assesses process improvement, quality management and analytical techniques taught to students in U.S. colleges and universities undergraduate and graduate systems engineering and the computing science discipline (e.g., software engineering, computer science, and information technology) degree programs during their academic training that can be applied to quantitatively manage processes for performance. Everyone involved in executing repeatable processes in the software and systems development lifecycle processes needs to become familiar with the concepts of quantitative management, statistical thinking, process improvement methods and how they relate to process-performance. Organizations are starting to embrace the de facto Software Engineering Institute (SEI) Capability Maturity Model Integration (CMMI RTM) Models as process improvement frameworks to improve business processes performance. High maturity process areas in the CMMI model imply the use of analytical, statistical, quantitative management techniques, and process performance modeling to identify and eliminate sources of variation, continually improve process-performance; reduce cost and predict future outcomes. The research study identifies and provides a detail discussion of the gap analysis findings of process improvement and quantitative analysis techniques taught in U.S. universities systems engineering and computing science degree programs, gaps that exist in the literature, and a comparison analysis which identifies the gaps that exist between the SEI's "healthy ingredients " of a process performance model and courses taught in U.S. universities degree program. The research also heightens awareness that academicians have conducted little research on applicable statistics and quantitative techniques that can be used to demonstrate high maturity as implied in the CMMI models. The research also includes a Monte Carlo simulation optimization model and dashboard that demonstrates the use of statistical methods, statistical process control, sensitivity analysis, quantitative and optimization techniques to establish a baseline and predict future customer satisfaction index scores (outcomes). The American Customer Satisfaction Index (ACSI) model and industry benchmarks were used as a framework for the simulation model.
The National Shipbuilding Research Program: Implementation of Past NSRP Research Through Education and Training

DTIC Science & Technology

1999-01-05

used in each chapter to define the techniques of waste minimization are: improved operation management , material substitution, process substitution...1994 – Reduce Quantity & Toxicity of Waste • Improved Operation Management • Material & Process Substitution • Recycling • Treatment Advantages
[Sustainable process improvement with application of 'lean philosophy'].

PubMed

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

2013-01-01

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

PubMed

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

2001-01-01

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

DTIC Science & Technology

1990-12-12

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

PubMed

Breslin, Susan Ellen; Hamilton, Karen Marie; Paynter, Jacquelyn

2014-01-01

This article presents a quality improvement project to reduce readmissions in the Medicare population related to heart failure, acute myocardial infarction, and pneumonia. The article describes a systematic approach to the discharge process aimed at improving transitions of care from hospital to post-acute care, utilizing Lean Six Sigma methodology. Inpatient acute care hospital. A coordinated discharge process, which includes postdischarge follow-up, can reduce avoidable readmissions. Implications for The quality improvement project demonstrated the significant role case management plays in preventing costly readmissions and improving outcomes for patients through better transitions of care from the hospital to the community. By utilizing Lean Six Sigma methodology, hospitals can focus on eliminating waste in their current processes and build more sustainable improvements to deliver a safe, quality, discharge process for their patients. Case managers are leading this effort to improve care transitions and assure a smoother transition into the community postdischarge..
Improving medical stores management through automation and effective communication.

PubMed

Kumar, Ashok; Cariappa, M P; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

2016-01-01

Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan-Do-Study-Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.
Improvement of nuclear power plants within the perspective of applications of lean manufacturing practices

NASA Astrophysics Data System (ADS)

Malek, A. K.; Muhammad, H. I.; Rosmaini, A.; Alaa, A. S.; Falah, A. M.

2017-09-01

Development and improvement process are essential to the companies and factories of various kinds and this necessity is related aspects of cost, time and risk that can be avoided, these aspects are available at the nuclear power stations essential demands cannot be ignored. The lean management technique is one of the recent trends in the management system. Where the lean management is stated as the system increases the customer value and reduces the wastage process in an industry or in a power plants. Therefore, there is an urgent necessity to ensure the development and improvement in nuclear power plants in the pre-established in process of being established and stage of the management and production. All of these stages according to the study are closely related to the necessity operationalize and apply lean manufacturing practices that these applications are ineffective and clear contribution to reduce costs and control of production processes and the process of reducing future risks that could be exposed to the station.

Apply TQM to E-Government Outsourcing Management

NASA Astrophysics Data System (ADS)

Huai, Jinmei

This paper developed an approach to e-government outsourcing quality management. E-government initiatives have rapidly increased in the last decades and the success of these activities will largely depend on their operation quality. As an instrument to improve operation quality, outsourcing can be applied to e-government. This paper inspected process of e-government outsourcing and discussed how to improve the outsourcing performance through total quality management (TQM). The characteristics and special requirements of e-government outsourcing were analyzed as the basis for discussion. Then the principles and application of total quality management were interpreted. Finally the process of improving performance of e-government was analyzed in the context of outsourcing.
How Differences Between Manager and Clinician Perceptions of Safety Culture Impact Hospital Processes of Care.

PubMed

Richter, Jason; Mazurenko, Olena; Kazley, Abby Swanson; Ford, Eric W

2017-11-04

Evidenced-based processes of care improve patient outcomes, yet universal compliance is lacking, and perceptions of the quality of care are highly variable. The purpose of this study is to examine how differences in clinician and management perceptions on teamwork and communication relate to adherence to hospital processes of care. Hospitals submitted identifiable data for the 2012 Hospital Survey on Patient Safety Culture and the Centers for Medicare and Medicaid Services' Hospital Compare. The dependent variable was a composite, developed from the scores on adherence to acute myocardial infarction, heart failure, and pneumonia process of care measures. The primary independent variables reflected 4 safety culture domains: communication openness, feedback about errors, teamwork within units, and teamwork between units. We assigned each hospital into one of 4 groups based on agreement between managers and clinicians on each domain. Each hospital was categorized as "high" (above the median) or "low" (below) for clinicians and managers in communication and teamwork. We found a positive relationship between perceived teamwork and communication climate and processes of care measures. If managers and clinicians perceived the communication openness as high, the hospital was more likely to adhere with processes of care. Similarly, if clinicians perceived teamwork across units as high, the hospital was more likely to adhere to processes of care. Manager and staff perceptions about teamwork and communications impact adherence to processes of care. Policies should recognize the importance of perceptions of both clinicians and managers on teamwork and communication and seek to improve organizational climate and practices. Clinician perceptions of teamwork across units are more closely linked to processes of care, so managers should be cognizant and try to improve their perceptions.
Business process study simulation for resource management in an emergency department.

PubMed

Poomkothammal, Velusamy

2006-01-01

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

ERIC Educational Resources Information Center

Hahn, William G.; Bart, Barbara D.

2003-01-01

Business students were taught a total quality management-based outlining process for course readings and a tally method to measure learning efficiency. Comparison of 233 who used the process and 99 who did not showed that the group means of users' test scores were 12.4 points higher than those of nonusers. (Contains 25 references.) (SK)
Three Big Ideas for Reforming Acquisition: Evidence-Based Propositions for Transformation

DTIC Science & Technology

2015-04-30

specific ideas for improving key aspects of defense acquisition reforming the process for managing capabilities, addressing technology insertion, and...offers three specific ideas for improving key aspects of defense acquisition: reforming the process for managing capabilities, addressing technology...and process changes need to be made for any significant change to be seen. This paper offers reform ideas in three specific areas: achieving the
The Perfect Process Storm: Integration of CMMI, Agile, and Lean Six Sigma

DTIC Science & Technology

2012-12-01

struggled over the past few decades with a blizzard of process improvement methodologies such as Total Quality Manage- ment (TQM), Kaizen , JIT...the Japanese Kaizen system, targeting quality, effort, employee involvement, willingness to change, communication, and elimina- tion of waste in...blizzard of process improvement methodologies such as Total Quality Management (TQM), Kaizen , JIT Production, and Re-Engineering. These operations are
Earth Sciences Data and Information System (ESDIS) program planning and evaluation methodology development

NASA Technical Reports Server (NTRS)

Dickinson, William B.

1995-01-01

An Earth Sciences Data and Information System (ESDIS) Project Management Plan (PMP) is prepared. An ESDIS Project Systems Engineering Management Plan (SEMP) consistent with the developed PMP is also prepared. ESDIS and related EOS program requirements developments, management and analysis processes are evaluated. Opportunities to improve the effectiveness of these processes and program/project responsiveness to requirements are identified. Overall ESDIS cost estimation processes are evaluated, and recommendations to improve cost estimating and modeling techniques are developed. ESDIS schedules and scheduling tools are evaluated. Risk assessment, risk mitigation strategies and approaches, and use of risk information in management decision-making are addressed.
Digitalisierung - Management Zwischen 0 und 1

NASA Astrophysics Data System (ADS)

Friedrich, Stefan; Rachholz, Josef

2017-09-01

Digitization as a process of expressing actions and values by codes 0 and 1 has already has become part of our lives. Digitization enables enterprises to improve production, sales and to increase volume of production. However, no standard digitization strategy has been yet developed. Even in the digitized business process management system, the most important position remains to a human being. The improvement of software products, their availability and the education system in the area of introduction and use of information technology is thus a striking feature in development of managing (but also other) current processes.
Identifying critical issues in recreation planning and management: improving the management-research partnership

Treesearch

John H. Schomaker; David W. Lime

1988-01-01

The "nominal group" process is a proven technique to systematically arrive at a consensus about critical information needs in recreation planning and management. Using this process, 41 managers who attended a 1983 conference on river management identified 114 specific information needs grouped under 11 general questions. Clearly, some concerns of...
Why Process Improvement Training Fails

ERIC Educational Resources Information Center

Lu, Dawei; Betts, Alan

2011-01-01

Purpose: The purpose of this paper is to explore the underlying reasons why providing process improvement training, by itself, may not be sufficient to achieve the desired outcome of improved processes; and to attempt a conceptual framework of management training for more effective improvement. Design/methodology/approach: Two similar units within…
The Power of Process Improvement

ERIC Educational Resources Information Center

Fairfield-Sonn, James W.; Morgan, Sandra; Sumukadas, Narendar

2004-01-01

Over the last several decades many systematic management approaches, such as Total Quality Management, aimed at improving organizational performance and employee satisfaction have captured organizations' attention. Given their origins in statistics, operations management, and engineering, many of the concepts and techniques are technical. When…
ISO 9001 in a neonatal intensive care unit (NICU).

PubMed

Vitner, Gad; Nadir, Erez; Feldman, Michael; Yurman, Shmuel

2011-01-01

The aim of this paper is to present the process for approving and certifying a neonatal intensive care unit to ISO 9001 standards. The process started with the department head's decision to improve services quality before deciding to achieve ISO 9001 certification. Department processes were mapped and quality management mechanisms were developed. Process control and performance measurements were defined and implemented to monitor the daily work. A service satisfaction review was conducted to get feedback from families. In total, 28 processes and related work instructions were defined. Process yields showed service improvements. Family satisfaction improved. The paper is based on preparing only one neonatal intensive care unit to the ISO 9001 standard. The case study should act as an incentive for hospital managers aiming to improve service quality based on the ISO 9001 standard. ISO 9001 is becoming a recommended tool to improve clinical service quality.
The Application of Collaborative Business Intelligence Technology in the Hospital SPD Logistics Management Model.

PubMed

Liu, Tongzhu; Shen, Aizong; Hu, Xiaojian; Tong, Guixian; Gu, Wei

2017-06-01

We aimed to apply collaborative business intelligence (BI) system to hospital supply, processing and distribution (SPD) logistics management model. We searched Engineering Village database, China National Knowledge Infrastructure (CNKI) and Google for articles (Published from 2011 to 2016), books, Web pages, etc., to understand SPD and BI related theories and recent research status. For the application of collaborative BI technology in the hospital SPD logistics management model, we realized this by leveraging data mining techniques to discover knowledge from complex data and collaborative techniques to improve the theories of business process. For the application of BI system, we: (i) proposed a layered structure of collaborative BI system for intelligent management in hospital logistics; (ii) built data warehouse for the collaborative BI system; (iii) improved data mining techniques such as supporting vector machines (SVM) and swarm intelligence firefly algorithm to solve key problems in hospital logistics collaborative BI system; (iv) researched the collaborative techniques oriented to data and business process optimization to improve the business processes of hospital logistics management. Proper combination of SPD model and BI system will improve the management of logistics in the hospitals. The successful implementation of the study requires: (i) to innovate and improve the traditional SPD model and make appropriate implement plans and schedules for the application of BI system according to the actual situations of hospitals; (ii) the collaborative participation of internal departments in hospital including the department of information, logistics, nursing, medical and financial; (iii) timely response of external suppliers.
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.
Achieving organizational change in pediatric pain management

PubMed Central

Dowden, Stephanie; McCarthy, Maria; Chalkiadis, George

2008-01-01

BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices. OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital. DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party. RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described. CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement. PMID:18719714
Efficiency improvement of technological preparation of power equipment manufacturing

NASA Astrophysics Data System (ADS)

Milukov, I. A.; Rogalev, A. N.; Sokolov, V. P.; Shevchenko, I. V.

2017-11-01

Competitiveness of power equipment primarily depends on speeding-up the development and mastering of new equipment samples and technologies, enhancement of organisation and management of design, manufacturing and operation. Actual political, technological and economic conditions cause the acute need in changing the strategy and tactics of process planning. At that the issues of maintenance of equipment with simultaneous improvement of its efficiency and compatibility to domestically produced components are considering. In order to solve these problems, using the systems of computer-aided process planning for process design at all stages of power equipment life cycle is economically viable. Computer-aided process planning is developed for the purpose of improvement of process planning by using mathematical methods and optimisation of design and management processes on the basis of CALS technologies, which allows for simultaneous process design, process planning organisation and management based on mathematical and physical modelling of interrelated design objects and production system. An integration of computer-aided systems providing the interaction of informative and material processes at all stages of product life cycle is proposed as effective solution to the challenges in new equipment design and process planning.
Improving medical stores management through automation and effective communication

PubMed Central

Kumar, Ashok; Cariappa, M.P.; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

2016-01-01

Background Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. Methods We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan–Do–Study–Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. Results After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Conclusion Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management. PMID:26900225
Weaknesses in Applying a Process Approach in Industry Enterprises

NASA Astrophysics Data System (ADS)

Kučerová, Marta; Mĺkva, Miroslava; Fidlerová, Helena

2012-12-01

The paper deals with a process approach as one of the main principles of the quality management. Quality management systems based on process approach currently represents one of a proofed ways how to manage an organization. The volume of sales, costs and profit levels are influenced by quality of processes and efficient process flow. As results of the research project showed, there are some weaknesses in applying of the process approach in the industrial routine and it has been often only a formal change of the functional management to process management in many organizations in Slovakia. For efficient process management it is essential that companies take attention to the way how to organize their processes and seek for their continuous improvement.
Office of Command Security Total Quality Management Plan

DTIC Science & Technology

1989-07-01

outlines the Office of Command Security instruction for TQM implementation. Keywords: TQM (Total Quality Management ), DLA Office of Command Security, Continuous process improvement, Automatic data processing security.
Evaluation of process excellence tools in improving donor flow management in a tertiary care hospital in South India

PubMed Central

Venugopal, Divya; Rafi, Aboobacker Mohamed; Innah, Susheela Jacob; Puthayath, Bibin T.

2017-01-01

BACKGROUND: Process Excellence is a value based approach and focuses on standardizing work processes by eliminating the non-value added processes, identify process improving methodologies and maximize capacity and expertise of the staff. AIM AND OBJECTIVES: To Evaluate the utility of Process Excellence Tools in improving Donor Flow Management in a Tertiary care Hospital by studying the current state of donor movement within the blood bank and providing recommendations for eliminating the wait times and to improve the process and workflow. MATERIALS AND METHODS: The work was done in two phases; The First Phase comprised of on-site observations with the help of an expert trained in Process Excellence Methodology who observed and documented various aspects of donor flow, donor turn around time, total staff details and operator process flow. The Second Phase comprised of constitution of a Team to analyse the data collected. The analyzed data along with the recommendations were presented before an expert hospital committee and the management. RESULTS: Our analysis put forward our strengths and identified potential problems. Donor wait time was reduced by 50% after lean due to better donor management with reorganization of the infrastructure of the donor area. Receptionist tracking showed that 62% of the total time the staff wastes in walking and 22% in other non-value added activities. Defining Duties for each staff reduced the time spent by them in non-value added activities. Implementation of the token system, generation of unique identification code for donors and bar code labeling of the tubes and bags are among the other recommendations. CONCLUSION: Process Excellence is not a programme; it's a culture that transforms an organization and improves its Quality and Efficiency through new attitudes, elimination of wastes and reduction in costs. PMID:28970681

Evaluation of process excellence tools in improving donor flow management in a tertiary care hospital in South India.

PubMed

Venugopal, Divya; Rafi, Aboobacker Mohamed; Innah, Susheela Jacob; Puthayath, Bibin T

2017-01-01

Process Excellence is a value based approach and focuses on standardizing work processes by eliminating the non-value added processes, identify process improving methodologies and maximize capacity and expertise of the staff. To Evaluate the utility of Process Excellence Tools in improving Donor Flow Management in a Tertiary care Hospital by studying the current state of donor movement within the blood bank and providing recommendations for eliminating the wait times and to improve the process and workflow. The work was done in two phases; The First Phase comprised of on-site observations with the help of an expert trained in Process Excellence Methodology who observed and documented various aspects of donor flow, donor turn around time, total staff details and operator process flow. The Second Phase comprised of constitution of a Team to analyse the data collected. The analyzed data along with the recommendations were presented before an expert hospital committee and the management. Our analysis put forward our strengths and identified potential problems. Donor wait time was reduced by 50% after lean due to better donor management with reorganization of the infrastructure of the donor area. Receptionist tracking showed that 62% of the total time the staff wastes in walking and 22% in other non-value added activities. Defining Duties for each staff reduced the time spent by them in non-value added activities. Implementation of the token system, generation of unique identification code for donors and bar code labeling of the tubes and bags are among the other recommendations. Process Excellence is not a programme; it's a culture that transforms an organization and improves its Quality and Efficiency through new attitudes, elimination of wastes and reduction in costs.
Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship

PubMed Central

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

2017-01-01

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

PubMed

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

2017-01-01

Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output.
Increasing Productivity with Microcomputers: Key to Improvement of Special Educattion in the 1980s.

ERIC Educational Resources Information Center

Brady, Richard C.; Dodge, Bernard J.

1982-01-01

Five microcomputer applications which may improve the management of teacher education programs are noted (database management, word processing, spread sheets, project scheduling and management, and test scoring), and six steps in introducing microcomputers into a department are discussed. (CL)
Forecasting, Forecasting

Treesearch

Michael A. Fosberg

1987-01-01

Future improvements in the meteorological forecasts used in fire management will come from improvements in three areas: observational systems, forecast techniques, and postprocessing of forecasts and better integration of this information into the fire management process.
Improving the claims process with EDI.

PubMed

Moynihan, J J

1993-01-01

Electronic data interchange (EDI) is redefining the healthcare claims process. The traditional managerial approach to claims processing emphasizes information flow within the patient accounting department and between patient accounting and other departments. EDI enlarges the scope of the claims process to include information exchange between providers and payers. Using EDI to improve both external and internal information exchange makes the claims process more efficient and less expensive. This article is excerpted from "The Healthcare Financial Manager's Guide to Healthcare EDI," by James J. Moynihan, published by the Healthcare Financial Management Association.
Can formal collaborative methodologies improve quality in primary health care in New Zealand? Insights from the EQUIPPED Auckland Collaborative.

PubMed

Palmer, Celia; Bycroft, Janine; Healey, Kate; Field, Adrian; Ghafel, Mazin

2012-12-01

Auckland District Health Board was one of four District Health Boards to trial the Breakthrough Series (BTS) methodology to improve the management of long-term conditions in New Zealand, with support from the Ministry of Health. To improve clinical outcomes, facilitate planned care and promote quality improvement within participating practices in Auckland. Implementation of the Collaborative followed the improvement model / Institute for Healthcare Improvement methodology. Three topic areas were selected: system redesign, cardio-vascular disease/diabetes, and self-management support. An expert advisory group and the Improvement Foundation Australia helped guide project development and implementation. Primary Health Organisation facilitators were trained in the methodology and 15 practice teams participated in the three learning workshops and action periods over 12 months. An independent evaluation study using both quantitative and qualitative methods was conducted. Improvements were recorded in cardiovascular disease risk assessment, practice-level systems of care, self-management systems and follow-up and coordination for patients. Qualitative research found improvements in coordination and teamwork, knowledge of practice populations and understanding of managing long-term conditions. The Collaborative process delivered some real improvements in the systems of care for people with long-term conditions and a change in culture among participating practices. The findings suggest that by strengthening facilitation processes, improving access to comprehensive population audit tools and lengthening the time frame, the process has the potential to make significant improvements in practice. Other organisations should consider this approach when investigating quality improvement programmes.
Meeting the needs of customers with health CRM.

PubMed

Phillips, Jon; Panchal, Samir

2002-01-01

Customer relationship management (CRM) is a business strategy, supported by applications and technologies, that can fundamentally transform how healthcare delivery organizations manage patient and physician interactions, reduce cost, improve customer-facing processes, drive market and revenue growth, and manage regulatory compliance processes.
Compound management beyond efficiency.

PubMed

Burr, Ian; Winchester, Toby; Keighley, Wilma; Sewing, Andreas

2009-06-01

Codeveloping alongside chemistry and in vitro screening, compound management was one of the first areas in research recognizing the need for efficient processes and workflows. Material management groups have centralized, automated, miniaturized and, importantly, found out what not to do with compounds. While driving down cost and improving quality in storage and processing, researchers still face the challenge of interfacing optimally with changing business processes, in screening groups, and with external vendors and focusing on biologicals in many companies. Here we review our strategy to provide a seamless link between compound acquisition and screening operations and the impact of material management on quality of the downstream processes. Although this is driven in part by new technologies and improved quality control within material management, redefining team structures and roles also drives job satisfaction and motivation in our teams with a subsequent positive impact on cycle times and customer feedback.
Contingency Management and Deliberative Decision-Making Processes.

PubMed

Regier, Paul S; Redish, A David

2015-01-01

Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation.
Contingency Management and Deliberative Decision-Making Processes

PubMed Central

Regier, Paul S.; Redish, A. David

2015-01-01

Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725
Introducing the CERT (Trademark) Resiliency Engineering Framework: Improving the Security and Sustainability Processes

DTIC Science & Technology

2007-05-01

business processes and services. 4. Security operations management addresses the day-to-day activities that the organization performs to protect the...Management TM – Technology Management Security Operations Management SOM – Security Operations Management 5.7.2 Important Operations Competency...deals with the provision of access rights to informa- tion and technical assets SOM – Security Operations Management , which addresses the fundamental
DESC (Defense Electronics Supply Center) Total Quality Management Plan

DTIC Science & Technology

1989-04-01

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

PubMed

Monto, Sari; Penttilä, Riku; Kärri, Timo; Puolakka, Kari; Valpas, Antti; Talonpoika, Anna-Maria

2016-04-01

The healthcare system in Finland has begun routine collection of health-related quality of life (HRQoL) information for patients in hospitals to support more systematic cost-effectiveness analysis (CEA). This article describes the systematic collection of HRQoL survey data, and addresses challenges in the implementation of patient surveys and acquisition of cost data in the case hospital. Challenges include problems with incomplete data and undefined management processes. In order to support CEA of hospital treatments, improvements are sought from the process management literature and in the observation of healthcare professionals. The article has been written from an information system and process management perspective, concluding that process ownership, automation of data collection and better staff training are keys to generating more reliable data.
Redesigning the care of fragility fracture patients to improve osteoporosis management: a health care improvement project.

PubMed

Harrington, J Timothy; Barash, Harvey L; Day, Sherry; Lease, Joellen

2005-04-15

To develop new processes that assure more reliable, population-based care of fragility fracture patients. A 4-year clinical improvement project was performed in a multispecialty, community practice health system using evidence-based guidelines and rapid cycle process improvement methods (plan-do-study-act cycles). Prior to this project, appropriate osteoporosis care was provided to only 5% of our 1999 hip fracture patients. In 2001, primary physicians were provided prompts about appropriate care (cycle 1), which resulted in improved care for only 20% of patients. A process improvement pilot in 2002 (cycle 2) and full program implementation in 2003 (cycle 3) have assured osteoporosis care for all willing and able patients with any fragility fracture. Altogether, 58% of 2003 fragility fracture patients, including 46% of those with hip fracture, have had a bone measurement, have been assigned to osteoporosis care with their primary physician or a consultant, and are being monitored regularly. Only 19% refused osteoporosis care. Key process improvements have included using orthopedic billings to identify patients, referring patients directly from orthopedics to an osteoporosis care program, organizing care with a nurse manager and process management computer software, assigning patients to primary or consultative physician care based on disease severity, and monitoring adherence to therapy by telephone. Reliable osteoporosis care is achievable by redesigning clinical processes. Performance data motivate physicians to reconsider traditional approaches. Improving the care of osteoporosis and other chronic diseases requires coordinated care across specialty boundaries and health system support.
The Impact of Knowledge Management and Technology: An Analysis of Administrative Behaviours

ERIC Educational Resources Information Center

Nurluoz, Ozdem; Birol, Cem

2011-01-01

Knowledge management is crucial in higher education practices that refer knowledge sharing, feedback and communication process as part of the quality improvements. In this process, technology has a role to diffuse knowledge and create a link for sharing within the knowledge management process. In this respect, this research study aims to examine…
A Process Model of Small Business Owner-Managers' Learning in Peer Networks

ERIC Educational Resources Information Center

Zhang, Jing; Hamilton, Eleanor

2009-01-01

Purpose: The purpose of this study is to explore how owner-managers of small businesses can learn in peer networks to improve their management skills. It aims to offer a new way of understanding owner-managers' learning as part of a social process, by highlighting the complex, interactive relationship that exists between the owner-manager, his or…
Quantitative CMMI Assessment for Offshoring through the Analysis of Project Management Repositories

NASA Astrophysics Data System (ADS)

Sunetnanta, Thanwadee; Nobprapai, Ni-On; Gotel, Olly

The nature of distributed teams and the existence of multiple sites in offshore software development projects pose a challenging setting for software process improvement. Often, the improvement and appraisal of software processes is achieved through a turnkey solution where best practices are imposed or transferred from a company’s headquarters to its offshore units. In so doing, successful project health checks and monitoring for quality on software processes requires strong project management skills, well-built onshore-offshore coordination, and often needs regular onsite visits by software process improvement consultants from the headquarters’ team. This paper focuses on software process improvement as guided by the Capability Maturity Model Integration (CMMI) and proposes a model to evaluate the status of such improvement efforts in the context of distributed multi-site projects without some of this overhead. The paper discusses the application of quantitative CMMI assessment through the collection and analysis of project data gathered directly from project repositories to facilitate CMMI implementation and reduce the cost of such implementation for offshore-outsourced software development projects. We exemplify this approach to quantitative CMMI assessment through the analysis of project management data and discuss the future directions of this work in progress.
ICT and mobile health to improve clinical process delivery. a research project for therapy management process innovation.

PubMed

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

2013-01-01

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

PubMed

Lin, Jen-Chiun; Su, Mei-Ju; Cheng, Po-Hsun; Weng, Yung-Chien; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei

2007-01-01

This paper illustrates a sustained conceptual service quality improvement process for the management of software development within a healthcare enterprise. Our proposed process is revised from Niland's healthcare quality information system (HQIS). This process includes functions to survey the satisfaction of system functions, describe the operation bylaws on-line, and provide on-demand training. To achieve these goals, we integrate five information systems in National Taiwan University Hospital, including healthcare information systems, health quality information system, requirement management system, executive information system, and digital learning system, to form a full Deming cycle. A preliminary user satisfaction survey showed that our outpatient information system scored an average of 71.31 in 2006.

Clinical engineering and risk management in healthcare technological process using architecture framework.

PubMed

Signori, Marcos R; Garcia, Renato

2010-01-01

This paper presents a model that aids the Clinical Engineering to deal with Risk Management in the Healthcare Technological Process. The healthcare technological setting is complex and supported by three basics entities: infrastructure (IS), healthcare technology (HT), and human resource (HR). Was used an Enterprise Architecture - MODAF (Ministry of Defence Architecture Framework) - to model this process for risk management. Thus, was created a new model to contribute to the risk management in the HT process, through the Clinical Engineering viewpoint. This architecture model can support and improve the decision making process of the Clinical Engineering to the Risk Management in the Healthcare Technological process.
The Application of Collaborative Business Intelligence Technology in the Hospital SPD Logistics Management Model

PubMed Central

LIU, Tongzhu; SHEN, Aizong; HU, Xiaojian; TONG, Guixian; GU, Wei

2017-01-01

Background: We aimed to apply collaborative business intelligence (BI) system to hospital supply, processing and distribution (SPD) logistics management model. Methods: We searched Engineering Village database, China National Knowledge Infrastructure (CNKI) and Google for articles (Published from 2011 to 2016), books, Web pages, etc., to understand SPD and BI related theories and recent research status. For the application of collaborative BI technology in the hospital SPD logistics management model, we realized this by leveraging data mining techniques to discover knowledge from complex data and collaborative techniques to improve the theories of business process. Results: For the application of BI system, we: (i) proposed a layered structure of collaborative BI system for intelligent management in hospital logistics; (ii) built data warehouse for the collaborative BI system; (iii) improved data mining techniques such as supporting vector machines (SVM) and swarm intelligence firefly algorithm to solve key problems in hospital logistics collaborative BI system; (iv) researched the collaborative techniques oriented to data and business process optimization to improve the business processes of hospital logistics management. Conclusion: Proper combination of SPD model and BI system will improve the management of logistics in the hospitals. The successful implementation of the study requires: (i) to innovate and improve the traditional SPD model and make appropriate implement plans and schedules for the application of BI system according to the actual situations of hospitals; (ii) the collaborative participation of internal departments in hospital including the department of information, logistics, nursing, medical and financial; (iii) timely response of external suppliers. PMID:28828316
Total Quality Management (TQM), an Overview

DTIC Science & Technology

1991-09-01

Quality Management (TQM). It discusses the reasons TQM is a current growth industry, what it is, and how one implements it. It describes the basic analytical tools, statistical process control, some advanced analytical tools, tools used by process improvement teams to enhance their own operations, and action plans for making improvements. The final sections discuss assessing quality efforts and measuring the quality to knowledge
Innovation in managing the referral process at a Canadian pediatric hospital.

PubMed

MacGregor, Daune; Parker, Sandra; MacMillan, Sharon; Blais, Irene; Wong, Eugene; Robertson, Chris J; Bruce-Barrett, Cindy

2009-01-01

The provision of timely and optimal patient care is a priority in pediatric academic health science centres. Timely access to care is optimized when there is an efficient and consistent referral system in place. In order to improve the patient referral process and, therefore, access to care, an innovative web-based system was developed and implemented. The Ambulatory Referral Management System enables the electronic routing for submission, review, triage and management of all outpatient referrals. The implementation of this system has provided significant metrics that have informed how processes can be improved to increase access to care. Use of the system has improved efficiency in the referral process and has reduced the work associated with the previous paper-based referral system. It has also enhanced communication between the healthcare provider and the patient and family and has improved the security and confidentiality of patient information management. Referral guidelines embedded within the system have helped to ensure that referrals are more complete and that the patient being referred meets the criteria for assessment and treatment in an ambulatory setting. The system calculates and reports on wait times, as well as other measures.
Strategic Planning Methodology for Financial Management in the Department of the Navy

DTIC Science & Technology

1983-05-24

objectives for accounting and financial management systems improvement for the Department of the Navy (DON) and for developing DON policy for overall...Strategic Financial Management Plan, in which we have provided recommendations for improving the planning process. This wedge packet is intended to provide a
Clinical audit of diabetes management can improve the quality of care in a resource-limited primary care setting.

PubMed

Govender, Indira; Ehrlich, Rodney; Van Vuuren, Unita; De Vries, Elma; Namane, Mosedi; De Sa, Angela; Murie, Katy; Schlemmer, Arina; Govender, Strini; Isaacs, Abdul; Martell, Rob

2012-12-01

To determine whether clinical audit improved the performance of diabetic clinical processes in the health district in which it was implemented. Patient folders were systematically sampled annually for review. Primary health-care facilities in the Metro health district of the Western Cape Province in South Africa. Health-care workers involved in diabetes management. Clinical audit and feedback. The Skillings-Mack test was applied to median values of pooled audit results for nine diabetic clinical processes to measure whether there were statistically significant differences between annual audits performed in 2005, 2007, 2008 and 2009. Descriptive statistics were used to illustrate the order of values per process. A total of 40 community health centres participated in the baseline audit of 2005 that decreased to 30 in 2009. Except for two routine processes, baseline medians for six out of nine processes were below 50%. Pooled audit results showed statistically significant improvements in seven out of nine clinical processes. The findings indicate an association between the application of clinical audit and quality improvement in resource-limited settings. Co-interventions introduced after the baseline audit are likely to have contributed to improved outcomes. In addition, support from the relevant government health programmes and commitment of managers and frontline staff contributed to the audit's success.
European Software Engineering Process Group Conference (2nd Annual), EUROPEAN SEPG󈨥. Delegate Material, Tutorials

DTIC Science & Technology

1997-06-17

There is Good and Bad News With CMMs8 *bad news: process improvement takes time *good news: the first benefit Is better schedule management With PSP s...e g similar supp v EURO not sudden death toolset for assessment and v EURO => Business benefits detailed analysis) . EURO could collapse (low risk...from SPI live on even after year 2000. Priority BENEFITS Actions * Improved management and application development processes * Strengthened Change
Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

PubMed

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

2012-06-01

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

PubMed Central

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

2012-01-01

Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342
44 CFR 78.6 - Flood Mitigation Plan approval process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... approval process. 78.6 Section 78.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... MITIGATION ASSISTANCE § 78.6 Flood Mitigation Plan approval process. The State POC will forward all Flood... reasons for non-approval and offer suggestions for improvement. ...
76 FR 2084 - Pacific Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... Pacific Fishery Management Council's (Council) Ad Hoc Groundfish Process Improvement Committee (PIC) will... the PIC work session is to develop an optimum detailed process and schedule for the 2013-14 groundfish...
Organizational management practices for achieving software process improvement

NASA Technical Reports Server (NTRS)

Kandt, Ronald Kirk

2004-01-01

The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.
MARKOV: A methodology for the solution of infinite time horizon MARKOV decision processes

USGS Publications Warehouse

Williams, B.K.

1988-01-01

Algorithms are described for determining optimal policies for finite state, finite action, infinite discrete time horizon Markov decision processes. Both value-improvement and policy-improvement techniques are used in the algorithms. Computing procedures are also described. The algorithms are appropriate for processes that are either finite or infinite, deterministic or stochastic, discounted or undiscounted, in any meaningful combination of these features. Computing procedures are described in terms of initial data processing, bound improvements, process reduction, and testing and solution. Application of the methodology is illustrated with an example involving natural resource management. Management implications of certain hypothesized relationships between mallard survival and harvest rates are addressed by applying the optimality procedures to mallard population models.
Identifying Training Needs to Improve Indigenous Community Representatives Input into Environmental Resource Management Consultative Processes: A Case Study of the Bundjalung Nation

ERIC Educational Resources Information Center

Lloyd, David; Norrie, Fiona

2004-01-01

Despite increased engagement of Indigenous representatives as participants on consultative panels charged with processes of natural resource management, concerns have been raised by both Indigenous representatives and management agencies regarding the ability of Indigenous people to have quality input into the decisions these processes produce. In…
PSP, TSP, XP, CMMI...Eating the Alphabet Soup!

DTIC Science & Technology

2011-05-19

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

PubMed

Tamm, Eric Peter

2016-03-01

Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.
A tale of two audits: statistical process control for improving diabetes care in primary care settings.

PubMed

Al-Hussein, Fahad Abdullah

2008-01-01

Diabetes constitutes a major burden of disease globally. Both primary and secondary prevention need to improve in order to face this challenge. Improving management of diabetes in primary care is therefore of fundamental importance. The objective of these series of audits was to find means of improving diabetes management in chronic disease mini-clinics in primary health care. In the process, we were able to study the effect and practical usefulness of different audit designs - those measuring clinical outcomes, process of care, or both. King Saud City Family and Community Medicine Centre, Saudi National Guard Health Affairs in Riyadh city, Saudi Arabia. Simple random samples of 30 files were selected every two weeks from a sampling frame of file numbers for all diabetes clients seen over the period. Information was transferred to a form, entered on the computer and an automated response was generated regarding the appropriateness of management, a criterion mutually agreed upon by care providers. The results were plotted on statistical process control charts, p charts, displayed for all employees. Data extraction, archiving, entry, analysis, plotting and design and preparation of p charts were managed by nursing staff specially trained for the purpose by physicians with relevant previous experience. Audit series with mixed outcome and process measures failed to detect any changes in the proportion of non-conforming cases over a period of one year. The process measures series, on the other hand, showed improvement in care corresponding to a reduction in the proportion non-conforming by 10% within a period of 3 months. Non-conformities dropped from a mean of 5.0 to 1.4 over the year (P < 0.001). It is possible to improve providers' behaviour regarding implementation of given guidelines through periodic process audits and feedbacks. Frequent process audits in the context of statistical process control should be supplemented with concurrent outcome audits, once or twice a year.
Total Quality Management Implementation Plan: Defense Depot, Ogden

DTIC Science & Technology

1989-07-01

NUMBERS Total Quality Management Implementation Plan Defense Depot Ogden 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...PAGES TQM (Total Quality Management ), Continuous Process Improvement, Depot Operations, Process Action Teams 16. PRICE CODE 17. SECURITY...034 A Message From The Commander On Total Quality Management i fully support the DLA aoproacii to Total Quality Management . As stated by General
Milestones of mathematical model for business process management related to cost estimate documentation in petroleum industry

NASA Astrophysics Data System (ADS)

Khamidullin, R. I.

2018-05-01

The paper is devoted to milestones of the optimal mathematical model for a business process related to cost estimate documentation compiled during construction and reconstruction of oil and gas facilities. It describes the study and analysis of fundamental issues in petroleum industry, which are caused by economic instability and deterioration of a business strategy. Business process management is presented as business process modeling aimed at the improvement of the studied business process, namely main criteria of optimization and recommendations for the improvement of the above-mentioned business model.
Risk Management

DTIC Science & Technology

2011-06-02

actively attack the risks, they will actively attack you.” -Tom Gib Why do Risk Management? 8 “The first step in the risk management process is to...opportunities to manage and improve our chances of success. - Roger Vanscoy “If you do not actively attack the risks, they will actively attack ...our risks provides opportunities to manage and improve our chances of success. - Roger Vanscoy “If you do not actively attack the risks, they will

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

ERIC Educational Resources Information Center

Aldowaisan, Tariq; Allahverdi, Ali

2016-01-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…
Adaptive management: Chapter 1

USGS Publications Warehouse

Allen, Craig R.; Garmestani, Ahjond S.; Allen, Craig R.; Garmestani, Ahjond S.

2015-01-01

Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive management has explicit structure, including a careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. The process is iterative, and serves to reduce uncertainty, build knowledge and improve management over time in a goal-oriented and structured process.
Adaptive management

USGS Publications Warehouse

Allen, Craig R.; Garmestani, Ahjond S.

2015-01-01

Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive management has explicit structure, including a careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. The process is iterative, and serves to reduce uncertainty, build knowledge and improve management over time in a goal-oriented and structured process.
[Lean thinking and brain-dead patient assistance in the organ donation process].

PubMed

Pestana, Aline Lima; dos Santos, José Luís Guedes; Erdmann, Rolf Hermann; da Silva, Elza Lima; Erdmann, Alacoque Lorenzini

2013-02-01

Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.
Adaptive management of urban watersheds

NASA Astrophysics Data System (ADS)

Garmestani, A.; Shuster, W.; Green, O. O.

2013-12-01

Consent decree settlements for violations of the Clean Water Act (1972) increasingly include provisions for redress of combined sewer overflow activity through hybrid approaches that incorporate the best of both gray (e.g., storage tunnels) and green infrastructure (e.g., rain gardens). Adaptive management is an environmental management strategy that uses an iterative process of decision-making to improve environmental management via system monitoring. A central tenet of adaptive management is that management involves a learning process that can help regulated communities achieve environmental quality objectives. We are using an adaptive management approach to guide a green infrastructure retrofit of a neighborhood in the Slavic Village Development Corporation area (Cleveland, Ohio). We are in the process of gathering hydrologic and ecosystem services data and will use this data as a basis for collaboration with area citizens on a plan to use green infrastructure to contain stormflows. Monitoring data provides researchers with feedback on the impact of green infrastructure implementation and suggest where improvements can be made.
Evaluating participation in water resource management: A review

NASA Astrophysics Data System (ADS)

Carr, G.; BlöSchl, G.; Loucks, D. P.

2012-11-01

Key documents such as the European Water Framework Directive and the U.S. Clean Water Act state that public and stakeholder participation in water resource management is required. Participation aims to enhance resource management and involve individuals and groups in a democratic way. Evaluation of participatory programs and projects is necessary to assess whether these objectives are being achieved and to identify how participatory programs and projects can be improved. The different methods of evaluation can be classified into three groups: (i) process evaluation assesses the quality of participation process, for example, whether it is legitimate and promotes equal power between participants, (ii) intermediary outcome evaluation assesses the achievement of mainly nontangible outcomes, such as trust and communication, as well as short- to medium-term tangible outcomes, such as agreements and institutional change, and (iii) resource management outcome evaluation assesses the achievement of changes in resource management, such as water quality improvements. Process evaluation forms a major component of the literature but can rarely indicate whether a participation program improves water resource management. Resource management outcome evaluation is challenging because resource changes often emerge beyond the typical period covered by the evaluation and because changes cannot always be clearly related to participation activities. Intermediary outcome evaluation has been given less attention than process evaluation but can identify some real achievements and side benefits that emerge through participation. This review suggests that intermediary outcome evaluation should play a more important role in evaluating participation in water resource management.
Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

PubMed

Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

2014-01-01

The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).
Improving Organizational Productivity in NASA. Volume 2

NASA Technical Reports Server (NTRS)

1986-01-01

Recognizing that NASA has traditionally been in the forefront of technological change, the NASA Administrator challenged the Agency in 1982 to also become a leader in developing and applying advanced technology and management practices to increase productivity. One of the activities undertaken by the Agency to support this ambitious productivity goal was participation in a 2-year experimental action research project devoted to learning more about improving and assessing the performance of professional organizations. Participating with a dozen private sector organizations, NASA explored the usefulness of a productivity improvement process that addressed all aspects of organizational performance. This experience has given NASA valuable insight into the enhancement of professional productivity. More importantly, it has provided the Agency with a specific management approach that managers and supervisors can effectively use to emphasize and implement continuous improvement. This report documents the experiences of the five different NASA installations participating in the project, describes the improvement process that was applied and refined, and offers recommendations for expanded application of that process. Of particular interest is the conclusion that measuring white collar productivity may be possible, and at a minimum, the measurement process itself is beneficial to management. Volume I of the report provides a project overview, significant findings, and recommendations. Volume II presents individual case studies of the NASA pilot projects that were part of the action research effort.
Applications of genetic data to improve management and conservation of river fishes and their habitats

USGS Publications Warehouse

Scribner, Kim T.; Lowe, Winsor H.; Landguth, Erin L.; Luikart, Gordon; Infante, Dana M.; Whelan, Gary; Muhlfeld, Clint C.

2015-01-01

Environmental variation and landscape features affect ecological processes in fluvial systems; however, assessing effects at management-relevant temporal and spatial scales is challenging. Genetic data can be used with landscape models and traditional ecological assessment data to identify biodiversity hotspots, predict ecosystem responses to anthropogenic effects, and detect impairments to underlying processes. We show that by combining taxonomic, demographic, and genetic data of species in complex riverscapes, managers can better understand the spatial and temporal scales over which environmental processes and disturbance influence biodiversity. We describe how population genetic models using empirical or simulated genetic data quantify effects of environmental processes affecting species diversity and distribution. Our summary shows that aquatic assessment initiatives that use standardized data sets to direct management actions can benefit from integration of genetic data to improve the predictability of disturbance–response relationships of river fishes and their habitats over a broad range of spatial and temporal scales.
Total quality management: It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

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

PubMed

Clark, Lauren; Fink, Regina; Pennington, Karen; Jones, Katherine

2006-06-01

Achieving optimal and safe pain-management practices in the nursing home setting continues to challenge administrators, nurses, physicians, and other health care providers. Several factors in nursing home settings complicate the conduct of clinical process improvement research. The purpose of this qualitative study was to explore the perceptions of a sample of Colorado nursing home staff who participated in a study to develop and evaluate a multifaceted pain-management intervention. Semistructured interviews were conducted with 103 staff from treatment and control nursing homes, audiotaped, and content analyzed. Staff identified changes in their knowledge and attitudes about pain and their pain-assessment and management practices. Progressive solutions and suggestions for changing practice include establishing an internal pain team and incorporating nursing assistants into the care planning process. Quality improvement strategies can accommodate the special circumstances of nursing home care and build the capacity of the nursing homes to initiate and monitor their own process-improvement programs using a participatory research approach.
Independent practice associations and physician-hospital organizations can improve care management for smaller practices.

PubMed

Casalino, Lawrence P; Wu, Frances M; Ryan, Andrew M; Copeland, Kennon; Rittenhouse, Diane R; Ramsay, Patricia P; Shortell, Stephen M

2013-08-01

Pay-for-performance, public reporting, and accountable care organization programs place pressures on physicians to use health information technology and organized care management processes to improve the care they provide. But physician practices that are not large may lack the resources and size to implement such processes. We used data from a unique national survey of 1,164 practices with fewer than twenty physicians to provide the first information available on the extent to which independent practice associations (IPAs) and physician-hospital organizations (PHOs) might make it possible for these smaller practices to share resources to improve care. Nearly a quarter of the practices participated in an IPA or a PHO that accounted for a significant proportion of their patients. On average, practices participating in these organizations provided nearly three times as many care management processes for patients with chronic conditions as nonparticipating practices did (10.4 versus 3.8). Half of these processes were provided only by IPAs or PHOs. These organizations may provide a way for small and medium-size practices to systematically improve care and participate in accountable care organizations.
[Design of medical devices management system supporting full life-cycle process management].

PubMed

Su, Peng; Zhong, Jianping

2014-03-01

Based on the analysis of the present status of medical devices management, this paper optimized management process, developed a medical devices management system with Web technologies. With information technology to dynamic master the use of state of the entire life-cycle of medical devices. Through the closed-loop management with pre-event budget, mid-event control and after-event analysis, improved the delicacy management level of medical devices, optimized asset allocation, promoted positive operation of devices.
Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.

PubMed

Hemens, Brian J; Holbrook, Anne; Tonkin, Marita; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

Computerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit. We conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements. CCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.
Process Improvement Teams: A TQM Strategy for Improving Community College Systems.

ERIC Educational Resources Information Center

Needham, Robbie Lee; And Others

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

PubMed

Hassan, Mohsen M D

The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.
An adaptive management process for forest soil conservation.

Treesearch

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

2005-01-01

Soil disturbance guidelines should be based on comparable disturbance categories adapted to specific local soil conditions, validated by monitoring and research. Guidelines, standards, and practices should be continually improved based on an adaptive management process, which is presented in this paper. Core components of this process include: reliable monitoring...
Developing and Managing University-Industry Research Collaborations through a Process Methodology/Industrial Sector Approach

ERIC Educational Resources Information Center

Philbin, Simon P.

2010-01-01

A management framework has been successfully utilized at Imperial College London in the United Kingdom to improve the process for developing and managing university-industry research collaborations. The framework has been part of a systematic approach to increase the level of research contracts from industrial sources, to strengthen the…
Institutional Researchers as Knowledge Managers in Universities: Envisioning New Roles for the IR Profession

ERIC Educational Resources Information Center

Teodorescu, Daniel

2006-01-01

Using concepts from Davenport and Prusak's "Working Knowledge" and other recent research on knowledge management, this article discusses the processes through which institutional knowledge is created, managed and transferred throughout the university and ways in which institutional researchers can improve these processes. A special emphasis is…
Pain management: a review of organisation models with integrated processes for the management of pain in adult cancer patients.

PubMed

Brink-Huis, Anita; van Achterberg, Theo; Schoonhoven, Lisette

2008-08-01

This paper reports a review of the literature conducted to identify organisation models in cancer pain management that contain integrated care processes and describe their effectiveness. Pain is experienced by 30-50% of cancer patients receiving treatment and by 70-90% of those with advanced disease. Efforts to improve pain management have been made through the development and dissemination of clinical guidelines. Early improvements in pain management were focussed on just one or two single processes such as pain assessment and patient education. Little is known about organisational models with multiple integrated processes throughout the course of the disease trajectory and concerning all stages of the care process. Systematic review. The review involved a systematic search of the literature, published between 1986-2006. Subject-specific keywords used to describe patients, disease, pain management interventions and integrated care processes, relevant for this review were selected using the thesaurus of the databases. Institutional models, clinical pathways and consultation services are three alternative models for the integration of care processes in cancer pain management. A clinical pathway is a comprehensive institutionalisation model, whereas a pain consultation service is a 'stand-alone' model that can be integrated in a clinical pathway. Positive patient and process outcomes have been described for all three models, although the level of evidence is generally low. Evaluation of the quality of pain management must involve standardised measurements of both patient and process outcomes. We recommend the development of policies for referrals to a pain consultation service. These policies can be integrated within a clinical pathway. To evaluate the effectiveness of pain management models standardised outcome measures are needed.

Quality management of human resources. Providers should begin by focusing on education, performance management, and reward systems.

PubMed

Blair, C S; Fordyce, M; Barney, S M

1993-10-01

For a quality management transformation to occur, a healthcare organization must focus on education and development, performance management, and recognition and reward systems during the first years of implementation. Education and development are perhaps the most important human resource management functions when implementing quality management principles and processes because behavioral changes will be required at all organizational levels. Specific programs that support an organization's quality management effort will vary but should include the conceptual, cultural, and technical aspects of quality management. The essence of quality management is to always satisfy the customer and to continuously improve the services and products the organization offers. The approach to performance management should therefore rely on customer feedback and satisfaction. An organization committed to quality management should base its performance management approach on customer orientation, process improvement, employee involvement, decision making with data, and continuous improvement. Managers and trustees are being challenged to provide innovative recognition and reward systems that reinforce the values and behaviors consistent with quality management. Such systems must also be aligned with the behaviors and outcomes that support the philosophy, mission, and values of the Catholic healthcare ministry. The following components should be considered for a recognition and reward system: base pay, incentives, benefits, and nonmonetary rewards.
[The balanced scorecard used as a management tool in a clinical laboratory: internal business processes indicators].

PubMed

Salinas La Casta, Maria; Flores Pardo, Emilio; Uris Selles, Joaquín

2009-01-01

to propose a set of indicators as a management tool for a clinical laboratory, by using the balanced scorecard internal business processes perspective. indicators proposed are obtained from different sources; external proficiency testing of the Valencia Community Government, by means of internal surveys and laboratory information system registers. One year testing process proportion indicators results are showed. internal management indicators are proposed (process, appropriateness and proficiency testing). The process indicators results show gradual improvement since its establishment. after one years of using a conceptually solid Balanced Scorecard Internal business processes perspective indicators, the obtained results validate the usefulness as a laboratory management tool.
Application of a Micro Computer-Based Management Information System to Improve the USAF Service Reporting Process

DTIC Science & Technology

1990-09-01

I. Introduction .......................................... 1 General Issue .................................. 1 Specific Research Problem...viii APPLICATION OF A MICRO COMPUTER-BASED MANAGEMENT INFORMATION SYSTEM TO IMPROVE THE USAF SERVICE REPORTING PROCESS I. Introduction General Issue...continued Transfer MIP Responsibility ,KNT WETSS0GEFORM UNCLASSIFIED 904 JAUG 19: iRR iRRl UUUUI HOWE271652_ D- FF:MCH INFO: NONE E. iUCH DATA DEF: NONE F
A whole process quality control system for energy measuring instruments inspection based on IOT technology

NASA Astrophysics Data System (ADS)

Yin, Bo; Liu, Li; Wang, Jiahan; Li, Xiran; Liu, Zhenbo; Li, Dewei; Wang, Jun; Liu, Lu; Wu, Jun; Xu, Tingting; Cui, He

2017-10-01

Electric energy measurement as a basic work, an accurate measurements play a vital role for the economic interests of both parties of power supply, the standardized management of the measurement laboratory at all levels is a direct factor that directly affects the fairness of measurement. Currently, the management of metering laboratories generally uses one-dimensional bar code as the recognition object, advances the testing process by manual management, most of the test data requires human input to generate reports. There are many problems and potential risks in this process: Data cannot be saved completely, cannot trace the status of inspection, the inspection process isn't completely controllable and so on. For the provincial metrology center's actual requirements of the whole process management for the performance test of the power measuring appliances, using of large-capacity RF tags as a process management information media, we developed a set of general measurement experiment management system, formulated a standardized full performance test process, improved the raw data recording mode of experimental process, developed a storehouse automatic inventory device, established a strict test sample transfer and storage system, ensured that all the raw data of the inspection can be traced back, achieved full life-cycle control of the sample, significantly improved the quality control level and the effectiveness of inspection work.
Adding intelligence to mobile asset management in hospitals: the true value of RFID.

PubMed

Castro, Linda; Lefebvre, Elisabeth; Lefebvre, Louis A

2013-10-01

RFID (Radio Frequency Identification) technology is expected to play a vital role in the healthcare arena, especially in times when cost containments are at the top of the priorities of healthcare management authorities. Medical equipment represents a significant share of yearly healthcare operational costs; hence, ensuring an effective and efficient management of such key assets is critical to promptly and reliably deliver a diversity of clinical services at the patient bedside. Empirical evidence from a phased-out RFID implementation in one European hospital demonstrates that RFID has the potential to transform asset management by improving inventory management, enhancing asset utilization, increasing staff productivity, improving care services, enhancing maintenance compliance, and increasing information visibility. Most importantly, RFID allows the emergence of intelligent asset management processes, which is, undoubtedly, the most important benefit that could be derived from the RFID system. Results show that the added intelligence can be rather basic (auto-status change) or a bit more advanced (personalized automatic triggers). More importantly, adding intelligence improves planning and decision-making processes.
Nuclear emergency management procedures in Europe

NASA Astrophysics Data System (ADS)

Carter, Emma

The Chernobyl accident brought to the fore the need for decision-making in nuclear emergency management to be transparent and consistent across Europe. A range of systems to support decision-making in future emergencies have since been developed, but, by and large, with little consultation with potential decision makers and limited understanding of the emergency management procedures across Europe and how they differ. In nuclear emergency management, coordination, communication and information sharing are of paramount importance. There are many key players with their own technical expertise, and several key activities occur in parallel, across different locations. Business process modelling can facilitate understanding through the representation of processes, aid transparency and structure the analysis, comparison and improvement of processes. This work has been conducted as part of a European Fifth Framework Programme project EVATECH, whose aim was to improve decision support methods, models and processes taking into account stakeholder expectations and concerns. It has involved the application of process modelling to document and compare the emergency management processes in four European countries. It has also involved a multidisciplinary approach taking a socio-technical perspective. The use of process modelling did indeed facilitate understanding and provided a common platform, which was not previously available, to consider emergency management processes. This thesis illustrates the structured analysis approach that process modelling enables. Firstly, through an individual analysis for the United Kingdom (UK) model that illustrated the potential benefits for a country. These are for training purposes, to build reflexive shared mental models, to aid coordination and for process improvement. Secondly, through a comparison of the processes in Belgium, Germany, Slovak Republic and the UK. In this comparison of the four processes we observed that the four process models are substantially different in their organisational structure and identified differences in the management of advice, where decisions are made and the communication network style. Another key aspect of this work is that through the structured analysis conducted we were able to develop a framework for the evaluation of DSS from the perspective of process. This work concludes reflecting on the challenges, which the European off-site nuclear emergency community face and suggest direction for future work, with particular reference to a recent conference on the capabilities and challenges of offsite nuclear emergency management, the Salzburg Symposium 2003.
Management of construction and demolition wastes as secondary building resources

NASA Astrophysics Data System (ADS)

Manukhina, Lyubov; Ivanova, Irina

2017-10-01

The article analyzes the methods of management of construction and demolition wastes. The authors developed suggestions for improving the management system of the turnover of construction and demolition wastes. Today the issue of improving the management of construction and demolition wastes is of the same importance as problems of protecting the life-support field from pollution and of preserving biological and land resources. The authors educed the prospective directions and methods for improving the management of the turnover processes for construction and demolition wastes, including the evaluation of potential of wastes as secondary raw materials and the formation of a centralized waste management system.
Developing a pain management program through continuous improvement strategies.

PubMed

Woodward, Dora

2005-01-01

Pain affects more than one third of cancer patients in the early stages of their disease, dramatically rising above 70% in the advanced stages. Numerous studies have been conducted in the pursuit of cancer pain relief, yet the prevalence of pain persists. This article focuses on a pain management program, developed by a performance improvement team, which addressed the inadequacies of current pain management. Performance improvement activities are described through the process of assessment, planning, implementation, and evaluation of the pain management program. This pain management program is uniquely derived from a unit core value that all staff is responsible and accountable for pain management.
National Aeronautics and Space Administration: Guidance for Improving Customer Satisfaction.

DTIC Science & Technology

1994-04-01

Logistics Management Institute National Aeronautics and Space Administration Guidance for Improving Customer Satisfaction NS302RD1 Lawrence... Management Institute (LMI) has been engaged to provide a common approach for planning, conducting, and analyzing customer satisfaction surveys. LMI...groups and formal surveys) (2) Process definition provides the understanding for addressing customer concerns (3) Management and employee
Priority setting in practice: participants opinions on vertical and horizontal priority setting for reallocation.

PubMed

Waldau, Susanne; Lindholm, Lars; Wiechel, Anna Helena

2010-08-01

In the Västerbotten County Council in Sweden a priority setting process was undertaken to reallocate existing resources for funding of new methods and activities. Resources were created by limiting low priority services. A procedure for priority setting was constructed and fully tested by engaging the entire organisation. The procedure included priority setting within and between departments and political decision making. Participants' views and experiences were collected as a basis for future improvement of the process. Results indicate that participants appreciated the overall approach and methodology and wished to engage in their improvement. Among the improvement proposals is prolongation of the process in order to improve the knowledge base quality. The procedure for identification of new items for funding also needs to be revised. The priority setting process was considered an overall success because it fulfilled its political goals. Factors considered crucial for success are a wish among managers for an economic strategy that addresses existing internal resource allocation; process management characterized by goal orientation and clear leadership; an elaborate communications strategy integrated early in the process and its management; political unity in support of the procedure, and a strong political commitment throughout the process. Generalizability has already been demonstrated by several health care organisations that performed processes founded on this working model. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
[Quality management (TQM) in public health-care (PHC): principles for cost-performance calculations and cost reductions with better quality].

PubMed

Bergholz, W

2008-11-01

In many high-tech industries, quality management (QM) has enabled improvements of quality by a factor of 100 or more, in combination with significant cost reductions. Compared to this, the application of QM methods in health care is in its initial stages. It is anticipated that stringent process management, embedded in an effective QM system will lead to significant improvements in health care in general and in the German public health service in particular. Process management is an ideal platform for controlling in the health care sector, and it will significantly improve the leverage of controlling to bring down costs. Best practice sharing in industry has led to quantum leap improvements. Process management will enable best practice sharing also in the public health service, in spite of the highly diverse portfolio of services that the public health service offers in different German regions. Finally, it is emphasised that "technical" QM, e.g., on the basis of the ISO 9001 standard is not sufficient to reach excellence. It is necessary to integrate soft factors, such as patient or employee satisfaction, and leadership quality into the system. The EFQM model for excellence can serve as proven tool to reach this goal.
Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

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

NASA Technical Reports Server (NTRS)

Sunazuka, Toshihiko; Basili, Victor R.

1989-01-01

Software managers are interested in the quantitative management of software quality, cost and progress. An integrated software management methodology, which can be applied throughout the software life cycle for any number purposes, is required. The TAME (Tailoring A Measurement Environment) methodology is based on the improvement paradigm and the goal/question/metric (GQM) paradigm. This methodology helps generate a software engineering process and measurement environment based on the project characteristics. The SQMAR (software quality measurement and assurance technology) is a software quality metric system and methodology applied to the development processes. It is based on the feed forward control principle. Quality target setting is carried out before the plan-do-check-action activities are performed. These methodologies are integrated to realize goal oriented measurement, process control and visual management. A metric setting procedure based on the GQM paradigm, a management system called the software management cycle (SMC), and its application to a case study based on NASA/SEL data are discussed. The expected effects of SMC are quality improvement, managerial cost reduction, accumulation and reuse of experience, and a highly visual management reporting system.
Interactive Management and Updating of Spatial Data Bases

NASA Technical Reports Server (NTRS)

French, P.; Taylor, M.

1982-01-01

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

ERIC Educational Resources Information Center

Caudle, Sharon L.

1996-01-01

Discusses six fundamental information resources management (IRM) practices in successful organizations that can improve government service delivery performance. Highlights include directing changes, integrating IRM decision making into a strategic management process, performance management, maintaining an investment philosophy, using business…
CM Process Improvement and the International Space Station Program (ISSP)

NASA Technical Reports Server (NTRS)

Stephenson, Ginny

2007-01-01

This viewgraph presentation reviews the Configuration Management (CM) process improvements planned and undertaken for the International Space Station Program (ISSP). It reviews the 2004 findings and recommendations and the progress towards their implementation.
Twelve evidence-based principles for implementing self-management support in primary care.

PubMed

Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

2010-12-01

Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.
A practical guide to applying lean tools and management principles to health care improvement projects.

PubMed

Simon, Ross W; Canacari, Elena G

2012-01-01

Manufacturing organizations have used Lean management principles for years to help eliminate waste, streamline processes, and cut costs. This pragmatic approach to structured problem solving can be applied to health care process improvement projects. Health care leaders can use a step-by-step approach to document processes and then identify problems and opportunities for improvement using a value stream process map. Leaders can help a team identify problems and root causes and consider additional problems associated with methods, materials, manpower, machinery, and the environment by using a cause-and-effect diagram. The team then can organize the problems identified into logical groups and prioritize the groups by impact and difficulty. Leaders must manage action items carefully to instill a sense of accountability in those tasked to complete the work. Finally, the team leaders must ensure that a plan is in place to hold the gains. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Improving cost-effectiveness of and outcomes from drug therapy in patients with atrial fibrillation in managed care: role of the pharmacist.

PubMed

Johnson, Samuel G

2009-08-01

The medical care costs for procedures, medications, and testing associated with atrial fibrillation (AF) in the United States are high and projected to increase markedly in the future as the number of Americans affected grows. The burden on patient quality of life, the health care system, and society are pharmacoeconomic considerations in managing AF. To identify key pharmacoeconomic considerations in managing AF and describe ways in which managed care pharmacists can improve the cost-effectiveness of and outcomes from drug therapy for AF. The high medical care costs of AF are largely the result of the high cost of hospitalization and inpatient procedures. Recurrence of AF dramatically increases costs, especially for hospital care. Managed care pharmacists have many opportunities to provide cost-effective care to and improve outcomes in patients with AF. Policy and process review, population management, and case management are key strategies for improving outcomes in patients with AF. Pharmacist input into policy and process review, including pharmacy benefits design, formulary management, and the use of information technology, can help ensure that the use of drug therapy for AF is cost-effective. Population management strategies, such as development of clinical pathways and patient registries, seek to improve the quality, consistency, and cost-effectiveness of care and the likelihood that desired therapeutic outcomes are achieved through targeted interventions. Case management strategies focus on longitudinal care for individuals in order to improve quality. Pharmacist-managed anticoagulation services and antiarrhythmic drug monitoring are the 2 most widely known case management strategies for patients with AF. Managed care pharmacists can screen patients with AF for the use of anticoagulation, which is needed to prevent embolic stroke but is under-used, even though recommended by evidence-based guidelines. The clinical efficacy and cost-effectiveness of pharmacist-managed anticoagulation services for patients with AF are well documented. Pharmacist-managed antiarrhythmic drug monitoring is a less well-known case management strategy that facilitates early detection and intervention to minimize toxicity. Managed care pharmacists can play an instrumental role in implementing strategies to improve the cost-effectiveness of and outcomes from drug therapy for AF.
Total Quality Management Implementation Strategy: Directorate of Quality Assurance

DTIC Science & Technology

1989-05-01

Total Quality Control Harrington, H. James The Improvement Process Imai, Masaaki Kaizen Ishikawa , Kaoru What is Total Quality Control Ishikawa ... Kaoru Statistical Quality Control Juran, J. M. Managerial Breakthrough Juran, J. M. Quality Control Handbook Mizuno, Ed Managing for Quality Improvements

Seven Ways to Make Your Training Department One of the Best.

ERIC Educational Resources Information Center

Vander Linde, Karen; And Others

1997-01-01

Explains how training organizations in high-performance companies such as Motorola are different from those in low-performing ones. Identifies management practices: customer focus, training closer to customers, leadership, employee involvement, innovation, process improvement, improvement measurement, and change management. (JOW)
Clinical operations management in radiology.

PubMed

Ondategui-Parra, Silvia; Gill, Ileana E; Bhagwat, Jui G; Intrieri, Lisa A; Gogate, Adheet; Zou, Kelly H; Nathanson, Eric; Seltzer, Steven E; Ros, Pablo R

2004-09-01

Providing radiology services is a complex and technically demanding enterprise in which the application of operations management (OM) tools can play a substantial role in process management and improvement. This paper considers the benefits of an OM process in a radiology setting. Available techniques and concepts of OM are addressed, along with gains and benefits that can be derived from these processes. A reference framework for the radiology processes is described, distinguishing two phases in the initial assessment of a unit: the diagnostic phase and the redesign phase.
Focus on Customer Service. Service Management: How to Plan for it Rather Than Hope for It [and] Learning to Say "Yes": A Customer Service Program for Library Staff [and] Maintaining Momentum in a Quality Improvement Process.

ERIC Educational Resources Information Center

Brewer, Julie; And Others

1995-01-01

Presents three articles that discuss customer service in libraries, with a focus on planning for service management, a customer service program for library staff, and a quality improvement process. Highlights include developing and implementing service strategies, dealing with requests, redefining work relationships, coworkers as customers,…
Total Quality Management (TQM): Group Dynamics Workshop

DTIC Science & Technology

1990-05-15

interactions with other OSD decision-making bodies. " Remove barriers /facilitate implementation. " Direct action on unresolved process problems referred...TQM leadership. - Total Quality Management FUNCTIONS: * Translate goals to tangible internal initiatives. " Remove barriers . " Establish and...Quality Management FUNCTIONS: • Identify and remove barriers . " Develop practical process improvements. " Install solutions and measurement systems for
Improving the U.S. Navy’s Execution of Technical Authority through a Common Risk Management and Technical Assessment Process

DTIC Science & Technology

2008-09-01

ITP . Assessment Indicators: • Has the risk management team (RMT) provided a risk management plan (RMP)? − Does the RMP provide an organized...processes. Diskettes, which contain the necessary programs for accessing BMP◊NET from IBM -compatible or Macintosh computers with a modem, and answers to
Why Deming and OBE Don't Mix.

ERIC Educational Resources Information Center

Holt, Maurice

1995-01-01

The central idea in W. Edwards Deming's approach to quality management is the need to improve process. Outcome-based education's central defect is its failure to address process. Deming would reject OBE along with management-by-objectives. Education is not a product defined by specific output measures, but a process to develop the mind. (MLH)
Incident management successful practices : a cross-cutting study : improving mobility and saving lives

DOT National Transportation Integrated Search

2000-04-01

Incident management is the process of managing multi-agency, multi-jurisdictional responses to highway traffic disruptions. Efficient and coordinated management of incidents reduces their adverse impacts on public safety, traffic conditions, and the ...
Evaluating Process Effectiveness to Reduce Risk

NASA Technical Reports Server (NTRS)

Shepherd, Christena C.

2017-01-01

It is well documented that government agencies do not have the same incentive as the private sector to focus on process effectiveness and continual improvement of those processes. It is also well documented whenever government agencies fail to deliver efficient, effective, consistent, and fair services to the citizens. In spite of the various "reinventing government" and "effectiveness initiatives" of the past decades, and in spite of the efforts on the part of many agencies to improve, government in general still lags behind industry in creating a culture of effective processes and systems. While the tragic events that unfolded recently in Flint, Michigan, teach us that running government "like a business" does not always take the needs of the citizenry into account, there are many lessons and techniques from the private sector that government agencies can use to improve. The incentive to improve, while mandated by various administrations1, needs to come from within the workforce, in order to effectively take root. The best, most effective incentive is to reduce, control or eliminate risk. Government agencies face some of the same risks as the private sector, while some are unique. While ISO 310002 has been around since 2009, risk has taken on increased visibility within the private sector with the advent of the emphasis on risk-based thinking in ISO 9001:20153. The relationship between risk-based thinking and effective processes is simple and direct. Those processes that are well thought out and standardized (i.e. Plan-Do-Check-Act), will have taken into account the applicable policy, statutory, regulatory, safety, quality and technical parameters, which may not occur to someone performing the process with minimal experience or training; and thus protect the employees, the public and the agency from statutory and regulatory violations; delay in providing services; non-delivery of services; harm to public or employee safety and health; cost overruns; breaches in security; loss of confidence in government; failure of publicly funded projects; damage to the environment; ethics violations, and the list goes on; with local, national and even international consequences. The Plan-Do-Check-Act process, also known as the "process approach" can be used at any time to establish and standardize a process, and it can also be used to check periodically for "process creep" (i.e., informal, unauthorized changes that have occurred over time), any necessary updates and improvements. While ISO 9001 compliance is not mandated for all government agencies, if interpreted correctly, it can be useful in establishing a framework and implementing effective management systems and processes.4 Another method that can be used to evaluate effectiveness is the scorecard definitions in Mallory's Process Management Standard5 as a basis for evaluating work on the process level on effective, and continuously improved and improving processes. With processes on the lower end of the scale, agencies are vulnerable to a great many risks, with employees and managers making up many of the rules as they go, leading to the above listed negative results. Without clear guidance for nominal operations, off-nominal situations can, and do, increase the likelihood of chaos. In an increasingly technical environment, with inter-agency communication and collaboration becoming the norm, agencies need to come to grips with the fact that processes can become rapidly outdated, and that the technical community should take on an increased role in the maturation of the agency's processes. Industry has long known that effective processes are also efficient, and process improvement methods such as Kaizen, Lean, Six Sigma, 5S, and mistake proofing lead to increased productivity, improved quality, and decreased cost. Again, government agencies have different concerns, but inefficiencies and mistakes can have dire and wide reaching consequences for the public that they serve. While no one goes to work planning to cause harm, it is up to agencies to establish upper level systems, which make establishment and compliance with processes possible. Again, Mallory provides us with a Systems Management Standard6, similar to the Process Management Standard, with a scale of 0-5 for systems effectiveness and maturity. Deming determined that "eighty-five percent of the reasons for failure are deficiencies in the systems and process rather than the employee. The role of management is to change the process rather than badgering individual employees to do better." 7 It is not just the working level employees who need effective processes, but the mid-and upper level managers as well. A disciplined management culture sets the tone for the employees, aids both routine and off-nominal decision-making, and incorporates risk -based thinking into the systems and processes as a matter of normal activity. Figure 1, illustrates the relationship between ineffective and effective processes and risk, through the use of the "stoplight" colors that are commonly used to show serious situations (red), situations which may be improving or deteriorating depending on trends (yellow), and situations that are under control and continuously improved (green).
Improving Learning Results and Reducing Cognitive Load through 3D Courseware on Color Management and Inspection Instruction

ERIC Educational Resources Information Center

Hsiung, Liang-Yuan; Lai, Mu-Hui

2013-01-01

This study intends to solve the problem that schools in Taiwan lack of the equipment for color management and inspection instruction and seek ways to improve learning results and reduce cognitive load. The researchers developed 3D courseware for color management and inspection through a research and development process. To further scrutinize the…
Total quality management - It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle.
Crew interface specifications development functions, phase 3A

NASA Technical Reports Server (NTRS)

Carl, J. G.

1973-01-01

The findings and data products developed during the crew interface specification study for inflight maintenance and stowage functions are presented. Guidelines are provided for improving the present progress of defining, controlling, and managing the flight crew requirements. The following data products were developed: (1) description of inflight maintenance management process, (2) specifications for inflight maintenance management requirements, and (3) suggested inflight maintenance data processing reports for logistics management.
Quality Improvement of Ground Works Process with the Use of Chosen Lean Management Tools - Case Study

NASA Astrophysics Data System (ADS)

Nowotarski, Piotr; Paslawski, Jerzy; Wysocki, Bartosz

2017-12-01

Ground works are one of the first processes connected with erecting structures. Based on ground conditions like the type of soil or level of underground water different types and solutions for foundations are designed. Foundations are the base for the buildings, and their proper design and execution is the key for the long and faultless use of the whole construction and might influence on the future costs of the eventual repairs (especially when ground water level is high, and there is no proper water insulation made). Article presents the introduction of chosen Lean Management tools for quality improvement of the process of ground works based on the analysis made on the construction site of vehicle control station located in Poznan, Poland. Processes assessment is made from different perspectives taking into account that 3 main groups of workers were directly involved in the process: blue collar-workers, site manager and site engineers. What is more comparison is made on the 3 points of view to the problems that might occur during this type of works, with details analysis on the causes of such situation? Authors presents also the change of approach of workers directly involved in the mentioned processes regarding introduction of Lean Management methodology, which illustrates the problem of scepticism for new ideas of the people used to perform works and actions in traditional way. Using Lean Management philosophy in construction is a good idea to streamline processes in company, get rid of constantly recurring problems, and in this way improve the productivity and quality of executed activities. Performed analysis showed that different groups of people have very different idea and opinion on the problems connected with executing the same process - ground works and only having full picture of the situation (especially in construction processes) management can take proper problems-preventing actions that consequently can influence on the amount of waste generated on the construction cite which positively influence on the external environment.
Management strategies to effect change in intensive care units: lessons from the world of business. Part I. Targeting quality improvement initiatives.

PubMed

Gershengorn, Hayley B; Kocher, Robert; Factor, Phillip

2014-02-01

The business community has developed strategies to ensure the quality of the goods or services they produce and to improve the management of multidisciplinary work teams. With modification, many of these techniques can be imported into intensive care units (ICUs) to improve clinical operations and patient safety. In Part I of a three-part ATS Seminar series, we argue for adopting business management strategies in ICUs and set forth strategies for targeting selected quality improvement initiatives. These tools are relevant to health care today as focus is placed on limiting low-value care and measuring, reporting, and improving quality. In the ICU, the complexity of illness and the need to standardize processes make these tools even more appealing. Herein, we highlight four techniques to help prioritize initiatives. First, the "80/20 rule" mandates focus on the few (20%) interventions likely to drive the majority (80%) of improvement. Second, benchmarking--a process of comparison with peer units or institutions--is essential to identifying areas of strength and weakness. Third, root cause analyses, in which structured retrospective reviews of negative events are performed, can be used to identify and fix systems errors. Finally, failure mode and effects analysis--a process aimed at prospectively identifying potential sources of error--allows for systems fixes to be instituted in advance to prevent negative outcomes. These techniques originated in fields other than health care, yet adoption has and can help ICU managers prioritize issues for quality improvement.
Application of the enterprise management tools Lean Six Sigma and PMBOK in developing a program of research management.

PubMed

Hors, Cora; Goldberg, Anna Carla; Almeida, Ederson Haroldo Pereira de; Babio Júnior, Fernando Galan; Rizzo, Luiz Vicente

2012-01-01

Introduce a program for the management of scientific research in a General Hospital employing the business management tools Lean Six Sigma and PMBOK for project management in this area. The Lean Six Sigma methodology was used to improve the management of the institution's scientific research through a specific tool (DMAIC) for identification, implementation and posterior analysis based on PMBOK practices of the solutions found. We present our solutions for the management of institutional research projects at the Sociedade Beneficente Israelita Brasileira Albert Einstein. The solutions were classified into four headings: people, processes, systems and organizational culture. A preliminary analysis of these solutions showed them to be completely or partially compliant to the processes described in the PMBOK Guide. In this post facto study, we verified that the solutions drawn from a project using Lean Six Sigma methodology and based on PMBOK enabled the improvement of our processes dealing with the management of scientific research carried out in the institution and constitutes a model to contribute to the search of innovative science management solutions by other institutions dealing with scientific research in Brazil.
5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2012 CFR

2012-01-01

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

Code of Federal Regulations, 2013 CFR

2013-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...
Adaptive management: The U.S. Department of the Interior technical guide

USGS Publications Warehouse

Williams, B K; Szaro, Robert C.; Shapiro, Carl D.

2009-01-01

The purpose of this technical guide is to present an operational definition of adaptive management, identify the conditions in which adaptive management should be considered, and describe the process of using adaptive management for managing natural resources. The guide is not an exhaustive discussion of adaptive management, nor does it include detailed specifications for individual projects. However, it should aid U.S. Department of the Interior (DOI) managers and practitioners in determining when and how to apply adaptive management. Adaptive management is framed within the context of structured decision making, with an emphasis on uncertainty about resource responses to management actions and the value of reducing that uncertainty to improve management. Though learning plays a key role in adaptive management, it is seen here as a means to an end, namely good management, and not an end in itself. The operational definition used in the guide is adopted from the National Research Council, which characterizes adaptive management as an iterative learning process producing improved understanding and improved management over time: Adaptive management [is a decision process that] promotes flexible decision making that can be adjusted in the face of uncertainties as outcomes from management actions and other events become better understood. Careful monitoring of these outcomes both advances scientific understanding and helps adjust policies or operations as part of an iterative learning process. Adaptive management also recognizes the importance of natural variability in contributing to ecological resilience and productivity. It is not a ‘trial and error’ process, but rather emphasizes learning while doing. Adaptive management does not represent an end in itself, but rather a means to more effective decisions and enhanced benefits. Its true measure is in how well it helps meet environmental, social, and economic goals, increases scientific knowledge, and reduces tensions among stakeholders. Adaptive management as defined here involves ongoing, real-time learning and knowledge creation, both in a substantive sense and in terms of the adaptive process itself. It is described in what follows in a series of 9 steps, as summarized in section 4.1, involving stakeholder involvement, management objectives, management alternatives, predictive models, monitoring plans, decision making, monitoring responses to management, assessment, and adjustment to management actions. An adaptive approach actively engages stakeholders in all phases of a project over its timeframe, facilitating mutual learning and reinforcing the commitment to learning-based management. Adaptive management in DOI is implemented within a legal context that includes statutory authorities such as the National Environmental Policy Act (NEPA), the Endangered Species Act, and the Federal Advisory Committee Act. For many important problems now facing the resource management community, adaptive management holds great promise in reducing the uncertainties that limit the effective management of natural resource systems. For many conservation and management problems, utilizing management itself in an experimental context may be the only feasible way to gain the system understanding needed to improve management. Though it is commonly thought that an adaptive approach can produce results quickly at low cost, the opposite is more likely to be true. An initial investment of time and effort will increase the likelihood of better decision making and resource stewardship in the future, but patience, flexibility, and support are needed over the life of an adaptive management project. For these reasons it is important to carefully consider the potential use of an adaptive approach, and to engage in careful planning and evaluation when adaptive management is used.
Senior managers' viewpoints toward challenges of implementing clinical governance: a national study in iran.

PubMed

Ravaghi, Hamid; Heidarpour, Peigham; Mohseni, Maryam; Rafiei, Sima

2013-11-01

Quality improvement should be assigned as the main mission for healthcare providers. Clinical Governance (CG) is used not only as a strategy focusing on responding to public and government's intolerance of poor healthcare standards, but also it is implemented for quality improvement in a number of countries. This study aims to identify the key contributing factors in the implementation process of CG from the viewpoints of senior managers in curative deputies of Medical Universities in Iran. A quantitative method was applied via a questionnaire distributed to 43 senior managers in curative deputies of Iran Universities of Medical Sciences. Data were analyzed using SPSS. Analysis revealed that a number of items were important in the successful implementation of CG from the senior managers' viewpoints. These items included: knowledge and attitude toward CG, supportive culture, effective communication, teamwork, organizational commitment, and the support given by top managers. Medical staff engagement in CG implementation process, presence of an official position for CG officers, adequate resources, and legal challenges were also regarded as important factors in the implementation process. Knowledge about CG, organizational culture, managerial support, ability to communicate goals and strategies, and the presence of effective structures to support CG, were all related to senior managers' attitude toward CG and ultimately affected the success of quality improvement activities.
[Does clinical risk management require a structured conflict management?].

PubMed

Neumann, Stefan

2015-01-01

A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management.

Instituting organizational learning for quality improvement through strategic planning nominal group processes.

PubMed

White, D B

2000-01-01

Healthcare managers are faced with unprecedented challenges as characterized by managed care constraints, downsizing, increased client needs, and a society demanding more responsive services. Managers must initiate change for quality, efficiency, and survival. This article provides information and strategies for (a) assessing the change readiness of an organization, (b) conducting an organizational diagnosis, (c) instituting a team culture, (d) developing a change strategy, (e) integrating the strategy with a quality improvement process, and (f) identifying the leadership skills to implement organization renewal. Nominal group processes, namely, SWOT and the Search Conference, are described, and case examples are provided. The implementation strategies have been used successfully in a variety of milieus; practical advice for success is described in detail.
Improving Logistics Processes in Industry Using Web Technologies

NASA Astrophysics Data System (ADS)

Jánošík, Ján; Tanuška, Pavol; Václavová, Andrea

2016-12-01

The aim of this paper is to propose the concept of a system that takes advantage of web technologies and integrates them into the management process and management of internal stocks which may relate to external applications and creates the conditions to transform a Computerized Control of Warehouse Stock (CCWS) in the company. The importance of implementing CCWS is in the elimination of the claims caused by the human factor, as well as to allow the processing of information for analytical purposes and their subsequent use to improve internal processes. Using CCWS in the company would also facilitate better use of the potential tools Business Intelligence and Data Mining.
Process maturity progress at Motorola Cellular Systems Division

NASA Technical Reports Server (NTRS)

Borgstahl, Ron; Criscione, Mark; Dobson, Kim; Willey, Allan

1994-01-01

We believe that the key success elements are related to our recognition that Software Process Improvement (SPI) can and should be organized, planned, managed, and measured as if it were a project to develop a new process, analogous to a software product. We believe that our process improvements have come as the result of these key elements: use of a rigorous, detailed requirements set (Capability Maturity Model, CMM); use of a robust, yet flexible architecture (IEEE 1074); use of a SPI project, resourced and managed like other work, to produce the specifications and implement them; and development of both internal and external goals, with metrics to support them.
An Analysis of Oregon State University's Total Quality Management Pilot Program.

ERIC Educational Resources Information Center

Coate, L. Edwin

1993-01-01

Adaptation of the Total Quality Management approach to organizational improvement at Oregon State University involved creation of 10 pilot finance and administration teams and implementation of a 10-step problem-solving process. The approach has improved staff morale as well as client services. (MSE)
Hierarchical adaptation scheme for multiagent data fusion and resource management in situation analysis

NASA Astrophysics Data System (ADS)

Benaskeur, Abder R.; Roy, Jean

2001-08-01

Sensor Management (SM) has to do with how to best manage, coordinate and organize the use of sensing resources in a manner that synergistically improves the process of data fusion. Based on the contextual information, SM develops options for collecting further information, allocates and directs the sensors towards the achievement of the mission goals and/or tunes the parameters for the realtime improvement of the effectiveness of the sensing process. Conscious of the important role that SM has to play in modern data fusion systems, we are currently studying advanced SM Concepts that would help increase the survivability of the current Halifax and Iroquois Class ships, as well as their possible future upgrades. For this purpose, a hierarchical scheme has been proposed for data fusion and resource management adaptation, based on the control theory and within the process refinement paradigm of the JDL data fusion model, and taking into account the multi-agent model put forward by the SASS Group for the situation analysis process. The novelty of this work lies in the unified framework that has been defined for tackling the adaptation of both the fusion process and the sensor/weapon management.
Understanding and managing organizational change: implications for public health management.

PubMed

Thompson, Jon M

2010-01-01

Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change.
Integrated management of depression: improving system quality and creating effective interfaces.

PubMed

Myette, Thomas L

2008-04-01

Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.
Emergy Analysis for the Sustainable Utilization of Biosolids ...

EPA Pesticide Factsheets

This contribution describes the application of an emergy-based methodology for comparing two management alternatives of biosolids produced in a wastewater treatment plant. The current management practice of using biosolids as soil fertilizers was evaluated and compared to another alternative, the recovery of energy from the biosolid gasification process. This emergy assessment and comparison approach identifies more sustainable processes which achieve economic and social benefits with a minimal environmental impact. In addition, emergy-based sustainability indicators and the GREENSCOPE methodology were used to compare the two biosolid management alternatives. According to the sustainability assessment results, the energy production from biosolid gasification is energetically profitable, economically viable, and environmentally suitable. Furthermore, it was found that the current use of biosolids as soil fertilizer does not generate any considerable environmental stress, has the potential to achieve more economic benefits, and a post-processing of biosolids prior to its use as soil fertilizer improves its sustainability performance. In conclusion, this emergy analysis provides a sustainability assessment of both alternatives of biosolid management and helps decision-makers to identify opportunities for improvement during the current process of biosolid management. This work aims to identify the best option for the use and management of biosolids generated in a wa
The Hepatitis Testing and Linkage-to-Care Data Review Process: An Approach to Ensuring the Quality of Program Data.

PubMed

Mezzo, Jennifer L; Lamia, Tamara L; Danelski, Lisa L; Schipani, Anne Marie; Stokes, Scott A; Jacobs-Ware, Elizabeth D

2016-01-01

CDC's 2012 Hepatitis Testing and Linkage to Care (HepTLC) initiative was a nationally coordinated effort to conduct hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites. This project provided support for data management and monthly data reviews between awardees and a data manager, which facilitated monitoring of awardee progress and regular program improvement opportunities. CDC provided technical assistance to awardees for testing processes and program improvement, including Internet-based data submission, reporting software and data management to awardees, offering assistance with submitting, and reviewing data in real time. We describe how one awardee, AIDS Resource Center of Wisconsin (ARCW), used the data management process to improve data quality, inform testing processes and implementation, and measure and report missing variables from an online database. From October 2012 through July 2014, ARCW performed 2,255 HCV antibody (anti-HCV) tests and 244 HCV ribonucleic acid (RNA) tests as part of the HepTLC initiative. Participants who tested HCV RNA positive (n=189) were referred to medical care. At the end of the study, no records were missing for the anti-HCV test result or HCV RNA test result variables, and only one record was missing for those who were referred to medical care. Regular data review and monitoring by awardees and CDC-supported data managers provided opportunities for data quality and program improvement. Through regular data review, ARCW reduced the amount of missing data and promoted timely follow-up with participants testing positive for HCV to ensure receipt of results and linkage to care. Other programs can adopt a similar data management model.
Does your equipment maintenance management program measure up?

PubMed

Deinstadt, Deborah C

2003-01-01

Identifying a clear maintenance philosophy is the first step toward choosing the right program for your healthcare organization. The second step is gaining a clear understanding of how proposed savings and improvements will be delivered. The third and last step is requiring that the proposed company or manager have specific tools in place for measuring and analyzing program performance. There are three primary philosophies underlying current equipment management options. These include risk-transfer philosophy (e.g., maintenance insurance, service contracts, multi-vendor and outsource programs), asset management philosophy (e.g., programs delivering a management system based on managed time-and-materials), and internal management (in-house managed programs). The last step in selecting the right program is insisting that proper performance measurements be built into the proposed management program. A well-managed program provides results in three general areas: financial outcomes, operational improvements and process improvements. Financial outcomes are the easiest to measure. Operational and process improvements are more challenging to assess but equally important to the program's overall success. To accurately identify results in these three areas, the overall management program should measure the following eight separate components: procedures and support for department staff; equipment inventory, benchmark costs, and budget guidelines; experienced equipment support team; objective, independent analysis of maintenance events; repair documentation and reporting; vendor relations; equipment acquisition analysis; and recommendations for improvement. Do everything you reasonably can to assure that the selected company can work side-by-side with you, providing objective, measurable advice that is ultimately in your best interest. You will then know that you have been thorough in your marketplace selection and can confidently move into implementation, expecting tangible and successful results.
A Corporate-Wide Application of Organizational Behavior Management.

ERIC Educational Resources Information Center

Wikoff, Martin B.

1984-01-01

Describes a longitudinal project in which organizational behavior management (OBM) procedures have been applied to improve performance of plant employees, increase sales of contract furniture, accelerate response time to customer inquiries, increase orders processed, and reduce processing errors at Krueger, a contract and institutional furniture…
NASA's Risk Management System

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2013-01-01

Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.
Project Management Meets Change Management - A Success Story. Focus Area: Tech Perspectives TI012SN

NASA Technical Reports Server (NTRS)

Hall, Wayne

2011-01-01

Utilizing the concepts and terminology from Project Management, the process of planning and executing a Change Management (CM) Infrastructure improvement project is described. The primary audience for this presentation includes both experienced and relatively new CM administrators and their managers. It also includes anyone with an interest in the application of project management knowledge to CM administration. There are several benefits: the complexity of the CM tool technology is more manageable, CM administrators get to use project management knowledge to complete a project (not "firefighting"), improve relations with your customers (that means developers and managers), and get the opportunity to do it again.
Terrestrial ecosystem process model Biome-BGCMuSo v4.0: summary of improvements and new modeling possibilities

NASA Astrophysics Data System (ADS)

Hidy, Dóra; Barcza, Zoltán; Marjanović, Hrvoje; Zorana Ostrogović Sever, Maša; Dobor, Laura; Gelybó, Györgyi; Fodor, Nándor; Pintér, Krisztina; Churkina, Galina; Running, Steven; Thornton, Peter; Bellocchi, Gianni; Haszpra, László; Horváth, Ferenc; Suyker, Andrew; Nagy, Zoltán

2016-12-01

The process-based biogeochemical model Biome-BGC was enhanced to improve its ability to simulate carbon, nitrogen, and water cycles of various terrestrial ecosystems under contrasting management activities. Biome-BGC version 4.1.1 was used as a base model. Improvements included addition of new modules such as the multilayer soil module, implementation of processes related to soil moisture and nitrogen balance, soil-moisture-related plant senescence, and phenological development. Vegetation management modules with annually varying options were also implemented to simulate management practices of grasslands (mowing, grazing), croplands (ploughing, fertilizer application, planting, harvesting), and forests (thinning). New carbon and nitrogen pools have been defined to simulate yield and soft stem development of herbaceous ecosystems. The model version containing all developments is referred to as Biome-BGCMuSo (Biome-BGC with multilayer soil module; in this paper, Biome-BGCMuSo v4.0 is documented). Case studies on a managed forest, cropland, and grassland are presented to demonstrate the effect of model developments on the simulation of plant growth as well as on carbon and water balance.
Successful integration of ergonomics into continuous improvement initiatives.

PubMed

Monroe, Kimberly; Fick, Faye; Joshi, Madina

2012-01-01

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

PubMed

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

2010-01-01

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

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

Fayne, V.; McAllister, A.; Weiner, S.B.

1995-12-31

Managing environmental programs can be effective only when good cost and cost-related management practices are developed and implemented. The Department of Energy`s Office of Environmental Management (EM), recognizing this key role of cost management, initiated several cost and cost-related management activities including the Cost Quality Management (CQM) Program. The CQM Program includes an assessment activity, Cost Quality Management Assessments (CQMAs), and a technical assistance effort to improve program/project cost effectiveness. CQMAs provide a tool for establishing a baseline of cost-management practices and for measuring improvement in those practices. The result of the CQMA program is an organization that has anmore » increasing cost-consciousness, improved cost-management skills and abilities, and a commitment to respond to the public`s concerns for both a safe environment and prudent budget outlays. The CQMA program is part of the foundation of quality management practices in DOE. The CQMA process has contributed to better cost and cost-related management practices by providing measurements and feedback; defining the components of a quality cost-management system; and helping sites develop/improve specific cost-management techniques and methods.« less
Addressing hospital-acquired pressure ulcers: patient care managers enhancing outcomes at the point of service.

PubMed

Frumenti, Jeanine M; Kurtz, Abby

2014-01-01

An innovative leadership training program for patient care managers (PCMs) aimed at improving the management of operational failures was conducted at a large metropolitan hospital center. The program focused on developing and enhancing the transformational leadership skills of PCMs by improving their ability to manage operational failures in general and, in this case, hospital-acquired pressure ulcers. The PCMs received 8 weeks of intense training using the Toyota Production System process improvement approach, along with executive coaching. Compared with the control group, the gains made by the intervention group were statistically significant.
A case study in R and D productivity: Helping the program manager cope with job stress and improve communication effectiveness

NASA Technical Reports Server (NTRS)

Bodensteiner, W. D.; Gerloff, E. A.

1985-01-01

Certain structural changes in the Naval Material Command which resulted from a comparison of its operations to those of selected large-scale private sector companies are described. Central to the change was a reduction in the number of formal reports from systems commands to headquarters, and the provision of Program Management Assistance Teams (at the request of the program manager) to help resolve project problems. It is believed that these changes improved communication and information-processing, reduced program manager stress, and resulted in improved productivity.
Final Exam.

ERIC Educational Resources Information Center

Coullahan, Richard

1998-01-01

Explains the use of a maintenance-management assessment process that educational facility managers can use to improve facility conditions and to provide evidence for future capital investments in maintenance management. Discusses questions a maintenance-management audit can answer and describes how to analyze the data to gain maximum understanding…

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
Case management redesign in an urban facility.

PubMed

Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

2011-01-01

To explore strategies for improving patient throughput and to redesign case management processes to facilitate level of care transitions and safe discharges. Large Urban Medical Center in South Los Angeles County, with 384 licensed beds that services poor, underserved communities. Both qualitative and quantitative methods were applied. Combined theoretical frameworks were used for needs assessment, intervention strategies, and change management. Observations, interviews, surveys, and database extraction methods were used. The sample consisted of case management staff members and several other staff from nursing, social work, and emergency department staff. Postintervention measures indicated improvement in reimbursements for services, reduction in length of stay, increased productivity, improved patients' access to care, and avoiding unnecessary readmission or emergency department visits. Effective change management strategies must consider multiple factors that influence daily operations and service delivery. Creating accountability by using performance measures associated with patient transitions is highlighted by the case study results. The authors developed a process model to assist in identifying and tracking outcome measures related to patient throughput, front-end assessments, and effective patient care transitions. This model can be used in future research to further investigate best case management practices.
Assuring quality by continuously improving quality: new directions for health record professionals.

PubMed

Howell, W T; Nickle, B W

1991-03-01

Quality improvement is catching fire in the health care community, but there is much work to be done, much to learn, and much to teach. All health care professionals must remember that there are no short cuts to improving quality. American managers are so steeped in a quick-fix mentality that they resist the systematic infrastructure rebuilding described above. They scurry about fighting the same fires over and over, thinking they are doing their jobs. The truth remains that if results are to be improved, not just manipulated, then the processes that produce those results must be improved. For this to occur managers must be given the process improvement technology that separates the world class companies from those who are still wondering what hit them during the 1970s.
Management Development and Training Program for Colleges and Universities. Program Handbook, May 1978.

ERIC Educational Resources Information Center

Higher Education Management Inst., Coconut Grove, FL.

A Management Development and Training Program has been developed by the Higher Education Management Institute to improve the overall functioning of higher education organizations. The Institute believes management development and training can: add to individuals' knowledge and skills, increase awareness of management processes and systems;…
Implementation of cold risk management in occupational safety, occupational health and quality practices. Evaluation of a development process and its effects at the finnish maritime administration.

PubMed

Risikko, Tanja; Remes, Jouko; Hassi, Juhani

2008-01-01

Cold is a typical environmental risk factor in outdoor work in northern regions. It should be taken into account in a company's occupational safety, health and quality systems. A development process for improving cold risk management at the Finnish Maritime Administration (FMA) was carried out by FMA and external experts. FMA was to implement it. Three years after the development phase, the outcomes and implementation were evaluated. The study shows increased awareness about cold work and few concrete improvements. Concrete improvements in occupational safety and health practices could be seen in the pilot group. However, organization-wide implementation was insufficient, the main reasons being no organization-wide practices, unclear process ownership, no resources and a major reorganization process. The study shows a clear need for expertise supporting implementation. The study also presents a matrix for analyzing the process.
Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.

PubMed

Cartmill, Randi S; Walker, James M; Blosky, Mary Ann; Brown, Roger L; Djurkovic, Svetolik; Dunham, Deborah B; Gardill, Debra; Haupt, Marilyn T; Parry, Dean; Wetterneck, Tosha B; Wood, Kenneth E; Carayon, Pascale

2012-11-01

To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients. We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated. The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration. The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
TQM in Rural Education: Managing Schools from a Business Perspective.

ERIC Educational Resources Information Center

Nelson, William

1994-01-01

Outlines the 14 points of Deming's business philosophy of Total Quality Management in terms of rural education, including adoption of a common mission, movement from mass inspection (standardized testing) to individualized assessment, constant system improvement, training for those involved in the process, improved communication, employee rewards…
GREENING OF OXIDATION CATALYSIS THROUGH IMPROVED CATALYST AND PROCESS DESIGN

EPA Science Inventory

Greening of Oxidation Catalysis Through Improved Catalysts and Process Design
Michael A. Gonzalez*, Thomas Becker, and Raymond Smith

United State Environmental Protection Agency, Office of Research and Development, National Risk Management Research Laboratory, 26 W...
Communication of the monitoring and evaluation process through the use of storyboards and story notebooks.

PubMed

Lewis, L C; Honea, S H; Kanter, D F; Haney, P E

1993-10-01

In preparation for the 1993 Joint Commission on Accreditation of Health Care Organizations (JCAHO) survey, Audie L. Murphy Memorial Veterans Hospital Nursing Service was faced with determining the best approach to presenting their Total Quality Improvement/Total Quality Management (TQI/TQM) process. Nursing Service management and staff, Quality Improvement Clinicians, and medical staff used the Storyboard concept and the accompanying Story Notebooks to organize and to communicate their TQI/TQM process and findings. This concept was extremely beneficial, enabling staff to successfully present the multidisciplinary TQI/TQM data to the JCAHO surveyors.
Lean methodology in health care.

PubMed

Kimsey, Diane B

2010-07-01

Lean production is a process management philosophy that examines organizational processes from a customer perspective with the goal of limiting the use of resources to those processes that create value for the end customer. Lean manufacturing emphasizes increasing efficiency, decreasing waste, and using methods to decide what matters rather than accepting preexisting practices. A rapid improvement team at Lehigh Valley Health Network, Allentown, Pennsylvania, implemented a plan, do, check, act cycle to determine problems in the central sterile processing department, test solutions, and document improved processes. By using A3 thinking, a consensus building process that graphically depicts the current state, the target state, and the gaps between the two, the team worked to improve efficiency and safety, and to decrease costs. Use of this methodology has increased teamwork, created user-friendly work areas and processes, changed management styles and expectations, increased staff empowerment and involvement, and streamlined the supply chain within the perioperative area. Copyright (c) 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.
The Wound CARE Instrument: the process for developing standards for wound management education and programming.

PubMed

Orsted, Heather L; Woodbury, M Gail; Stevenson, Kimberly

2012-06-01

This article describes the collaborative process undertaken by the Canadian Association for Enterostomal Therapy and the Canadian Association of Wound Care in an effort to improve the quality of wound prevention and management education and programming. The end result of this process is the Wound CARE Instrument which promotes an interprofessional, collaborative appraisal process to support the development, adoption or adaption of wound management educational events and programs. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

PubMed

Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.
Improving a Dental School's Clinic Operations Using Lean Process Improvement.

PubMed

Robinson, Fonda G; Cunningham, Larry L; Turner, Sharon P; Lindroth, John; Ray, Deborah; Khan, Talib; Yates, Audrey

2016-10-01

The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients' average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project.
Total Quality Management Implementation Plan.

DTIC Science & Technology

1989-06-01

Quality Management Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Defense General...E 14. SUBJECT TERMS 15. NUMBER OF PAGES TOM (Total Quality Management ), Continuous Process Improvement,_________ Depot Operations, Supply Support 16
23 CFR 500.109 - CMS.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Congestion management means the application of strategies to improve system performance and reliability by... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at... management system or process is a systematic and regionally accepted approach for managing congestion that...
23 CFR 500.109 - CMS.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Congestion management means the application of strategies to improve system performance and reliability by... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at... management system or process is a systematic and regionally accepted approach for managing congestion that...
23 CFR 500.109 - CMS.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at.... Congestion management means the application of strategies to improve system performance and reliability by... management system or process is a systematic and regionally accepted approach for managing congestion that...
23 CFR 500.109 - CMS.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at.... Congestion management means the application of strategies to improve system performance and reliability by... management system or process is a systematic and regionally accepted approach for managing congestion that...
23 CFR 500.109 - CMS.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at.... Congestion management means the application of strategies to improve system performance and reliability by... management system or process is a systematic and regionally accepted approach for managing congestion that...
Human Milk Management Redesign: Improving Quality and Safety and Reducing Neonatal Intensive Care Unit Nurse Stress.

PubMed

Settle, Margaret Doyle; Coakley, Amanda Bulette; Annese, Christine Donahue

2017-02-01

Human milk provides superior nutritional value for infants in the neonatal intensive care unit and is the enteral feeding of choice. Our hospital used the system engineering initiative for patient safety model to evaluate the human milk management system in our neonatal intensive care unit. Nurses described the previous process in a negative way, fraught with opportunities for error, increased stress for nurses, and the need to be away from the bedside and their patients. The redesigned process improved the quality and safety of human milk management and created time for the nurses to spend with their patients.

Applications for radio-frequency identification technology in the perioperative setting.

PubMed

Zhao, Tiyu; Zhang, Xiaoxiang; Zeng, Lili; Xia, Shuyan; Hinton, Antentor Othrell; Li, Xiuyun

2014-06-01

We implemented a two-year project to develop a security-gated management system for the perioperative setting using radio-frequency identification (RFID) technology to enhance the management efficiency of the OR. We installed RFID readers beside the entrances to the OR and changing areas to receive and process signals from the RFID tags that we sewed into surgical scrub attire and shoes. The system also required integrating automatic access control panels, computerized lockers, light-emitting diode (LED) information screens, wireless networks, and an information system. By doing this, we are able to control the flow of personnel and materials more effectively, reduce OR costs, optimize the registration and attire-changing process for personnel, and improve management efficiency. We also anticipate this system will improve patient safety by reducing the risk of surgical site infection. Application of security-gated management systems is an important and effective way to help ensure a clean, convenient, and safe management process to manage costs in the perioperative area and promote patient safety. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Corporate Information Management and Business Process Improvement under the Unit Cost Program: An Analysis of a System for the Air Force Institute of Technology

DTIC Science & Technology

1992-12-01

rights or on management issues such as personnel and infrastructure investments are addresseud in the directive only at the broadest level, or in many...area with investments , including information systems. c. Functional processes improvements shall be accomplished though activity modeling and busi ass...an enterprise has invested considerable time, money and effort into the current system and has limited funds to upgrade the system (111:37). Software
A Knowledge Management Approach to Support Software Process Improvement Implementation Initiatives

NASA Astrophysics Data System (ADS)

Montoni, Mariano Angel; Cerdeiral, Cristina; Zanetti, David; Cavalcanti da Rocha, Ana Regina

The success of software process improvement (SPI) implementation initiatives depends fundamentally of the strategies adopted to support the execution of such initiatives. Therefore, it is essential to define adequate SPI implementation strategies aiming to facilitate the achievement of organizational business goals and to increase the benefits of process improvements. The objective of this work is to present an approach to support the execution of SPI implementation initiatives. We also describe a methodology applied to capture knowledge related to critical success factors that influence SPI initiatives. This knowledge was used to define effective SPI strategies aiming to increase the success of SPI initiatives coordinated by a specific SPI consultancy organization. This work also presents the functionalities of a set of tools integrated in a process-centered knowledge management environment, named CORE-KM, customized to support the presented approach.
WISE: Automated support for software project management and measurement. M.S. Thesis

NASA Technical Reports Server (NTRS)

Ramakrishnan, Sudhakar

1995-01-01

One important aspect of software development and IV&V is measurement. Unless a software development effort is measured in some way, it is difficult to judge the effectiveness of current efforts and predict future performances. Collection of metrics and adherence to a process are difficult tasks in a software project. Change activity is a powerful indicator of project status. Automated systems that can handle change requests, issues, and other process documents provide an excellent platform for tracking the status of the project. A World Wide Web based architecture is developed for (a) making metrics collection an implicit part of the software process, (b) providing metric analysis dynamically, (c) supporting automated tools that can complement current practices of in-process improvement, and (d) overcoming geographical barrier. An operational system (WISE) instantiates this architecture allowing for the improvement of software process in a realistic environment. The tool tracks issues in software development process, provides informal communication between the users with different roles, supports to-do lists (TDL), and helps in software process improvement. WISE minimizes the time devoted to metrics collection, analysis, and captures software change data. Automated tools like WISE focus on understanding and managing the software process. The goal is improvement through measurement.
A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons.

PubMed

Ajeani, Judith; Mangwi Ayiasi, Richard; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Namazzi, Gertrude; Muhumuza Kananura, Ronald; Namusoke Kiwanuka, Suzanne; Beyeza-Kashesya, Jolly

2017-08-01

There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model. The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors. Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better. The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved capacity among local mentors to provide mentorship among local district staff.
System Safety in an IT Service Organization

NASA Astrophysics Data System (ADS)

Parsons, Mike; Scutt, Simon

Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.
Combining Project Management Methods: A Case Study of Dlstributed Work Practices

NASA Astrophysics Data System (ADS)

Backlund, Per; Lundell, Björn

The increasing complexity of information systems development (ISD) projects call for improved project management practices. This, together with an endeavour to improve the success rate of ISD projects (Lyytinen and Robey 1999; Cooke-Davies 2002; White and Fortune 2002), has served as drivers for various efforts in process improvement such as the introduction of new development methods (Fitzgerald 1997; Iivari and Maansaari 1998).
Quality management benchmarking: FDA compliance in pharmaceutical industry.

PubMed

Jochem, Roland; Landgraf, Katja

2010-01-01

By analyzing and comparing industry and business best practice, processes can be optimized and become more successful mainly because efficiency and competitiveness increase. This paper aims to focus on some examples. Case studies are used to show knowledge exchange in the pharmaceutical industry. Best practice solutions were identified in two companies using a benchmarking method and five-stage model. Despite large administrations, there is much potential regarding business process organization. This project makes it possible for participants to fully understand their business processes. The benchmarking method gives an opportunity to critically analyze value chains (a string of companies or players working together to satisfy market demands for a special product). Knowledge exchange is interesting for companies that like to be global players. Benchmarking supports information exchange and improves competitive ability between different enterprises. Findings suggest that the five-stage model improves efficiency and effectiveness. Furthermore, the model increases the chances for reaching targets. The method gives security to partners that did not have benchmarking experience. The study identifies new quality management procedures. Process management and especially benchmarking is shown to support pharmaceutical industry improvements.
Use of a Business Approach to Improve Disease Surveillance Data Management Systems and Information Technology Process in Florida's Bureau of STD Prevention and Control.

PubMed

Shiver, Stacy A; Schmitt, Karla; Cooksey, Adrian

2009-01-01

The business of sexually transmitted disease (STD) prevention and control demands technology that is capable of supporting a wide array of program activities-from the processing of laboratory test results to the complex and confidential process involved in contact investigation. The need for a tool that enables public health officials to successfully manage the complex operations encountered in an STD prevention and control program, and the need to operate in an increasingly poor resource environment, led the Florida Bureau of STD to develop the Patient Reporting Investigation Surveillance Manager. Its unique approach, technical architecture, and sociotechnical philosophy have made this business application successful in real-time monitoring of disease burden for local communities, identification of emerging outbreaks, monitoring and assurance of appropriate treatments, improving access to laboratory data, and improving the quality of data for epidemiologic analysis. Additionally, the effort attempted to create and release a product that promoted the Centers for Disease Control and Prevention's ideas for integration of programs and processes.
Evaluation of a quality improvement intervention for diabetes management.

PubMed

Schmidt, Siegfried O F; Burns, Cathy; Feller, David B; Chang, Ku-Lang; Hernandez, Betsy; McCarthy, Jen; Burg, Mary Ann

2003-01-01

The purpose of this study was to develop and test two interventions designed to improve provider compliance with diabetes management guidelines: the use of a diabetes management flowsheet inserted into patient charts and the use of a diabetes management flowsheet plus quarterly provider feedback about compliance levels. Diabetic patient charts from six family practice clinics were randomly selected and audited at baseline and at 12 months. The analysis indicated that the use of the flowsheet was associated with improved provider compliance in the completion of foot examinations only. Providers involved in the study believed that the process of the flowsheet plus feedback contributed to their greater awareness of diabetes management guidelines.
Communicating Knowing through Communities of Practice: Exploring Internal Communicative Processes and Differences among CoPs

ERIC Educational Resources Information Center

Iverson, Joel O.; McPhee, Robert D.

2008-01-01

Knowing is an enacted, communicated process that is difficult to observe, let alone manage, in organizations. Communities of practice (CoPs) offer a productive solution for improving knowledge and knowledge management, but the communicative processes that enact CoPs have not been explored, leaving CoPs as an organizational black box. This research…
Evidence-based management - healthcare manager viewpoints.

PubMed

Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

2018-06-11

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.
Multidisciplinary strategies in the management of early chronic kidney disease.

PubMed

Martínez-Ramírez, Héctor R; Cortés-Sanabria, Laura; Rojas-Campos, Enrique; Hernández-Herrera, Aurora; Cueto-Manzano, Alfonso M

2013-11-01

Chronic kidney disease (CKD) is a worldwide epidemic especially in developing countries, with clear deficiencies in identification and treatment. Better care of CKD requires more than only economic resources, utilization of health research in policy-making and health systems changes that produce better outcomes. A multidisciplinary approach may facilitate and improve management of patients from early CKD in the primary health-care setting. This approach is a strategy for improving comprehensive care, initiating and maintaining healthy behaviors, promoting teamwork, eliminating barriers to achieve goals and improving the processes of care. A multidisciplinary intervention may include educational processes guided by health professional, use of self-help groups and the development of a CKD management plan. The complex and fragmented care management of patients with CKD, associated with poor outcome, enhances the importance of implementing a multidisciplinary approach in the management of this disease from the early stages. Multidisciplinary strategies should focus on the needs of patients (to increase their empowerment) and should be adapted to the resources and health systems prevailing in each country; its systematic implementation can help to improve patient care and slow the progression of CKD. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.
Total quality management in American industry.

PubMed

Widtfeldt, A K; Widtfeldt, J R

1992-07-01

The definition of total quality management is conformance to customer requirements and specifications, fitness for use, buyer satisfaction, and value at an affordable price. The three individuals who have developed the total quality management concepts in the United States are W.E. Deming, J.M. Juran, and Philip Crosby. The universal principles of total quality management are (a) a customer focus, (b) management commitment, (c) training, (d) process capability and control, and (e) measurement through quality improvement tools. Results from the National Demonstration Project on Quality Improvement in Health Care showed the principles of total quality management could be applied to healthcare.
Improvements to information management systems simulator

NASA Technical Reports Server (NTRS)

Bilek, R. W.

1972-01-01

The performance of personnel in the augmentation and improvement of the interactive IMSIM information management simulation model is summarized. With this augmented model, NASA now has even greater capabilities for the simulation of computer system configurations, data processing loads imposed on these configurations, and executive software to control system operations. Through these simulations, NASA has an extremely cost effective capability for the design and analysis of computer-based data management systems.
Voice, Collaboration and School Culture: Creating a Community for School Improvement. Evaluation of the Pioneer SCBM Schools, Hawaii's School/Community-Based Management Initiative. Executive Summary.

ERIC Educational Resources Information Center

Izu, Jo Ann; And Others

Site-based management is designed to bring decision making to the school level and involve all stakeholders in a process that will result ultimately in improved student outcomes. Enacted into law in June 1989, Hawaii's School/Community-Based Management Initiative (SCBM) is part of a national trend toward decentralizing decision making and…
Proceedings of the AMCP Partnership Forum: Breaking the Link Between Pain Management and Opioid Use Disorder.

PubMed

2015-12-01

Prescription drug misuse and abuse, especially with opioid analgesics, is the fastest growing drug problem in the United States. Addressing this public health crisis demands the coordinated efforts and actions of all stakeholders to establish a process of improving patient care and decreasing misuse and abuse. On September 9, 2014, the Academy of Managed Care Pharmacy (AMCP) convened a meeting of multiple stakeholders to recommend activities and programs that AMCP can promote to improve pain management, prevent opioid use disorder (OUD), and improve medication-assisted treatment outcomes. The speakers and panelists recommended that efforts to improve pain management outcomes and reduce the potential for OUD should rely on demonstrated evidence and best practices. It was recommended that AMCP promote a more holistic and evidence-based approach to pain management and OUD treatment that actively engages the patient in the decision-making process and includes care coordination with medical, pharmacy, behavioral, and mental health aspects of organizations, all of which is seamlessly supported by a technology infrastructure. To accomplish this, it was recommended that AMCP work to collaborate with organizations representing these stakeholders. Additionally, it was recommended that AMCP conduct continuing pharmacy education programs, develop a best practices toolkit on pain management, and actively promote quality standards for OUD prevention and treatment.
Using Knowledge Management to Revise Software-Testing Processes

ERIC Educational Resources Information Center

Nogeste, Kersti; Walker, Derek H. T.

2006-01-01

Purpose: This paper aims to use a knowledge management (KM) approach to effectively revise a utility retailer's software testing process. This paper presents a case study of how the utility organisation's customer services IT production support group improved their test planning skills through applying the American Productivity and Quality Center…
An Overview of Hydrologic Studies at Center for Forested Wetlands Research, USDA Forest Service

Treesearch

Devendra M. Amatya; Carl C. Trettin; R. Wayne Skaggs; Timothy J. Callahan; Ge Sun; Masato Miwa; John E. Parsons

2004-01-01

Managing forested wetland landscapes for water quality improvement and productivity requires a detailed understanding of functional linkages between ecohydrological processes and management practices. Studies are being conducted at Center for Forested Wetlands Research (CFWR), USDA Forest Service to understand the fundamental hydrologic and biogeochemical processes...
Improving Program Performance through Management Information. A Workbook.

ERIC Educational Resources Information Center

Bienia, Nancy

Designed specifically for state and local managers and supervisors who plan, direct, and operate child support enforcement programs, this workbook provides a four-part, step-by-step process for identifying needed information and methods of using the information to operate an effective program. The process consists of: (1) determining what…

Exemplars in the use of technology for management of depression in primary care.

PubMed

Serrano, Neftali; Molander, Rachel; Monden, Kimberley; Grosshans, Ashley; Krahn, Dean D

2012-06-01

Depression care management as part of larger efforts to integrate behavioral health care into primary care has been shown to be effective in helping patients and primary care clinicians achieve improved outcomes within the primary care environment. Central to care management systems is the use of registries which enable effective clinic population management. The aim of this article is to detail the methods and utility of technology in depression care management processes while also highlighting the real-world variations and barriers that exist in different clinical environments, namely a federally qualified health center and a Veterans Administration clinic. We analyzed descriptive data from the registries of Access Community Health Centers and the William S. Middleton Veterans Administration clinics along with historical reviews of their respective care management processes. Both registry reviews showed trend data indicating improvement in scores of depression and provided baseline data on important system variables, such as the number of patients who are not making progress, the percentage of patients who are unreachable by phone, and the kind of actions needed to ensure evidence-based and efficient care. Both sites also highlighted systemic technical barriers to more complete implementation of care management processes. Care management processes are an effective and efficient part of population-based care for depression in primary care. Implementation depends on available resources including hardware, software, and clinical personnel. Additionally, care management processes and technology have evolved over time based on local needs and are part of an integrated method to support the work of primary care clinicians in providing care for patients with depression.
Case Study: IRS Business System Modernization Process Improvement

DTIC Science & Technology

2004-03-01

31 CMU/SEI-2004-TR-002 iii List of Figures Figure 1: Managing Organizational Change ............................................................ 9...and constant emphasis on training in project management and acquisition, as well as in the SA-CMM. Figure 1: Managing Organizational Change Other
[Application of supply chain integration management of medical consumables].

PubMed

Zhang, Jian

2013-07-01

This paper introduces the background, the content, the information management system of material supply chain integration management and the consumables management process. The system helps to expand the selection of hospital supplies varieties, to reduce consumables management costs, to improve the efficiency of supplies, to ensure supplies safety, reliability and traceability.
Total Quality Management and Organizational Behavior Management: An Integration for Continual Improvement.

ERIC Educational Resources Information Center

Mawhinney, Thomas C.

1992-01-01

The history and main features of organizational behavior management (OBM) are compared and integrated with those of total quality management (TQM), with emphasis on W.E. Deming's 14 points and OBM's operant-based approach to performance management. Interventions combining OBM, TQM, and statistical process control are recommended. (DB)
A Decentralized Compositional Framework for Dependable Decision Process in Self-Managed Cyber Physical Systems

PubMed Central

Hou, Kun-Mean; Zhang, Zhan

2017-01-01

Cyber Physical Systems (CPSs) need to interact with the changeable environment under various interferences. To provide continuous and high quality services, a self-managed CPS should automatically reconstruct itself to adapt to these changes and recover from failures. Such dynamic adaptation behavior introduces systemic challenges for CPS design, advice evaluation and decision process arrangement. In this paper, a formal compositional framework is proposed to systematically improve the dependability of the decision process. To guarantee the consistent observation of event orders for causal reasoning, this work first proposes a relative time-based method to improve the composability and compositionality of the timing property of events. Based on the relative time solution, a formal reference framework is introduced for self-managed CPSs, which includes a compositional FSM-based actor model (subsystems of CPS), actor-based advice and runtime decomposable decisions. To simplify self-management, a self-similar recursive actor interface is proposed for decision (actor) composition. We provide constraints and seven patterns for the composition of reliability and process time requirements. Further, two decentralized decision process strategies are proposed based on our framework, and we compare the reliability with the static strategy and the centralized processing strategy. The simulation results show that the one-order feedback strategy has high reliability, scalability and stability against the complexity of decision and random failure. This paper also shows a way to simplify the evaluation for dynamic system by improving the composability and compositionality of the subsystem. PMID:29120357
A Decentralized Compositional Framework for Dependable Decision Process in Self-Managed Cyber Physical Systems.

PubMed

Zhou, Peng; Zuo, Decheng; Hou, Kun-Mean; Zhang, Zhan

2017-11-09

Cyber Physical Systems (CPSs) need to interact with the changeable environment under various interferences. To provide continuous and high quality services, a self-managed CPS should automatically reconstruct itself to adapt to these changes and recover from failures. Such dynamic adaptation behavior introduces systemic challenges for CPS design, advice evaluation and decision process arrangement. In this paper, a formal compositional framework is proposed to systematically improve the dependability of the decision process. To guarantee the consistent observation of event orders for causal reasoning, this work first proposes a relative time-based method to improve the composability and compositionality of the timing property of events. Based on the relative time solution, a formal reference framework is introduced for self-managed CPSs, which includes a compositional FSM-based actor model (subsystems of CPS), actor-based advice and runtime decomposable decisions. To simplify self-management, a self-similar recursive actor interface is proposed for decision (actor) composition. We provide constraints and seven patterns for the composition of reliability and process time requirements. Further, two decentralized decision process strategies are proposed based on our framework, and we compare the reliability with the static strategy and the centralized processing strategy. The simulation results show that the one-order feedback strategy has high reliability, scalability and stability against the complexity of decision and random failure. This paper also shows a way to simplify the evaluation for dynamic system by improving the composability and compositionality of the subsystem.
Design and practice of a comprehensively functional integrated management information system for major construction

NASA Astrophysics Data System (ADS)

Liu, Yuling; Wang, Xiaoping; Zhu, Yuhui; Fei, Lanlan

2017-08-01

This paper introduces a Comprehensively Functional Integrated Management Information System designed for the Optical Engineering Major by the College of Optical Science and Engineering, Zhejiang University, which combines the functions of teaching, students learning, educational assessment and management. The system consists of 5 modules, major overview, online curriculum, experiment teaching management, graduation project management and teaching quality feedback. The major overview module introduces the development history, training program, curriculums and experiment syllabus and teaching achievements of optical engineering major in Zhejiang University. The Management Information System is convenient for students to learn in a mobile and personalized way. The online curriculum module makes it very easy for teachers to setup a website for new curriculums. On the website, teachers can help students on their problems about the curriculums in time and collect their homework online. The experiment teaching management module and the graduation project management module enables the students to fulfill their experiment process and graduation thesis under the help of their supervisors. Before students take an experiment in the lab, they must pass the pre-experiment quiz on the corresponding module. After the experiment, students need to submit the experiment report to the web server. Moreover, the module contains experiment process video recordings, which are very helpful to improve the effect of the experiment education. The management of the entire process of a student's graduation program, including the project selection, mid-term inspection, progress report of every two weeks, final thesis, et al, is completed by the graduation project management module. The teaching quality feedback module is not only helpful for teachers to know whether the education effect of curriculum is good or not, but also helpful for the administrators of the college to know whether the design of syllabus is reasonable or not. The Management Information System changes the management object from the education results to the entire education processes. And it improves the efficiency of the management. It provides an effective method to promote curriculum construction management by supervision and evaluation, which improves students' learning outcomes and the quality of curriculums. As a result, it promotes the quality system of education obviously.
Marshaling and Acquiring Resources for the Process Improvement Process

DTIC Science & Technology

1993-06-01

stakeholders. ( Geber , 1990) D. IDENTIFYING SUPPLIERS Suppliers are just as crucial to setting requirements for processes as are customers. Although...output ( Geber , 1990, p. 32). Before gathering resources for process improvement, the functional manager must ensure that the relationship of internal...him patent information and clerical people process his applications. ( Geber , 1990, pp. 29-34) To get the full benefit of a white-collar worker as a
Using task analysis to improve the requirements elicitation in health information system.

PubMed

Teixeira, Leonor; Ferreira, Carlos; Santos, Beatriz Sousa

2007-01-01

This paper describes the application of task analysis within the design process of a Web-based information system for managing clinical information in hemophilia care, in order to improve the requirements elicitation and, consequently, to validate the domain model obtained in a previous phase of the design process (system analysis). The use of task analysis in this case proved to be a practical and efficient way to improve the requirements engineering process by involving users in the design process.
Developing the Mathematics Learning Management Model for Improving Creative Thinking in Thailand

ERIC Educational Resources Information Center

Sriwongchai, Arunee; Jantharajit, Nirat; Chookhampaeng, Sumalee

2015-01-01

The study purposes were: 1) To study current states and problems of relevant secondary students in developing mathematics learning management model for improving creative thinking, 2) To evaluate the effectiveness of model about: a) efficiency of learning process, b) comparisons of pretest and posttest on creative thinking and achievement of…
School-Based Management: Promise and Process. CPRE Finance Briefs.

ERIC Educational Resources Information Center

Wohlstetter, Priscilla; Mohrman, Susan Albers

This publication summarizes research that investigated how school-based management (SBM) can be implemented for long-term school improvement. It is argued that a successful SBM plan must be part of a quest for improvement and utilize a "high involvement" model. In addition to having more power, schools need knowledge of the organization,…
Contract management techniques for improving construction quality

DOT National Transportation Integrated Search

1997-07-01

Efforts to improve quality in highway construction embrace many aspects of the construction process. Quality goals include enhanced efficiency and productivity, optimal cost and delivery time, improved performance, and changes in attitude-promoting a...
Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

PubMed

Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

2016-05-01

This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress.
CO₂-neutral wastewater treatment plants or robust, climate-friendly wastewater management? A systems perspective.

PubMed

Larsen, Tove A

2015-12-15

CO2-neutral wastewater treatment plants can be obtained by improving the recovery of internal wastewater energy resources (COD, nutrients, energy) and reducing energy demand as well as direct emissions of the greenhouse gases N2O and CH4. Climate-friendly wastewater management also includes the management of the heat resource, which is most efficiently recovered at the household level, and robust wastewater management must be able to cope with a possible resulting temperature decrease. At the treatment plant there is a substantial energy optimization potential, both from improving electromechanical devices and sludge treatment as well as through the implementation of more energy-efficient processes like the mainstream anammox process or nutrient recovery from urine. Whether CO2 neutrality can be achieved depends not only on the actual net electricity production, but also on the type of electricity replaced: the cleaner the marginal electricity the more difficult to compensate for the direct emissions, which can be substantial, depending on the stability of the biological processes. It is possible to combine heat recovery at the household scale and nutrient recovery from urine, which both have a large potential to improve the climate friendliness of wastewater management. Copyright © 2015 Elsevier Ltd. All rights reserved.
Using Group Projects to Teach Process Improvement in a Quality Class

ERIC Educational Resources Information Center

Neidigh, Robert O.

2016-01-01

This paper provides a description of a teaching approach that uses experiential learning to teach process improvement. The teaching approach uses student groups to perform and gather process data in a senior-level quality management class that focuses on Lean Six Sigma. A strategy to link the experiential learning in the group projects to the…
Process-aware EHR BPM systems: two prototypes and a conceptual framework.

PubMed

Webster, Charles; Copenhaver, Mark

2010-01-01

Systematic methods to improve the effectiveness and efficiency of electronic health record-mediated processes will be key to EHRs playing an important role in the positive transformation of healthcare. Business process management (BPM) systematically optimizes process effectiveness, efficiency, and flexibility. Therefore BPM offers relevant ideas and technologies. We provide a conceptual model based on EHR productivity and negative feedback control that links EHR and BPM domains, describe two EHR BPM prototype modules, and close with the argument that typical EHRs must become more process-aware if they are to take full advantage of BPM ideas and technology. A prediction: Future extensible clinical groupware will coordinate delivery of EHR functionality to teams of users by combining modular components with executable process models whose usability (effectiveness, efficiency, and user satisfaction) will be systematically improved using business process management techniques.
The Joint Convention on the Safety of Spent fuel Management and on the safety of Radioactive Waste Management: A UK Regulator's Perspective

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

Lacey, D.; Bacon, M.L.

The UK fully supports the objective of the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management to achieve and maintain a high level of safety worldwide in spent fuel and radioactive waste management, through the enhancement of national measures and international co-operation, including where appropriate, safety-related co-operation. The UK's Health and Safety Executive, through its Nuclear Safety Directorate (NSD), has been committed to the Convention since the initial negotiations to set up the Convention and provided the president of the first review meeting in 2003. It would be wrong of anymore » nation to believe that they have all the best solutions to managing spent fuel and radioactive waste. The process of compiling reports for the Convention review meetings provides a structured process through which every contracting party can review its provisions against a common set of standards and identify for itself possible areas of improvements. The sharing of reports and the asking and answering of questions then provides a further opportunity for both sharing of experience and learning. The UK was encouraged by the spirit of constructive discussion rather than negative criticism that pervaded the first review meeting that provided an incentive for all to learn and improve. While, as could be expected of the first meeting of such a group, not everything worked as well as could be hoped for, all parties seemed committed to learn from mistakes and to make the process more effective. Lessons were learned from the Nuclear Safety Convention on the process of submitting reports electronically and the UK actively supported aims to use IAEA requirements documents as an additional focus for reports. This should, we hope, provide for even better benchmarking of achievements and provide feedback for improvements of the IAEA requirements where appropriate. In summary, the UK finds the Joint Convention process to be a very positive one that can only improve the worldwide standards of safety in spent fuel and radioactive waste management. (authors)« less
Benefits of information technology-enabled diabetes management.

PubMed

Bu, Davis; Pan, Eric; Walker, Janice; Adler-Milstein, Julia; Kendrick, David; Hook, Julie M; Cusack, Caitlin M; Bates, David W; Middleton, Blackford

2007-05-01

To determine the financial and clinical benefits of implementing information technology (IT)-enabled disease management systems. A computer model was created to project the impact of IT-enabled disease management on care processes, clinical outcomes, and medical costs for patients with type 2 diabetes aged >25 years in the U.S. Several ITs were modeled (e.g., diabetes registries, computerized decision support, remote monitoring, patient self-management systems, and payer-based systems). Estimates of care process improvements were derived from published literature. Simulations projected outcomes for both payer and provider organizations, scaled to the national level. The primary outcome was medical cost savings, in 2004 U.S. dollars discounted at 5%. Secondary measures include reduction of cardiovascular, cerebrovascular, neuropathy, nephropathy, and retinopathy clinical outcomes. All forms of IT-enabled disease management improved the health of patients with diabetes and reduced health care expenditures. Over 10 years, diabetes registries saved $14.5 billion, computerized decision support saved $10.7 billion, payer-centered technologies saved $7.10 billion, remote monitoring saved $326 million, self-management saved $285 million, and integrated provider-patient systems saved $16.9 billion. IT-enabled diabetes management has the potential to improve care processes, delay diabetes complications, and save health care dollars. Of existing systems, provider-centered technologies such as diabetes registries currently show the most potential for benefit. Fully integrated provider-patient systems would have even greater potential for benefit. These benefits must be weighed against the implementation costs.
NASA's Risk Management System

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2011-01-01

Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.
Risk Management Issues - An Aerospace Perspective

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2011-01-01

Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks--risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements.. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner, Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.
International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals. PMID:20807408
Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity.

PubMed

Shivaji, Tara; Cortes Martins, Helena

2015-01-01

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25-6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46-8:52).
Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity

PubMed Central

Shivaji, Tara; Cortes Martins, Helena

2015-01-01

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53–10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25–6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46–8:52). PMID:26734448
Social acceptability of forest conditions and management practices: a problem analysis.

Treesearch

Bruce A. Shindler; Mark Brunson; George H. Stankey

2002-01-01

The purpose of this report is to improve understanding of the complex sociopolitical processes related to resource management and to help structure management response to conflict and contentiousness, misunderstanding among participants, and failed citizen-agency interactions. Public acceptance is essential to every resource management decision public agencies must...
Process' standardization and change management in higher education. The case of TEI of Athens

NASA Astrophysics Data System (ADS)

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

2015-02-01

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

NASA Astrophysics Data System (ADS)

Pan, Tianheng

2018-01-01

In recent years, the combination of workflow management system and Multi-agent technology is a hot research field. The problem of lack of flexibility in workflow management system can be improved by introducing multi-agent collaborative management. The workflow management system adopts distributed structure. It solves the problem that the traditional centralized workflow structure is fragile. In this paper, the agent of Distributed workflow management system is divided according to its function. The execution process of each type of agent is analyzed. The key technologies such as process execution and resource management are analyzed.
Optimization of the production process using virtual model of a workspace

NASA Astrophysics Data System (ADS)

Monica, Z.

2015-11-01

Optimization of the production process is an element of the design cycle consisting of: problem definition, modelling, simulation, optimization and implementation. Without the use of simulation techniques, the only thing which could be achieved is larger or smaller improvement of the process, not the optimization (i.e., the best result it is possible to get for the conditions under which the process works). Optimization is generally management actions that are ultimately bring savings in time, resources, and raw materials and improve the performance of a specific process. It does not matter whether it is a service or manufacturing process. Optimizing the savings generated by improving and increasing the efficiency of the processes. Optimization consists primarily of organizational activities that require very little investment, or rely solely on the changing organization of work. Modern companies operating in a market economy shows a significant increase in interest in modern methods of production management and services. This trend is due to the high competitiveness among companies that want to achieve success are forced to continually modify the ways to manage and flexible response to changing demand. Modern methods of production management, not only imply a stable position of the company in the sector, but also influence the improvement of health and safety within the company and contribute to the implementation of more efficient rules for standardization work in the company. This is why in the paper is presented the application of such developed environment like Siemens NX to create the virtual model of a production system and to simulate as well as optimize its work. The analyzed system is the robotized workcell consisting of: machine tools, industrial robots, conveyors, auxiliary equipment and buffers. In the program could be defined the control program realizing the main task in the virtual workcell. It is possible, using this tool, to optimize both the object trajectory and the cooperation process.
Prevention and management of "do not return" notices: a quality improvement process for supplemental staffing nursing agencies.

PubMed

Ade-Oshifogun, Jochebed Bosede; Dufelmeier, Thaddeus

2012-01-01

This article describes a quality improvement process for "do not return" (DNR) notices for healthcare supplemental staffing agencies and healthcare facilities that use them. It is imperative that supplemental staffing agencies partner with healthcare facilities in assuring the quality of supplemental staff. Although supplemental staffing agencies attempt to ensure quality staffing, supplemental staff are sometimes subjectively evaluated by healthcare facilities as "DNR." The objective of this article is to describe a quality improvement process to prevent and manage "DNR" within healthcare organizations. We developed a curriculum and accompanying evaluation tool by adapting Rampersad's problem-solving discipline approach: (a) definition of area(s) for improvement; (b) identification of all possible causes; (c) development of an action plan; (d) implementation of the action plan; (e) evaluation for program improvement; and (f) standardization of the process. Face and content validity of the evaluation tool was ascertained by input from a panel of experienced supplemental staff and nursing faculty. This curriculum and its evaluation tool will have practical implications for supplemental staffing agencies and healthcare facilities in reducing "DNR" rates and in meeting certification/accreditation requirements. Further work is needed to translate this process into future research. © 2012 Wiley Periodicals, Inc.
TQM: the essential concepts.

PubMed

Chambers, D W

1998-01-01

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

DTIC Science & Technology

2009-09-01

comprehensive risk model for DoD milestone review documentation as well as recommended changes to the Capability Maturity Model Integration ( CMMI ) Project...Milestone Documentation, Project Planning, Rational Frame, Political Frame, CMMI Project Planning Process Area, CMMI Risk Management Process Area...well as recommended changes to the Capability Maturity Model Integration ( CMMI ) Project Planning and Risk Management process areas. The intent is to
TQM in a test environment

NASA Technical Reports Server (NTRS)

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

1992-01-01

In response to the changing aerospace economic climate, Martin Marietta Astronautics Group (MMAG) has adopted a Total Quality Management (TQM) philosophy to maintain a competitive edge. TQM emphasizes continuous improvement of processes, motivation to improve from within, cross-functional involvement, people empowerment, customer satisfaction, and modern process control techniques. The four major initiatives of TQM are Product Excellence, Manufacturing Resource Planning (MRP II), People Empowerment, and Subcontract Management. The Defense Space and Communications (DS&C) Test Lab's definition and implementation of the MRP II and people empowerment initiatives within TQM are discussed. The application of MRP II to environmental test planning and operations processes required a new and innovative approach. In an 18 month span, the test labs implemented MRP II and people empowerment and achieved a Class 'A' operational status. This resulted in numerous benefits, both tangible and intangible, including significant cost savings and improved quality of life. A detailed description of the implementation process and results are addressed.
Bootstrapping Process Improvement Metrics: CMMI Level 4 Process Improvement Metrics in a Level 3 World

NASA Technical Reports Server (NTRS)

Hihn, Jairus; Lewicki, Scott; Morgan, Scott

2011-01-01

The measurement techniques for organizations which have achieved the Software Engineering Institutes CMMI Maturity Levels 4 and 5 are well documented. On the other hand, how to effectively measure when an organization is Maturity Level 3 is less well understood, especially when there is no consistency in tool use and there is extensive tailoring of the organizational software processes. Most organizations fail in their attempts to generate, collect, and analyze standard process improvement metrics under these conditions. But at JPL, NASA's prime center for deep space robotic exploration, we have a long history of proving there is always a solution: It just may not be what you expected. In this paper we describe the wide variety of qualitative and quantitative techniques we have been implementing over the last few years, including the various approaches used to communicate the results to both software technical managers and senior managers.
TQM in a test environment

NASA Astrophysics Data System (ADS)

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

1992-11-01

In response to the changing aerospace economic climate, Martin Marietta Astronautics Group (MMAG) has adopted a Total Quality Management (TQM) philosophy to maintain a competitive edge. TQM emphasizes continuous improvement of processes, motivation to improve from within, cross-functional involvement, people empowerment, customer satisfaction, and modern process control techniques. The four major initiatives of TQM are Product Excellence, Manufacturing Resource Planning (MRP II), People Empowerment, and Subcontract Management. The Defense Space and Communications (DS&C) Test Lab's definition and implementation of the MRP II and people empowerment initiatives within TQM are discussed. The application of MRP II to environmental test planning and operations processes required a new and innovative approach. In an 18 month span, the test labs implemented MRP II and people empowerment and achieved a Class 'A' operational status. This resulted in numerous benefits, both tangible and intangible, including significant cost savings and improved quality of life. A detailed description of the implementation process and results are addressed.
The experience factory: Can it make you a 5? or what is its relationship to other quality and improvement concepts?

NASA Technical Reports Server (NTRS)

Basili, Victor R.

1992-01-01

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

PubMed

Sands, J J

2006-02-01

Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence based guidelines and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total health-care costs including payments from all insurance and government entities, pharmacy costs and out-of-pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present, current data suggests that the promise of disease management, improved care at reduced cost, can and is being realized in ESRD.
Dysphagia management in a 3-year dental hygiene education programme in Japan.

PubMed

Sato, Yoko; Miura, Ai; Saito, Atsushi

2005-11-01

This paper reports the development and evaluation of a dysphagia management course taught to the third year dental hygiene students during 2004-2005 as one framework of the new curriculum. The course consisted of lectures by specialists in each field, basic practice and clinical practice at a facility for the elderly. Evaluation of the course showed that improvements were found in students' understanding in certain subjects when compared with that during 2003-2004. Scores on the post-test were statistically significantly higher than those on the pre-test, showing that basic knowledge of the students had been improved. Introductory and follow-up lectures by dental hygiene instructors and appropriate basic practice enhanced the learning process of the students. In the clinical practice, the concept of 'dental hygiene process of care' was incorporated. The dental hygiene process facilitated the students in planning and implementing dental hygiene care that meets the needs of the individual clients. This active learning experience enhanced the students' understanding of dysphagia management. Although further improvements are necessary, this dysphagia management course should help dental hygienists in playing a greater role in the field of oral care and dysphagia rehabilitation.
Assessment of the Orion-SLS Interface Management Process in Achieving the EIA 731.1 Systems Engineering Capability Model Generic Practices Level 3 Criteria

NASA Technical Reports Server (NTRS)

Jellicorse, John J.; Rahman, Shamin A.

2016-01-01

NASA is currently developing the next generation crewed spacecraft and launch vehicle for exploration beyond earth orbit including returning to the Moon and making the transit to Mars. Managing the design integration of major hardware elements of a space transportation system is critical for overcoming both the technical and programmatic challenges in taking a complex system from concept to space operations. An established method of accomplishing this is formal interface management. In this paper we set forth an argument that the interface management process implemented by NASA between the Orion Multi-Purpose Crew Vehicle (MPCV) and the Space Launch System (SLS) achieves the Level 3 tier of the EIA 731.1 System Engineering Capability Model (SECM) for Generic Practices. We describe the relevant NASA systems and associated organizations, and define the EIA SECM Level 3 Generic Practices. We then provide evidence for our compliance with those practices. This evidence includes discussions of: NASA Systems Engineering Interface (SE) Management standard process and best practices; the tailoring of that process for implementation on the Orion to SLS interface; changes made over time to improve the tailored process, and; the opportunities to take the resulting lessons learned and propose improvements to our institutional processes and best practices. We compare this evidence against the practices to form the rationale for the declared SECM maturity level.
Results of a Regional Effort to Improve Warfarin Management.

PubMed

Rose, Adam J; Park, Angela; Gillespie, Christopher; Van Deusen Lukas, Carol; Ozonoff, Al; Petrakis, Beth Ann; Reisman, Joel I; Borzecki, Ann M; Benedict, Ashley J; Lukesh, William N; Schmoke, Timothy J; Jones, Ellen A; Morreale, Anthony P; Ourth, Heather L; Schlosser, James E; Mayo-Smith, Michael F; Allen, Arthur L; Witt, Daniel M; Helfrich, Christian D; McCullough, Megan B

2017-05-01

Improved anticoagulation control with warfarin reduces adverse events and represents a target for quality improvement. No previous study has described an effort to improve anticoagulation control across a health system. To describe the results of an effort to improve anticoagulation control in the New England region of the Veterans Health Administration (VA). Our intervention encompassed 8 VA sites managing warfarin for more than 5000 patients in New England (Veterans Integrated Service Network 1 [VISN 1]). We provided sites with a system to measure processes of care, along with targeted audit and feedback. We focused on processes of care associated with site-level anticoagulation control, including prompt follow-up after out-of-range international normalized ratio (INR) values, minimizing loss to follow-up, and use of guideline-concordant INR target ranges. We used a difference-in-differences (DID) model to examine changes in anticoagulation control, measured as percentage time in therapeutic range (TTR), as well as process measures and compared VISN 1 sites with 116 VA sites located outside VISN 1. VISN 1 sites improved on TTR, our main indicator of quality, from 66.4% to 69.2%, whereas sites outside VISN 1 improved from 65.9% to 66.4% (DID 2.3%, P < 0.001). Improvement in TTR correlated strongly with the extent of improvement on process-of-care measures, which varied widely across VISN 1 sites. A regional quality improvement initiative, using performance measurement with audit and feedback, improved TTR by 2.3% more than control sites, which is a clinically important difference. Improving relevant processes of care can improve outcomes for patients receiving warfarin.
Do patients with symptoms and signs of lower urinary tract dysfunction need a urodynamic diagnosis? ICI-RS 2013.

PubMed

Rosier, Peter F W M; Giarenis, Ilias; Valentini, Francoise A; Wein, Alan; Cardozo, Linda

2014-06-01

The ICI-RS Think Tank discussed the diagnostic process for patients who present with symptoms and signs of lower urinary tract (LUT) dysfunction. This manuscript reflects the Think Tank's summary and opinion. An overview of the existing evidence and consensus regarding urodynamic testing was presented and discussed in relation to contemporary treatment strategies. Evidence of the validity of the diagnostic process in relation to the contemporary management paradigm is incomplete, scattered, and sometimes conflicting and therefore a process redesign may be necessary. The Think Tanks' suggestion, contained in this manuscript, is that the symptoms and signs that the patients present can be more precisely delineated as syndromes. The overactive bladder syndrome (OAB-S); the stress urinary incontinence syndrome (SUI-S); the urinary incontinence syndrome (UI-S); the voiding dysfunction syndrome (VD-S); and or the neurogenic LUT dysfunction syndrome (NLUTD-S) may become evidence based starting point for initial management. Consistent addition of the word syndrome, if adequately defined, acknowledges the uncertainty, but will improve outcome and will improve selection of patients that need further (invasive) diagnosis before management. The ICS-RS Think Tank has summarized the level of evidence for UDS and discussed the evidence in association with the currently changing management paradigm. The ICI-RS Think Tank recommends that the diagnostic process for patients with LUTD can be redesigned. Carefully delineated and evidence based LUTD syndromes may better indicate, personalize and improve the outcome of initial management, and may also contribute to improved and rational selection of patients for invasive UDS. Neurourol. Urodynam. 33:581-586, 2014. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Quality improvement tools for chronic disease care--more effective processes are less likely to be implemented in developing countries.

PubMed

Hashim, Muhammad Jawad; Prinsloo, Adrianna; Mirza, Deen M

2013-01-01

Chronic disease services may be improved if care management processes (CMPs), such as disease-specific flowsheets and chronic disease registries, are used. The newly industrialized Gulf state health service has underdeveloped primary care but higher diabetes prevalence. This paper's aim is to investigate care management processes in United Arab Emirates (UAE) primary care clinics to explore these issues. A cross-sectional survey using self-administered questionnaires given to family physicians and nurses attending a UAE University workshop was used to collect data. All 38 participants completed the questionnaire: 68 per cent were women and 81 per cent physicians. Care management processes in use included: medical records, 76 per cent; clinical guidelines, 74 per cent; chronic disease care rooms, 74 per cent; disease-specific flowsheets, 61 per cent; medical record audits, 57 per cent; chronic disease nurse-educators, 58 per cent; electronic medical records (EMR), 34 per cent; and incentive plans based on clinical performance, 21 per cent. Only 62 per cent and 48 per cent reported that flowsheets and problem lists, respectively, were completed by physicians. Responses to the open-ended question included using traditional quality improvement (QI) approaches such as continuing education and staff meetings, but not proactive systems such as disease registries and self-management. The study used a small, non-random sample and the survey instrument's psychometric properties were not collected. Chronic disease care CMPs are present in UAE clinics but use is limited. Quality improvement should include disease registries, reminder-tracking systems, patient self-management support and quality incentives. This report highlights the lag regarding adopting more effective CMPs in developing countries.
Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?

PubMed

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

2014-01-01

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

PubMed Central

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

2014-01-01

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

NASA Astrophysics Data System (ADS)

Zhang, Ruosi; Hao, Tianyi; Li, Yunxiao; Zhang, Fangqing; Ding, Sheng

2017-05-01

In view of the universal problem which the material management is loose, and lack of standardization and interactive real-time in the biomass power plant, a system based on the method of intensive management is proposed in this paper to control the whole process of power plant material. By analysing the whole process of power plant material management and applying the Internet of Things, the method can simplify the management process. By making use of the resources to maximize and data mining, material utilization, circulation rate and quality control management can be improved. The system has been applied in Gaotang power plant, which raised the level of materials management and economic effectiveness greatly. It has an important significance for safe, cost-effective and highly efficient operation of the plant.
A Recipe for Streamlining Mission Management

NASA Technical Reports Server (NTRS)

Mitchell, Andrew E.; Semancik, Susan K.

2004-01-01

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

PubMed

Hosseini, Nazafarin; Sharif, Farkhondeh; Ahmadi, Fazlollah; Zare, Mohammad

2016-01-01

Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease management process in patients with epilepsy in Iran. This qualitative approach and grounded theory study was conducted from January 2009 to February 2012 in Isfahan city (Iran). Thirty-two participants were recruited by the goal-oriented, and snowball sample selection and theoretical sampling methods. After conducting a total of 43 in-depth interviews with the participants, the researchers reached data saturation. Data were analyzed using Strauss and Corbin method. With a focus on disease management process, researchers found three main themes and seven sub-themes as a psychosocial process (PSP). The main themes were: perception of threat to self-identity, effort to preserve self-identity, and burn out. The psychosocial aspect of the disease generated one main variable "the perception of identity loss" and one central variable "searching for self-identity." Participants attributed threat to self-identity and burn out to the way their disease was managed requiring efforts to preserve their identity. Recommendations consist of support programs and strategies to improve the public perception of epilepsy in Iran, help patients accept their condition and preserve self-identity, and most importantly, enhance medical management of epilepsy.
Planning and Implementing Total Quality Management in the Royal Australian Air Force: A Multiple Case Study Analysis

DTIC Science & Technology

1990-09-01

change barriers, and necessary checks and balances built into processes. Furthermore, this assessment should address management system variables which...organisation’s 69 immediate product and their worklife . Focus must be maintained on improving RAAF processes. In addition to a quality committee structure as
Improving Educational Objectives of the Industrial and Management Systems Engineering Programme at Kuwait University

ERIC Educational Resources Information Center

Aldowaisan, Tariq; Allahverdi, Ali

2016-01-01

This paper describes the process 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…
How the Organizational Learning Process Mediates the Impact of Strategic Human Resource Management Practices on Performance in Korean Organizations

ERIC Educational Resources Information Center

Cho, Sei Hyoung; Song, Ji Hoon; Yun, Suk Chun; Lee, Cheol Ki

2013-01-01

The primary purpose of this research is to examine the structural relationships among several workplace-related constructs, including strategic human resource management (HRM) practices, organizational learning processes, and performance improvement in the Korean business context. More specifically, the research examined the mediating effect of…
Introduction of Transplant Registry Unified Management Program 2 (TRUMP2): scripts for TRUMP data analyses, part I (variables other than HLA-related data).

PubMed

Atsuta, Yoshiko

2016-01-01

Collection and analysis of information on diseases and post-transplant courses of allogeneic hematopoietic stem cell transplant recipients have played important roles in improving therapeutic outcomes in hematopoietic stem cell transplantation. Efficient, high-quality data collection systems are essential. The introduction of the Second-Generation Transplant Registry Unified Management Program (TRUMP2) is intended to improve data quality and more efficient data management. The TRUMP2 system will also expand possible uses of data, as it is capable of building a more complex relational database. The construction of an accessible data utilization system for adequate data utilization by researchers would promote greater research activity. Study approval and management processes and authorship guidelines also need to be organized within this context. Quality control of processes for data manipulation and analysis will also affect study outcomes. Shared scripts have been introduced to define variables according to standard definitions for quality control and improving efficiency of registry studies using TRUMP data.
Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.
Strengthening the regulatory system through the implementation and use of a quality management system.

PubMed

Eisner, Reinhold; Patel, Rakeshkumar

2017-04-20

Quality management systems (QMS), based on ISO 9001 requirements, are applicable to government service organizations such as Health Canada's Biologics and Genetic Therapies Directorate (BGTD). This communication presents the process that the BGTD followed since the early 2000s to implement a quality management system and describes how the regulatory system was improved as a result of this project. BGTD undertook the implementation of a quality management system based on ISO 9001 and containing aspects of ISO 17025 with the goal of strengthening the regulatory system through improvements in the people, processes, and services of the organization. We discuss the strategy used by BGTD to implement the QMS and the benefits that were realized from the various stages of implementation. The eight quality principals upon which the QMS standards of the ISO 9000 series are based were used by senior management as a framework to guide QMS implementation.
A Chronic Disease Prevention and Management Corridor© to Supporting System-Level Transformations for Chronic Conditions.

PubMed

Sampalli, Tara; Christian, Erin; Edwards, Lynn; Ryer, Ashley

2015-01-01

Improving care for chronic conditions requires system-level transformations to ensure multiple levels of adoption and sustainability of the implemented improvements. These comprehensive solutions require transformations and supports at various levels, leadership and process changes at service/program level. Recognizing the importance of an organization-wide strategy to mitigate the growing issue of chronic disease prevention and management, a novel system-level approach has been developed in a district health authority in Nova Scotia, Canada. In this paper, the contextual factors and efforts that led to the conceptual framework of the Chronic Disease Prevention and Management (CDPM) "Corridor©" to management of chronic conditions are discussed. The CDPM Corridor© essentially constitutes a system-level redesign process; common elements, tools and resources; and a hub of supports for chronic disease prevention and management. The CDPM Corridor © will include a toolkit to guide the implementation of the proposed transformations.
Communal Cooperation in Sensor Networks for Situation Management

NASA Technical Reports Server (NTRS)

Jones, Kennie H.; Lodding, Kenneth N.; Olariu, Stephan; Wilson, Larry; Xin,Chunsheng

2006-01-01

Situation management is a rapidly evolving science where managed sources are processed as realtime streams of events and fused in a way that maximizes comprehension, thus enabling better decisions for action. Sensor networks provide a new technology that promises ubiquitous input and action throughout an environment, which can substantially improve information available to the process. Here we describe a NASA program that requires improvements in sensor networks and situation management. We present an approach for massively deployed sensor networks that does not rely on centralized control but is founded in lessons learned from the way biological ecosystems are organized. In this approach, fully distributed data aggregation and integration can be performed in a scalable fashion where individual motes operate based on local information, making local decisions that achieve globally-meaningful results. This exemplifies the robust, fault-tolerant infrastructure required for successful situation management systems.
Health Monitoring and Management for Manufacturing Workers in Adverse Working Conditions.

PubMed

Xu, Xiaoya; Zhong, Miao; Wan, Jiafu; Yi, Minglun; Gao, Tiancheng

2016-10-01

In adverse working conditions, environmental parameters such as metallic dust, noise, and environmental temperature, directly affect the health condition of manufacturing workers. It is therefore important to implement health monitoring and management based on important physiological parameters (e.g., heart rate, blood pressure, and body temperature). In recent years, new technologies, such as body area networks, cloud computing, and smart clothing, have allowed the improvement of the quality of services. In this article, we first give five-layer architecture for health monitoring and management of manufacturing workers. Then, we analyze the system implementation process, including environmental data processing, physical condition monitoring and system services and management, and present the corresponding algorithms. Finally, we carry out an evaluation and analysis from the perspective of insurance and compensation for manufacturing workers in adverse working conditions. The proposed scheme will contribute to the improvement of workplace conditions, realize health monitoring and management, and protect the interests of manufacturing workers.
Total Quality Management (TQM) as the Procedure for Management of Integrated Academics.

ERIC Educational Resources Information Center

Anderson, Lowell D.

Total Quality Management (TQM) is a way of doing business that involves every employee, both labor and management, in an effort to improve quality and productivity. The quality management concept consists of common principles: (1) customer focus; (2) process focus; (3) failure prevention; (4) mobilization of work force; (5) decision making based…
Expanding horizons of forest ecosystem management: proceedings of the third habitat futures workshop; 1992 October; Vernon, B.C.

Treesearch

Mark H. Huff; Lisa K. Norris; J. Brian Nyberg; Nancy L. Wilkin; coords.

1994-01-01

New approaches and technologies to evaluate wildlife-habitat relations, implement integrated forest management, and improve public participation in the process are needed to implement ecosystem management. Presented here are five papers that examine ecosystem management concepts at international, national, regional, and local scales. Two general management problems...
A quality improvement management model for renal care.

PubMed

Vlchek, D L; Day, L M

1991-04-01

The purpose of this article is to explore the potential for applying the theory and tools of quality improvement (total quality management) in the renal care setting. We believe that the coupling of the statistical techniques used in the Deming method of quality improvement, with modern approaches to outcome and process analysis, will provide the renal care community with powerful tools, not only for improved quality (i.e., reduced morbidity and mortality), but also for technology evaluation and resource allocation.
Major accident prevention through applying safety knowledge management approach.

PubMed

Kalatpour, Omid

2016-01-01

Many scattered resources of knowledge are available to use for chemical accident prevention purposes. The common approach to management process safety, including using databases and referring to the available knowledge has some drawbacks. The main goal of this article was to devise a new emerged knowledge base (KB) for the chemical accident prevention domain. The scattered sources of safety knowledge were identified and scanned. Then, the collected knowledge was formalized through a computerized program. The Protégé software was used to formalize and represent the stored safety knowledge. The domain knowledge retrieved as well as data and information. This optimized approach improved safety and health knowledge management (KM) process and resolved some typical problems in the KM process. Upgrading the traditional resources of safety databases into the KBs can improve the interaction between the users and knowledge repository.
Developing a multidisciplinary approach within the ED towards domestic violence presentations.

PubMed

Basu, Subhashis; Ratcliffe, Giles

2014-03-01

To improve the detection and quality of care of patients who attend the emergency department (ED) with confirmed or suspected domestic abuse (DA). A quality improvement report on the design, implementation and evaluation of a specialised service and structured training programme to detect and manage DA presentations within an emergency medicine department. The study was set in the ED at the Northern General Hospital, Sheffield, UK. Key measures for improvement included introducing a service within the ED to help staff manage DA and coordinate responses; improve staff confidence in detecting DA; develop a structured and consistent process by which to manage DA presentations. An Independent Domestic Violence Advocate service was introduced into the department in July 2011 through a multiagency agreement. A structured training and education programme was delivered to ED staff. A 'communications form' was developed for DA risk assessment and case management. The process was reviewed quarterly. One hundred and seventy-two referrals were made to the service (121 distinct clients) over a 12-month period. Staff reported greater confidence in detecting DA, and community partners highlighted the role the service had in improving DA detection and care quality within the city. Strong leadership and prioritising the issue within the department has facilitated the development of the process and contributed substantially to its success. Support from community partners has been invaluable in tailoring the service and education programme to the needs of staff and patients within the department.

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation

PubMed Central

Alemnji, George; Edghill, Lisa; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Background Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. Objectives We report the development of a stepwise process for quality systems improvement in the Caribbean Region. Methods The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called ‘Laboratory Quality Management System – Stepwise Improvement Process (LQMS-SIP) Towards Accreditation’ to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. Results This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. Conclusion This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement. PMID:28879149
Healthcare managers' roles, competencies, and outputs in organizational performance improvement.

PubMed

Wallick, William G

2002-01-01

Healthcare CEOs recognize that managers are under increasing pressure to work smarter and more efficiently with fewer available resources. Jobs in the healthcare industry are in a constant state of change, requiring a workforce that is not only prepared to adjust quickly to the changing environment but to simultaneously maintain or improve overall organizational performance. Traditionally, trainers were viewed as the people with the primary responsibility for improving organizational performance. Today some CEOs believe healthcare managers should own that responsibility, and other CEOs believe the responsibility should be shared among healthcare managers and trainers. This shift in how accountability is viewed poses at least two important questions. Are managers aware of the various roles they need to enact to achieve successful organizational performance improvement? Do managers possess the competencies associated with those roles? The seven most contemporary trainer roles, now referred to as workplace learning and performance roles, are examined in this article to help managers increase their knowledge of the roles, competencies, and outputs expected of them. Based on findings of a study conducted to examine CEO's perceptions of managers' roles in the performance improvement process, this article provides theoretical backgrounds, includes verbatim study comments, and offers practical recommendations or tips for managers.
Quality-Focused Management.

ERIC Educational Resources Information Center

Needham, Robbie Lee

1993-01-01

Presents the quality-focused management (QFM) system and explains the departure QFM makes from established community college management practices. Describes the system's self-directed teams engaged in a continuous improvement process driven by customer demand and long-term commitment to quality and cost control. (13 references.) (MAB)
Computerizing Maintenance Management Improves School Processes.

ERIC Educational Resources Information Center

Conroy, Pat

2002-01-01

Describes how a Computerized Maintenance Management System (CMMS), a centralized maintenance operations database that facilitates work order procedures and staff directives, can help individual school campuses and school districts to manage maintenance. Presents the benefits of CMMS and things to consider in CMMS selection. (EV)
Database management systems for process safety.

PubMed

Early, William F

2006-03-17

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

NASA Astrophysics Data System (ADS)

Guo, Kai; Qiao, Lihong; Qie, Yifan

2018-03-01

The design of Process Bill of Materials (PBOM) holds a hinge position in the process of product development. The requirements of PBOM configuration design and management for complex products are analysed in this paper, which include the reuse technique of configuration procedure and urgent management need of huge quantity of product family PBOM data. Based on the analysis, the function framework of PBOM configuration and management has been established. Configuration templates and modules are defined in the framework to support the customization and the reuse of configuration process. The configuration process of a detection sensor PBOM is shown as an illustration case in the end. The rapid and agile PBOM configuration and management can be achieved utilizing template-based method, which has a vital significance to improve the development efficiency for complex products.
Implementing Laboratory Quality Management Systems in Mozambique: The Becton Dickinson-US President's Emergency Plan for AIDS Relief Public-Private Partnership Initiative.

PubMed

Skaggs, Beth; Pinto, Isabel; Masamha, Jessina; Turgeon, David; Gudo, Eduardo Samo

2016-04-15

Mozambique's ministry of health (MOH) recognized the need to establish a national laboratory quality assurance (NLQA) program to improve the reliability and accuracy of laboratory testing. The Becton Dickinson-US President's Emergency Plan for AIDS Relief Public-Private Partnership (PPP) was used to garner MOH commitment and train a cadre of local auditors and managers to support sustainability and country ownership of a NLQA program. From January 2011 to April 2012, the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist and the Strengthening Laboratory Management Towards Accreditation (SLMTA) curriculum were used in 6 MOH laboratories. PPP volunteers provided training and mentorship to build the capacity of local auditors and program managers to promote institutionalization and sustainability of the program within the MOH. SLIPTA was launched in 6 MOH laboratories, and final audits demonstrated improvements across the 13 quality system essentials, compared with baseline. Training and mentorship of MOH staff by PPP volunteers resulted in 18 qualified auditors and 28 managers/quality officers capacitated to manage the improvement process in their laboratories. SLIPTA helps laboratories improve the quality and reliability of their service even in the absence of full accreditation. Local capacity building ensures sustainability by creating country buy-in, reducing costs of audits, and institutionalizing program management. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Application of a theoretical model to evaluate COPD disease management.

PubMed

Lemmens, Karin M M; Nieboer, Anna P; Rutten-Van Mölken, Maureen P M H; van Schayck, Constant P; Asin, Javier D; Dirven, Jos A M; Huijsman, Robbert

2010-03-26

Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.
Application of a theoretical model to evaluate COPD disease management

PubMed Central

2010-01-01

Background Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. Methods A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Results Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. Conclusions The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care. PMID:20346135
Strengthening the management of ESA - the Inter-Directorate Reform of Corporate and Risk Management

NASA Astrophysics Data System (ADS)

Feustel-Büechl, Jörg; Arend, Harald; Derio, Eric; Infante, Giovanni; Kreiner, Gerhard; Phaler, Jesse; Tabbert, Michael

2007-02-01

ESA has undertaken the Inter-Directorate Reform of Corporate and Risk Management to strengthen the Agency's internal operations. The reform was completed at the end of 2006, encompassing five dedicated projects on Risk Management, Agency-Wide Controlling System, Project Plan and Integrated Project Review, General Budget Structure and Charging Policy, and Corporate Information Systems. It has contributed to improved management of the Agency's internal operations by engaging all internal stakeholders in a common objective, introducing improvements to planning and management methods, elaborating consolidated information structures and tools, contributing to enhanced transparency and accountability, and by providing qualified new policies, processes and tools.
Application of Strategic Management Principles as Tool to Improve Quality of Construction Technological Process

NASA Astrophysics Data System (ADS)

Kluchnikova, O.; Pobegaylov, O.

2017-11-01

The article focuses on the basic theory and practical aspects of the strategic management improving in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at the selection of an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research as well as on the experimental data obtained in the experiment.
Incorporating Total Quality Management in an Engineering Design Course. Report 5-1993.

ERIC Educational Resources Information Center

Wilczynski, V.; And Others

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

DTIC Science & Technology

2007-06-01

systems to joint portfolio management Refinement of a human capital strategy Improvement of governance of the business transformation effort...Management, Senior- Level Tri-Chaired investment panel for the new Concept Decision process for major programs, and Defense Acquisition Executive Summary...establishment of centers of excellence. DLA reorganized to implement the Business Systems Modernization (BSM) initiative designed to improve end-to-end
[IMPLEMENTATION OF A QUALITY MANAGEMENT SYSTEM IN A NUTRITION UNIT ACCORDING TO ISO 9001:2008].

PubMed

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

2015-09-01

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

PubMed

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

2016-01-01

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

NASA Technical Reports Server (NTRS)

Greenhalgh, Phillip O.

2009-01-01

Launching a rocket, running a business, driving to work and even day-to-day living all involve some degree of risk. Risk is ever present yet not always recognized, adequately assessed and appropriately mitigated. Identification, assessment and mitigation of risk are elements of the risk management component of the "continuous improvement" way of life that has become a hallmark of successful and progressive enterprises. While the application of risk management techniques to provide continuous improvement may be detailed and extensive, the philosophy, ideals and tools can be beneficially applied to all situations. Experiences with the use of risk identification, assessment and mitigation techniques for complex systems and processes are described. System safety efforts and tools used to examine potential risks of the Ares I First Stage of NASA s new Constellation Crew Launch Vehicle (CLV) presently being designed are noted as examples. Recommendations from lessons learned are provided for the application of risk management during the development of new systems as well as for the improvement of existing systems. Lessons learned and suggestions given are also examined for applicability to simple systems, uncomplicated processes and routine personal daily tasks. This paper informs the reader of varied uses of risk management efforts and techniques to identify, assess and mitigate risk for improvement of products, success of business, protection of people and enhancement of personal life.
Teamwork for Oversight of Processes and Systems (TOPS). Implementation guide for TOPS version 2.0, 10 August 1992

NASA Technical Reports Server (NTRS)

Strand, Albert A.; Jackson, Darryl J.

1992-01-01

As the nation redefines priorities to deal with a rapidly changing world order, both government and industry require new approaches for oversight of management systems, particularly for high technology products. Declining defense budgets will lead to significant reductions in government contract management personnel. Concurrently, defense contractors are reducing administrative and overhead staffing to control costs. These combined pressures require bold approaches for the oversight of management systems. In the Spring of 1991, the DPRO and TRW created a Process Action Team (PAT) to jointly prepare a Performance Based Management (PBM) system titled Teamwork for Oversight of Processes and Systems (TOPS). The primary goal is implementation of a performance based management system based on objective data to review critical TRW processes with an emphasis on continuous improvement. The processes are: Finance and Business Systems, Engineering and Manufacturing Systems, Quality Assurance, and Software Systems. The team established a number of goals: delivery of quality products to contractual terms and conditions; ensure that TRW management systems meet government guidance and good business practices; use of objective data to measure critical processes; elimination of wasteful/duplicative reviews and audits; emphasis on teamwork--all efforts must be perceived to add value by both sides and decisions are made by consensus; and synergy and the creation of a strong working trust between TRW and the DPRO. TOPS permits the adjustment of oversight resources when conditions change or when TRW systems performance indicate either an increase or decrease in surveillance is appropriate. Monthly Contractor Performance Assessments (CPA) are derived from a summary of supporting system level and process-level ratings obtained from objective process-level data. Tiered, objective, data-driven metrics are highly successful in achieving a cooperative and effective method of measuring performance. The teamwork-based culture developed by TOPS proved an unequaled success in removing adversarial relationships and creating an atmosphere of continuous improvement in quality processes at TRW. The new working relationship does not decrease the responsibility or authority of the DPRO to ensure contract compliance and it permits both parties to work more effectively to improve total quality and reduce cost. By emphasizing teamwork in developing a stronger approach to efficient management of the defense industrial base TOPS is a singular success.
Teamwork for Oversight of Processes and Systems (TOPS). Implementation guide for TOPS version 2.0, 10 August 1992

NASA Astrophysics Data System (ADS)

Strand, Albert A.; Jackson, Darryl J.

As the nation redefines priorities to deal with a rapidly changing world order, both government and industry require new approaches for oversight of management systems, particularly for high technology products. Declining defense budgets will lead to significant reductions in government contract management personnel. Concurrently, defense contractors are reducing administrative and overhead staffing to control costs. These combined pressures require bold approaches for the oversight of management systems. In the Spring of 1991, the DPRO and TRW created a Process Action Team (PAT) to jointly prepare a Performance Based Management (PBM) system titled Teamwork for Oversight of Processes and Systems (TOPS). The primary goal is implementation of a performance based management system based on objective data to review critical TRW processes with an emphasis on continuous improvement. The processes are: Finance and Business Systems, Engineering and Manufacturing Systems, Quality Assurance, and Software Systems. The team established a number of goals: delivery of quality products to contractual terms and conditions; ensure that TRW management systems meet government guidance and good business practices; use of objective data to measure critical processes; elimination of wasteful/duplicative reviews and audits; emphasis on teamwork--all efforts must be perceived to add value by both sides and decisions are made by consensus; and synergy and the creation of a strong working trust between TRW and the DPRO. TOPS permits the adjustment of oversight resources when conditions change or when TRW systems performance indicate either an increase or decrease in surveillance is appropriate. Monthly Contractor Performance Assessments (CPA) are derived from a summary of supporting system level and process-level ratings obtained from objective process-level data. Tiered, objective, data-driven metrics are highly successful in achieving a cooperative and effective method of measuring performance. The teamwork-based culture developed by TOPS proved an unequaled success in removing adversarial relationships and creating an atmosphere of continuous improvement in quality processes at TRW. The new working relationship does not decrease the responsibility or authority of the DPRO to ensure contract compliance and it permits both parties to work more effectively to improve total quality and reduce cost. By emphasizing teamwork in developing a stronger approach to efficient management of the defense industrial base TOPS is a singular success.
Beyond Theory: Improving Public Relations Writing through Computer Technology.

ERIC Educational Resources Information Center

Neff, Bonita Dostal

Computer technology (primarily word processing) enables the student of public relations writing to improve the writing process through increased flexibility in writing, enhanced creativity, increased support of management skills and team work. A new instructional model for computer use in public relations courses at Purdue University Calumet…
Improved water allocation utilizing probabilistic climate forecasts: Short-term water contracts in a risk management framework

NASA Astrophysics Data System (ADS)

Sankarasubramanian, A.; Lall, Upmanu; Souza Filho, Francisco Assis; Sharma, Ashish

2009-11-01

Probabilistic, seasonal to interannual streamflow forecasts are becoming increasingly available as the ability to model climate teleconnections is improving. However, water managers and practitioners have been slow to adopt such products, citing concerns with forecast skill. Essentially, a management risk is perceived in "gambling" with operations using a probabilistic forecast, while a system failure upon following existing operating policies is "protected" by the official rules or guidebook. In the presence of a prescribed system of prior allocation of releases under different storage or water availability conditions, the manager has little incentive to change. Innovation in allocation and operation is hence key to improved risk management using such forecasts. A participatory water allocation process that can effectively use probabilistic forecasts as part of an adaptive management strategy is introduced here. Users can express their demand for water through statements that cover the quantity needed at a particular reliability, the temporal distribution of the "allocation," the associated willingness to pay, and compensation in the event of contract nonperformance. The water manager then assesses feasible allocations using the probabilistic forecast that try to meet these criteria across all users. An iterative process between users and water manager could be used to formalize a set of short-term contracts that represent the resulting prioritized water allocation strategy over the operating period for which the forecast was issued. These contracts can be used to allocate water each year/season beyond long-term contracts that may have precedence. Thus, integrated supply and demand management can be achieved. In this paper, a single period multiuser optimization model that can support such an allocation process is presented. The application of this conceptual model is explored using data for the Jaguaribe Metropolitan Hydro System in Ceara, Brazil. The performance relative to the current allocation process is assessed in the context of whether such a model could support the proposed short-term contract based participatory process. A synthetic forecasting example is also used to explore the relative roles of forecast skill and reservoir storage in this framework.

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 crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

PubMed

Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

2012-07-01

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.
Challenges and potential improvements in the admission process of patients with spinal cord injury in a specialized rehabilitation clinic - an interview based qualitative study of an interdisciplinary team.

PubMed

Röthlisberger, Fabian; Boes, Stefan; Rubinelli, Sara; Schmitt, Klaus; Scheel-Sailer, Anke

2017-06-26

The admission process of patients to a hospital is the starting point for inpatient services. In order to optimize the quality of the health services provision, one needs a good understanding of the patient admission workflow in a clinic. The aim of this study was to identify challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic from the perspective of an interdisciplinary team of health professionals. Semi-structured interviews with eight health professionals (medical doctors, physical therapists, occupational therapists, nurses) at the Swiss Paraplegic Centre (acute and rehabilitation clinic) were conducted based on a maximum variety purposive sampling strategy. The interviews were analyzed using a thematic analysis approach. The interviewees described the challenges and potential improvements in this admission process, focusing on five themes. First, the characteristics of the patient with his/her health condition and personality and his/her family influence different areas in the admission process. Improvements in the exchange of information between the hospital and the patient could speed up and simplify the admission process. In addition, challenges and potential improvements were found concerning the rehabilitation planning, the organization of the admission process and the interdisciplinary work. This study identified five themes of challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic. When planning adaptations of process steps in one of the areas, awareness of effects in other fields is necessary. Improved pre-admission information would be a first important step to optimize the admission process. A common IT-system providing an interdisciplinary overview and possibilities for interdisciplinary exchange would support the management of the admission process. Managers of other hospitals can supplement the results of this study with their own process analyses, to improve their own patient admission processes.
Managerial process improvement: a lean approach to eliminating medication delivery.

PubMed

Hussain, Aftab; Stewart, LaShonda M; Rivers, Patrick A; Munchus, George

2015-01-01

Statistical evidence shows that medication errors are a major cause of injuries that concerns all health care oganizations. Despite all the efforts to improve the quality of care, the lack of understanding and inability of management to design a robust system that will strategically target those factors is a major cause of distress. The paper aims to discuss these issues. Achieving optimum organizational performance requires two key variables; work process factors and human performance factors. The approach is that healthcare administrators must take in account both variables in designing a strategy to reduce medication errors. However, strategies that will combat such phenomena require that managers and administrators understand the key factors that are causing medication delivery errors. The authors recommend that healthcare organizations implement the Toyota Production System (TPS) combined with human performance improvement (HPI) methodologies to eliminate medication delivery errors in hospitals. Despite all the efforts to improve the quality of care, there continues to be a lack of understanding and the ability of management to design a robust system that will strategically target those factors associated with medication errors. This paper proposes a solution to an ambiguous workflow process using the TPS combined with the HPI system.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Edward J., Jr.; Henry, Karen Lynne

Sandia National Laboratories develops technologies to: (1) sustain, modernize, and protect our nuclear arsenal (2) Prevent the spread of weapons of mass destruction; (3) Provide new capabilities to our armed forces; (4) Protect our national infrastructure; (5) Ensure the stability of our nation's energy and water supplies; and (6) Defend our nation against terrorist threats. We identified the need for a single overarching Integrated Workplace Management System (IWMS) that would enable us to focus on customer missions and improve FMOC processes. Our team selected highly configurable commercial-off-the-shelf (COTS) software with out-of-the-box workflow processes that integrate strategic planning, project management, facilitymore » assessments, and space management, and can interface with existing systems, such as Oracle, PeopleSoft, Maximo, Bentley, and FileNet. We selected the Integrated Workplace Management System (IWMS) from Tririga, Inc. Facility Management System (FMS) Benefits are: (1) Create a single reliable source for facility data; (2) Improve transparency with oversight organizations; (3) Streamline FMOC business processes with a single, integrated facility-management tool; (4) Give customers simple tools and real-time information; (5) Reduce indirect costs; (6) Replace approximately 30 FMOC systems and 60 homegrown tools (such as Microsoft Access databases); and (7) Integrate with FIMS.« less
Use of performance indicators to assess the solid waste management of health services.

PubMed

Assis, Mayara C; Gomes, Vanielle A P; Balista, Wagner C; Freitas, Rodrigo R DE

2017-01-01

Modern society faces serious challenges, among them, the complexity of environmental problems. Thus, there are several possible sources of environmental degradation, however, the waste produced by health services have an important peculiarity due to its toxic or pathogenic characteristics, since when managed improperly provide also health risk public. The involvement of solid waste from healthcare services environmental impact integrates matters a little more complex, because in addition to environmental health, they also interfere with the healthiness of environments that generate, with the consequences of nosocomial infections, occupational health and public. Thus, the management has become an urgent need, especially when we see no use of performance indicators management in healthcare environments in the city of São Mateus, ES. For this, we used the Analytic Hierarchy Process Method to prioritize such indicators as the potential improvement in health services waste management process - WHS and thus environmental analysis was performed with the use of a template for SWOT analysis. The results showed that the performance indicator training strategies developed with employees has the greatest potential to assist in improvements in WHS (Health Services Waste) management process followed indicator knowledge of the regulations associated with procedures performed by employees and importance of biosafety regulations.
Improving Software Quality and Management Through Use of Service Level Agreements

DTIC Science & Technology

2005-03-01

many who believe that the quality of the development process is the best predictor of software product quality. ( Fenton ) Repeatable software processes...reduced errors per KLOC for small projects ( Fenton ), and the quality management metric (QMM) (Machniak, Osmundson). There are also numerous IEEE 14...attention to cosmetic user interface issues and any problems that may arise with the prototype. (Sawyer) The validation process is also another check
DISC (Defense Industrial Supply Center) TQM (Total Quality Management) Operations Plan

DTIC Science & Technology

1989-07-01

This document represents the continuance of the Defense Industrial Supply Center implementation of Total Quality Management which began in 1986. It...outlines how DISC intends to emphasize process improvement through the integration of all TQM initiates. Quality management at DISC prescribes defining
A design for a new catalog manager and associated file management for the Land Analysis System (LAS)

NASA Technical Reports Server (NTRS)

Greenhagen, Cheryl

1986-01-01

Due to the larger number of different types of files used in an image processing system, a mechanism for file management beyond the bounds of typical operating systems is necessary. The Transportable Applications Executive (TAE) Catalog Manager was written to meet this need. Land Analysis System (LAS) users at the EROS Data Center (EDC) encountered some problems in using the TAE catalog manager, including catalog corruption, networking difficulties, and lack of a reliable tape storage and retrieval capability. These problems, coupled with the complexity of the TAE catalog manager, led to the decision to design a new file management system for LAS, tailored to the needs of the EDC user community. This design effort, which addressed catalog management, label services, associated data management, and enhancements to LAS applications, is described. The new file management design will provide many benefits including improved system integration, increased flexibility, enhanced reliability, enhanced portability, improved performance, and improved maintainability.
Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

PubMed Central

Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2014-01-01

Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, p<0.01) and SF-12 physical scores (ES 0.25, p=0.03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. ATSM is a strategy for improving patient-reported self-management and may also improve some outcomes. PMID:24594561
Ecosystem services as a common language for coastal ecosystem-based management.

PubMed

Granek, Elise F; Polasky, Stephen; Kappel, Carrie V; Reed, Denise J; Stoms, David M; Koch, Evamaria W; Kennedy, Chris J; Cramer, Lori A; Hacker, Sally D; Barbier, Edward B; Aswani, Shankar; Ruckelshaus, Mary; Perillo, Gerardo M E; Silliman, Brian R; Muthiga, Nyawira; Bael, David; Wolanski, Eric

2010-02-01

Ecosystem-based management is logistically and politically challenging because ecosystems are inherently complex and management decisions affect a multitude of groups. Coastal ecosystems, which lie at the interface between marine and terrestrial ecosystems and provide an array of ecosystem services to different groups, aptly illustrate these challenges. Successful ecosystem-based management of coastal ecosystems requires incorporating scientific information and the knowledge and views of interested parties into the decision-making process. Estimating the provision of ecosystem services under alternative management schemes offers a systematic way to incorporate biogeophysical and socioeconomic information and the views of individuals and groups in the policy and management process. Employing ecosystem services as a common language to improve the process of ecosystem-based management presents both benefits and difficulties. Benefits include a transparent method for assessing trade-offs associated with management alternatives, a common set of facts and common currency on which to base negotiations, and improved communication among groups with competing interests or differing worldviews. Yet challenges to this approach remain, including predicting how human interventions will affect ecosystems, how such changes will affect the provision of ecosystem services, and how changes in service provision will affect the welfare of different groups in society. In a case study from Puget Sound, Washington, we illustrate the potential of applying ecosystem services as a common language for ecosystem-based management.
Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies.

PubMed

Gershengorn, Hayley B; Kocher, Robert; Factor, Phillip

2014-03-01

The success of quality-improvement projects relies heavily on both project design and the metrics chosen to assess change. In Part II of this three-part American Thoracic Society Seminars series, we begin by describing methods for determining which data to collect, tools for data presentation, and strategies for data dissemination. As Avedis Donabedian detailed a half century ago, defining metrics in healthcare can be challenging; algorithmic determination of the best type of metric (outcome, process, or structure) can help intensive care unit (ICU) managers begin this process. Choosing appropriate graphical data displays (e.g., run charts) can prompt discussions about and promote quality improvement. Similarly, dashboards/scorecards are useful in presenting performance improvement data either publicly or privately in a visually appealing manner. To have compelling data to show, ICU managers must plan quality-improvement projects well. The second portion of this review details four quality-improvement tools-checklists, Six Sigma methodology, lean thinking, and Kaizen. Checklists have become commonplace in many ICUs to improve care quality; thinking about how to maximize their effectiveness is now of prime importance. Six Sigma methodology, lean thinking, and Kaizen are techniques that use multidisciplinary teams to organize thinking about process improvement, formalize change strategies, actualize initiatives, and measure progress. None originated within healthcare, but each has been used in the hospital environment with success. To conclude this part of the series, we demonstrate how to use these tools through an example of improving the timely administration of antibiotics to patients with sepsis.
Embedding quality improvement and patient safety at Liverpool Women's NHS Foundation Trust.

PubMed

Scholefield, Helen

2007-08-01

The provision of safe high-quality care in obstetrics and gynaecology is a key target in the UK National Health Service (NHS), in part because of the high cost of litigation in this area. Good risk management processes should improve safety and reduce the cost of litigation to the NHS. This chapter looks at structures and processes for improving quality and patient safety, using the stepwise approach described by the National Patient Safety Authority (NPSA). This encompasses building a safety culture, leading and supporting staff, integrating risk management activity, promoting reporting, involving and communicating with patients and the public, learning and sharing safety lessons, and implementing solutions to prevent harm. Examples from the Liverpool Women's NHS Foundation Trust are used to illustrate these steps, including how they were developed, what obstacles had to be overcome, ongoing challenges, and whether good risk management has translated into better, safer health care.
ACHS Quality Awards 2000. Quality is the way we do business.

PubMed

Cruickshank, N; Bullock, J

2001-01-01

Hollywood Private Hospital recognized that the use of quality management processes can achieve numerous benefits; however, for this to occur quality must be regarded as normal business practice rather than a separate programme. Therefore, the means of ensuring a quality service must be embedded in the strategic plans of both the organization and individual departments. The Hollywood Private Hospital Executive committed the organization to this approach further building on the 'core values' of the hospital by: integrating quality into the Strategic Planning of the organization; integrating risk management into the existing quality system; further embedding of the core values into the culture of the organisation; introducing systems thinking into the organization; taking a process improvement approach to improving quality; involving staff in Quality Action Teams and utilizing the Evaluation and Quality Improvement Programme as the management framework to co-ordinate all the above.
An overview of Quality Management System implementation in a research laboratory

NASA Astrophysics Data System (ADS)

Molinéro-Demilly, Valérie; Charki, Abdérafi; Jeoffrion, Christine; Lyonnet, Barbara; O'Brien, Steve; Martin, Luc

2018-02-01

The aim of this paper is to show the advantages of implementing a Quality Management System (QMS) in a research laboratory in order to improve the management of risks specific to research programmes and to increase the reliability of results. This paper also presents experience gained from feedback following the implementation of the Quality process in a research laboratory at INRA, the French National Institute for Agronomic Research and details the various challenges encountered and solutions proposed to help achieve smoother adoption of a QMS process. The 7Ms (Management, Measurement, Manpower, Methods, Materials, Machinery, Mother-nature) methodology based on the Ishikawa `Fishbone' diagram is used to show the effectiveness of the actions considered by a QMS, which involve both the organization and the activities of the laboratory. Practical examples illustrate the benefits and improvements observed in the laboratory.
Disease management improves end-stage renal disease outcomes.

PubMed

Sands, Jeffrey J

2006-01-01

Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence-based guidelines, and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total healthcare costs, including payments from all insurance and government entities, pharmacy costs and out of pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present current data suggest that the promise of disease management, improved care at reduced cost, can and is being realized in end-stage renal disease. Copyright 2006 S. Karger AG, Basel.
Reservoir management strategy for East Randolph Field, Randolph Township, Portage County, Ohio

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

Safley, L.E.; Salamy, S.P.; Young, M.A.

1998-07-01

The primary objective of the Reservoir Management Field Demonstration Program is to demonstrate that multidisciplinary reservoir management teams using appropriate software and methodologies with efforts scaled to the size of the resource are a cost-effective method for: Increasing current profitability of field operations; Forestalling abandonment of the reservoir; and Improving long-term economic recovery for the company. The primary objective of the Reservoir Management Demonstration Project with Belden and Blake Corporation is to develop a comprehensive reservoir management strategy to improve the operational economics and optimize oil production from East Randolph field, Randolph Township, Portage County, Ohio. This strategy identifies themore » viable improved recovery process options and defines related operational and facility requirements. In addition, strategies are addressed for field operation problems, such as paraffin buildup, hydraulic fracture stimulation, pumping system optimization, and production treatment requirements, with the goal of reducing operating costs and improving oil recovery.« less
Maximizing root/rhizosphere efficiency to improve crop productivity and nutrient use efficiency in intensive agriculture of China.

PubMed

Shen, Jianbo; Li, Chunjian; Mi, Guohua; Li, Long; Yuan, Lixing; Jiang, Rongfeng; Zhang, Fusuo

2013-03-01

Root and rhizosphere research has been conducted for many decades, but the underlying strategy of root/rhizosphere processes and management in intensive cropping systems remain largely to be determined. Improved grain production to meet the food demand of an increasing population has been highly dependent on chemical fertilizer input based on the traditionally assumed notion of 'high input, high output', which results in overuse of fertilizers but ignores the biological potential of roots or rhizosphere for efficient mobilization and acquisition of soil nutrients. Root exploration in soil nutrient resources and root-induced rhizosphere processes plays an important role in controlling nutrient transformation, efficient nutrient acquisition and use, and thus crop productivity. The efficiency of root/rhizosphere in terms of improved nutrient mobilization, acquisition, and use can be fully exploited by: (1) manipulating root growth (i.e. root development and size, root system architecture, and distribution); (2) regulating rhizosphere processes (i.e. rhizosphere acidification, organic anion and acid phosphatase exudation, localized application of nutrients, rhizosphere interactions, and use of efficient crop genotypes); and (3) optimizing root zone management to synchronize root growth and soil nutrient supply with demand of nutrients in cropping systems. Experiments have shown that root/rhizosphere management is an effective approach to increase both nutrient use efficiency and crop productivity for sustainable crop production. The objectives of this paper are to summarize the principles of root/rhizosphere management and provide an overview of some successful case studies on how to exploit the biological potential of root system and rhizosphere processes to improve crop productivity and nutrient use efficiency.
Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

PubMed

Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.
How Visual Management for Continuous Improvement Might Guide and Affect Hospital Staff: A Case Study.

PubMed

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

2015-01-01

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

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

PubMed

Duncan, Fiona; Haigh, Carol

2013-10-01

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

PubMed

Motschman, T L; Moore, S B

1996-12-01

Error management plays a major role in facility process improvement efforts. By detecting and reducing errors, quality and, therefore, patient care improve. It begins with a strong organizational foundation of management attitude with clear, consistent employee direction and appropriate physical facilities. Clearly defined critical processes, critical activities, and SOPs act as the framework for operations as well as active quality monitoring. To assure that personnel can detect an report errors they must be trained in both operational duties and error management practices. Use of simulated/intentional errors and incorporation of error detection into competency assessment keeps employees practiced, confident, and diminishes fear of the unknown. Personnel can clearly see that errors are indeed used as opportunities for process improvement and not for punishment. The facility must have a clearly defined and consistently used definition for reportable errors. Reportable errors should include those errors with potentially harmful outcomes as well as those errors that are "upstream," and thus further away from the outcome. A well-written error report consists of who, what, when, where, why/how, and follow-up to the error. Before correction can occur, an investigation to determine the underlying cause of the error should be undertaken. Obviously, the best corrective action is prevention. Correction can occur at five different levels; however, only three of these levels are directed at prevention. Prevention requires a method to collect and analyze data concerning errors. In the authors' facility a functional error classification method and a quality system-based classification have been useful. An active method to search for problems uncovers them further upstream, before they can have disastrous outcomes. In the continual quest for improving processes, an error management program is itself a process that needs improvement, and we must strive to always close the circle of quality assurance. Ultimately, the goal of better patient care will be the reward.
Implementation of an integrated pharmacy supply management strategy.

PubMed

Amerine, Lindsey B; Calvert, Daniel R; Pappas, Ashley L; Lee, Sarah M; Valgus, John M; Savage, Scott W

2017-12-15

Implementation of an integrated pharmacy supply management strategy is described. In 2011, the formulary approval process and supply management for oncology medications were independent of each other at an oncology infusion center. Numerous nonformulary medications were kept on hand and reordered based on inventory levels that were established with inadequate usage information, while some formulary agents did not have on-hand inventory levels and had to be reordered on a patient-specific basis, which required paperwork and then a review by drug information staff per institutional policy. Because there was no true distinction in the ordering of formulary versus nonformulary oncology agents, the medical staff prescribed both in the same manner, leaving the pharmacy staff responsible for ensuring that enough quantities were on hand for many drugs, regardless of formulary status. Using supply chain management principles, a formal analysis of the on-hand inventory was performed. In addition, the formulary process for oncology drugs was restructured to align with how oncology drugs are managed for on-hand inventory levels. The alignment of these processes allowed the operation to have 1 supply strategy for the ambulatory oncology infusion center. As a result, inventory exhaustion rates were reduced by 70% and inventory turn rates improved by 78%. There was also significant time savings in the operational process streamlining, eliminating the rework and inefficiencies caused by an unclear process that was not fully captured in this assessment. Alignment of the formulary review process with inventory analyses that support supply management principles reduced inventory exhaustion while improving inventory turn rates. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

The Quality Management System (QMS) is one that recognizes the need to continuously change and improve an organization s products and services as determined by system feedback, and corresponding management decisions. The purpose of a Quality Management System is to minimize quality variability of an organization's products and services. The optimal Quality Management System balances the need for an organization to maintain flexibility in the products and services it provides with the need for providing the appropriate level of discipline and control over the processes used to provide them. The goal of a Quality Management System is to ensure the quality of the products and services while consistently (through minimizing quality variability) meeting or exceeding customer expectations. The GRC Business Management System (BMS) is the foundation of the Center's ISO 9001:2000 registered quality system. ISO 9001 is a quality system model developed by the International Organization for Standardization. BMS supports and promote the Glenn Research Center Quality Policy and wants to ensure the customer satisfaction while also meeting quality standards. My assignment during this summer is to examine the manufacturing processes used to develop research hardware, which in most cases are one of a kind hardware, made with non conventional equipment and materials. During this process of observation I will make a determination, based on my observations of the hardware development processes the best way to meet customer requirements and at the same time achieve the GRC quality standards. The purpose of my task is to review the manufacturing processes identifying opportunities in which to optimize the efficiency of the processes and establish a plan for implementation and continuous improvement.
Modeling the Supply Process Using the Application of Selected Methods of Operational Analysis

NASA Astrophysics Data System (ADS)

Chovancová, Mária; Klapita, Vladimír

2017-03-01

Supply process is one of the most important enterprise activities. All raw materials, intermediate products and products, which are moved within enterprise, are the subject of inventory management and by their effective management significant improvement of enterprise position on the market can be achieved. For that reason, the inventory needs to be managed, monitored, evaluated and affected. The paper deals with utilizing the methods of the operational analysis in the field of inventory management in terms of achieving the economic efficiency and ensuring the particular customer's service level as well.
Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

PubMed

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.
A Project Management Approach to an ACPE Accreditation Self-study

PubMed Central

Iwanowicz, Susan L.; Bailie, George R.; Clarke, David W.; McGraw, Patrick S.

2007-01-01

In preparation for an on-site evaluation and accreditation by the American Council on Pharmaceutical Education (ACPE), the Albany College of Pharmacy employed project management techniques to complete a comprehensive self-study. A project lifecycle approach, including planning, production, and turnover phases, was used by the project's Self-Study Steering Committee. This approach, with minimal disruption to college operations, resulted in the completion of the self-study process on schedule. Throughout the project, the Steering Committee maintained a log of functions that either were executed successfully or in hindsight, could have been improved. To assess the effectiveness of the project management approach to the the self-study process, feedback was obtained from the College community through a poststudy survey. This feedback, coupled with the Steering Committee's data on possible improvements, form the basis for the lessons learned during this self-study process. PMID:17533432
A project management approach to an ACPE accreditation self-study.

PubMed

Dominelli, Angela; Iwanowicz, Susan L; Bailie, George R; Clarke, David W; McGraw, Patrick S

2007-04-15

In preparation for an on-site evaluation and accreditation by the American Council on Pharmaceutical Education (ACPE), the Albany College of Pharmacy employed project management techniques to complete a comprehensive self-study. A project lifecycle approach, including planning, production, and turnover phases, was used by the project's Self-Study Steering Committee. This approach, with minimal disruption to college operations, resulted in the completion of the self-study process on schedule. Throughout the project, the Steering Committee maintained a log of functions that either were executed successfully or in hindsight, could have been improved. To assess the effectiveness of the project management approach to the the self-study process, feedback was obtained from the College community through a poststudy survey. This feedback, coupled with the Steering Committee's data on possible improvements, form the basis for the lessons learned during this self-study process.
Clinical governance and operations management methodologies.

PubMed

Davies, C; Walley, P

2000-01-01

The clinical governance mechanism, introduced since 1998 in the UK National Health Service (NHS), aims to deliver high quality care with efficient, effective and cost-effective patient services. Scally and Donaldson recognised that new approaches are needed, and operations management techniques comprise potentially powerful methodologies in understanding the process of care, which can be applied both within and across professional boundaries. This paper summarises four studies in hospital Trusts which took approaches to improving process that were different from and less structured than business process re-engineering (BPR). The problems were then amenable to change at a relatively low cost and short timescale, producing significant improvement to patient care. This less structured approach to operations management avoided incurring overhead costs of large scale and costly change such as new information technology (IT) systems. The most successful changes were brought about by formal tools to control quantity, content and timing of changes.
Total Quality Management in Space Shuttle Main Engine manufacturing

NASA Technical Reports Server (NTRS)

Ding, J.

1992-01-01

The Total Quality Management (TQM) philosophy developed in the Marshall Space Flight Center (MSFC) is briefly reviewed and the ongoing TQM implementation effort which is being pursued through the continuous improvement (CI) process is discussed. TQM is based on organizational excellence which integrates the new supportive culture with the technical tools necessary to identify, assess, and correct manufacturing processes. Particular attention is given to the prime contractor's change to the organizational excellence management philosophy in SSME manufacturing facilities.
Determining the disease management process for epileptic patients: A qualitative study

PubMed Central

Hosseini, Nazafarin; Sharif, Farkhondeh; Ahmadi, Fazlollah; Zare, Mohammad

2016-01-01

Background: Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease management process in patients with epilepsy in Iran. Materials and Methods: This qualitative approach and grounded theory study was conducted from January 2009 to February 2012 in Isfahan city (Iran). Thirty-two participants were recruited by the goal-oriented, and snowball sample selection and theoretical sampling methods. After conducting a total of 43 in-depth interviews with the participants, the researchers reached data saturation. Data were analyzed using Strauss and Corbin method. Results: With a focus on disease management process, researchers found three main themes and seven sub-themes as a psychosocial process (PSP). The main themes were: perception of threat to self-identity, effort to preserve self-identity, and burn out. The psychosocial aspect of the disease generated one main variable “the perception of identity loss” and one central variable “searching for self-identity.” Conclusions: Participants attributed threat to self-identity and burn out to the way their disease was managed requiring efforts to preserve their identity. Recommendations consist of support programs and strategies to improve the public perception of epilepsy in Iran, help patients accept their condition and preserve self-identity, and most importantly, enhance medical management of epilepsy. PMID:26985223
IEC 61511 and the capital project process--a protective management system approach.

PubMed

Summers, Angela E

2006-03-17

This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.
Improved safety culture and labor-management relations attributed to changing at-risk behavior process at Union Pacific.

DOT National Transportation Integrated Search

2009-09-01

Changing At-Risk Behavior (CAB) is a safety process that is being conducted at Union Pacifics San Antonio Service Unit (SASU) with the aim of improving road and yard safety. CAB is an example of a proactive safety risk-reduction method called Clea...
Using "Kaizen" to Improve Graduate Business School Degree Programs

ERIC Educational Resources Information Center

Emiliani, M. L.

2005-01-01

Purpose: To illustrate the applicability of "kaizen" in higher education. Design/methodology/approach: "Kaizen" process was used for ten courses contained in a part-time executive MS degree program in management. Findings: "Kaizen" was found to be an effective process for improving graduate business school courses and the value proposition for…
Improving data collection, documentation, and workflow in a dementia screening study.

PubMed

Read, Kevin B; LaPolla, Fred Willie Zametkin; Tolea, Magdalena I; Galvin, James E; Surkis, Alisa

2017-04-01

A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies' data collection, entry, and processing workflows. The librarians' role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library's broader user community.
Building an exceptional imaging management team: from theory to practice.

PubMed

Hogan, Laurie

2010-01-01

Building a strong, cohesive, and talented managerial team is a critical endeavor for imaging administrators, as the job will be enhanced if supported by a group of high-performing, well-developed managers. For the purposes of this article, leadership and management are discussed as two separate, yet equally important, components of an imaging administrator's role. The difference between the two is defined as: leadership relates to people, management relates to process. There are abundant leadership and management theories that can help imaging administrators develop managers and ultimately build a better team. Administrators who apply these theories in practical and meaningful ways will improve their teams' leadership and management aptitude. Imaging administrators will find it rewarding to coach and develop managers and witness transformations that result from improved leadership and management abilities.
Value-driven process management: using value to improve processes.

PubMed

Melnyk, S A; Christensen, R T

2000-08-01

Every firm can be viewed as consisting of various processes. These processes affect everything that the firm does from accepting orders and designing products to scheduling production. In many firms, the management of processes often reflects considerations of efficiency (cost) rather than effectiveness (value). In this article, we introduce a well-structured process for managing processes that begins not with the process, but rather with the customer and the product and the concept of value. This process progresses through a number of steps which include issues such as defining value, generating the appropriate metrics, identifying the critical processes, mapping and assessing the performance of these processes, and identifying long- and short-term areas for action. What makes the approach presented in this article so powerful is that it explicitly links the customer to the process and that the process is evaluated in term of its ability to effectively serve the customers.
Department of Education Management Commitment Needed To Improve Information Resources Management. Report to the Secretary of Education.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Information Management and Technology Div.

This study, which was conducted to determine how effectively the U.S. Department of Education plans for and manages its information resources in supporting its mission and administering its programs, focused on the Department's strategic information resources management (IRM) planning process. Meetings were held with program officials to ascertain…
Guidelines for Risk-Based Changeover of Biopharma Multi-Product Facilities.

PubMed

Lynch, Rob; Barabani, David; Bellorado, Kathy; Canisius, Peter; Heathcote, Doug; Johnson, Alan; Wyman, Ned; Parry, Derek Willison

2018-01-01

In multi-product biopharma facilities, the protection from product contamination due to the manufacture of multiple products simultaneously is paramount to assure product quality. To that end, the use of traditional changeover methods (elastomer change-out, full sampling, etc.) have been widely used within the industry and have been accepted by regulatory agencies. However, with the endorsement of Quality Risk Management (1), the use of risk-based approaches may be applied to assess and continuously improve established changeover processes. All processes, including changeover, can be improved with investment (money/resources), parallel activities, equipment design improvements, and standardization. However, processes can also be improved by eliminating waste. For product changeover, waste is any activity not needed for the new process or that does not provide added assurance of the quality of the subsequent product. The application of a risk-based approach to changeover aligns with the principles of Quality Risk Management. Through the use of risk assessments, the appropriate changeover controls can be identified and controlled to assure product quality is maintained. Likewise, the use of risk assessments and risk-based approaches may be used to improve operational efficiency, reduce waste, and permit concurrent manufacturing of products. © PDA, Inc. 2018.
Applying lean management principles to the creation of a postpartum hemorrhage care bundle.

PubMed

Faulkner, Beth

2013-10-01

A lean management process is a set of interventions, each of which creates value for the customer. Lean management is not a new concept, but is relatively new to health care. Postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide in both developing and developed countries. We applied lean management principles as an innovative approach to improving outcomes in patients with PPH. Initial results using principles of lean management indicated significant improvements in response time and family-centered care. When applied rigorously and throughout the organization, lean principles can have a dramatic effect on productivity, cost and quality. © 2013 AWHONN.

Applying Lean to the AC-130 Maintenance Process for the Royal Saudi Air Force

DTIC Science & Technology

2016-09-01

inventory management. Quality Management Poor quality of maintenance contributes to rework , which is an obvious form of waste. It would be very...consequences of rework are very significant. Within the C-130 maintenance squadron, quality must be achieved through continual process improvements, rather...maintenance “product” quality by lowering measurable process outputs such as amount of rework , number of maintenance-induced failures, and so on. 71
Clinical image processing engine

NASA Astrophysics Data System (ADS)

Han, Wei; Yao, Jianhua; Chen, Jeremy; Summers, Ronald

2009-02-01

Our group provides clinical image processing services to various institutes at NIH. We develop or adapt image processing programs for a variety of applications. However, each program requires a human operator to select a specific set of images and execute the program, as well as store the results appropriately for later use. To improve efficiency, we design a parallelized clinical image processing engine (CIPE) to streamline and parallelize our service. The engine takes DICOM images from a PACS server, sorts and distributes the images to different applications, multithreads the execution of applications, and collects results from the applications. The engine consists of four modules: a listener, a router, a job manager and a data manager. A template filter in XML format is defined to specify the image specification for each application. A MySQL database is created to store and manage the incoming DICOM images and application results. The engine achieves two important goals: reduce the amount of time and manpower required to process medical images, and reduce the turnaround time for responding. We tested our engine on three different applications with 12 datasets and demonstrated that the engine improved the efficiency dramatically.
Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

PubMed

Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.
Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

PubMed Central

2011-01-01

Background The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Results Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. Conclusions A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes. PMID:21824386
[The basis of modern technologies in management of health care system].

PubMed

Nemytin, Iu V

2014-12-01

For the development of national heaIth care it is required to implement modern and effective methods and forms of governance. It is necessary to clearly identify transition to process management followed by an introduction of quality management care. It is necessary to create a complete version of the three-level health care system based on the integration into the system "Clinic - Hospital - Rehabilitation", which will ensure resource conservation in general throughout the industry. The most important task is purposeful comprehensive management training for health care--statesmen who have the potential ability to manage. The leader must possess all forms of management and apply them on a scientific basis. Standards and other tools of health management should constantly improve. Standards should be a teaching tool and help to improve the quality and effectiveness of treatment processes, the transition to the single-channel financing--the most advanced form of payment for the medical assistance. This type of financing requires managers to new management approaches, knowledge of business economics. One of the breakthrough objectives is the creation of a new type of health care organizations, which as lead locomotives for a rest.
Daily Readiness Huddles in Radiology-Improving Communication, Coordination, and Problem-Solving Reliability.

PubMed

Donnelly, Lane F

Deploying an intentional daily management process is a key part to create high-reliability culture. Key components described in the literature for a successfully daily management process include leadership standard work, visual controls, daily accountability processes, and the discipline to stick to the process over the long term. We believe that the institution of a daily readiness huddle has helped us better coordinate and communicate as a department and improved our ability to deliver imaging services on a daily basis. The daily readiness huddle has enabled us to more rapidly identify issues and has brought accountability to seeing solutions to those issues brought to fruition. In addition, it has helped with team building, including between the radiologists and the nonphysician staff. Copyright © 2017 Elsevier Inc. All rights reserved.
Does disease management improve clinical and economic outcomes in patients with chronic diseases? A systematic review.

PubMed

Ofman, Joshua J; Badamgarav, Enkhe; Henning, James M; Knight, Kevin; Gano, Anacleto D; Levan, Rebecka K; Gur-Arie, Shoval; Richards, Margaret S; Hasselblad, Vic; Weingarten, Scott R

2004-08-01

To assess the clinical and economic effects of disease management in patients with chronic diseases. Electronic databases were searched for English-language articles from 1987 to 2001. Articles were included if they used a systematic approach to care and evaluated patients with chronic disease, reported objective measurements of the processes or outcomes of care, and employed acceptable experimental or quasi-experimental study designs as defined by the Cochrane Effective Practice and Organization of Care Group. Two reviewers evaluated 16,917 titles and identified 102 studies that met the inclusion criteria. Identified studies represented 11 chronic conditions: depression, diabetes, rheumatoid arthritis, chronic pain, coronary artery disease, asthma, heart failure, back pain, chronic obstructive pulmonary disease, hypertension, and hyperlipidemia. Disease management programs for patients with depression had the highest percentage of comparisons (48% [41/86]) showing substantial improvements in patient care, whereas programs for patients with chronic obstructive pulmonary disease (9% [2/22]) or chronic pain (8% [1/12]) appeared to be the least effective. Of the outcomes more frequently studied, disease management appeared to improve patient satisfaction (71% [12/17]), patient adherence (47% [17/36]), and disease control (45% [33/74]) most commonly and cost-related outcomes least frequently (11% to 16%). Disease management programs were associated with marked improvements in many different processes and outcomes of care. Few studies demonstrated a notable reduction in costs. Further research is needed to understand how disease management can most effectively improve the quality and cost of care for patients with chronic diseases.
Total Quality Management in Higher Education.

ERIC Educational Resources Information Center

Sherr, Lawrence A.; Lozier, G. Gredgory

1991-01-01

Total Quality Management, based on theories of W. Edward Deming and others, is a style of management using continuous process improvement characterized by mission and customer focus, a systematic approach to operations, vigorous development of human resources, long-term thinking, and a commitment to ensuring quality. The values espoused by this…
Facilities Management of Existing School Buildings: Two Models.

ERIC Educational Resources Information Center

Building Technology, Inc., Silver Spring, MD.

While all school districts are responsible for the management of their existing buildings, they often approach the task in different ways. This document presents two models that offer ways a school district administration, regardless of size, may introduce activities into its ongoing management process that will lead to improvements in earthquake…
Holistic Quality: Managing, Restructuring, and Empowering Schools.

ERIC Educational Resources Information Center

Herman, Jerry J.

Because the quality management (QM) movement can be very important in school improvement efforts, it is essential to determine how QM can fit with relatively new restructuring ideas and whether this approach is consistent with existing school structures and processes. This book presents an integrated approach to holistic quality management that…
Improving the Performance of Educational Managers. Working Paper Series.

ERIC Educational Resources Information Center

Lavin, Richard J.; Sanders, Jean E.

The Educational Management Development Center (EMDC) seeks to build the organizational capability for problem-solving through a process offered in the context of a dynamic, operating system. The problem-oriented school manager is helped by support staff to take administrative theory, successful practices, personal experiences, and leadership…
DCASR (Defense Contract Administration Services Region) Boston, Strategic/Total Quality Management Master Plan Using Management by Planning (MBP)

DTIC Science & Technology

1989-06-01

employees. A policy consists of targets, plans, and target values. Policy Deployment: One English translation for hoshin kanri . (Others are management by...policy and hoshin planning.) Policy deployment orchestrates continuous improvement in a way that fosters individual initiative and alignment. Process
Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya.

PubMed

Maruti, Phidelis M; Mulianga, Ekesa A; Wambani, Lorna N; Wafula, Melda N; Mambo, Fidelis A; Mutisya, Shadrack M; Wakaria, Eric N; Mbati, Erick M; Amayo, Angela A; Majani, Jonathan M; Nyary, Bryan; Songwe, Kilian A

2014-01-01

Bungoma District Hospital Laboratory (BDHL), which supports a 200-bed referral facility, began its Strengthening Laboratory Management Toward Accreditation (SLMTA) journey in 2011 together with eight other laboratories in the second round of SLMTA rollout in Kenya. To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come. SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders - including upper management, clinicians, laboratory staff and maintenance staff - to the mission of sustainable quality practices at BDHL. After 16 months in the SLMTA programme, BDHL improved from zero stars (38%) to four stars (89%). Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81%) in an external surveillance audit conducted by Kenya Accreditation Service (KENAS). Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.
A management, leadership, and board road map to transforming care for patients.

PubMed

Toussaint, John

2013-01-01

Over the last decade I have studied 115 healthcare organizations in II countries, examining them from the boardroom to the patient bedside. In that time, I have observed one critical element missing from just about every facility: a set of standards that could reliably produce zero-defect care for patients. This lack of standards is largely rooted in the Sloan management approach, a top-down management and leadership structure that is void of standardized accountability. This article offers an alternative approach: management by process--an operating system that engages frontline staff in decisions and imposes standards and processes on the act of managing. Organizations that have adopted management by process have seen quality improve and costs decrease because the people closest to the work are expected to identify problems and solve them. Also detailed are the leadership behaviors required for an organization to successfully implement the management-by-process operating system and the board of trustees' role in supporting the transformation.
Reinvention/reengineering of business and technical processes

NASA Technical Reports Server (NTRS)

Olsen, Eugene A.

1996-01-01

The changing marketplace as evidenced by global competition is requiring American organizations to rethink, regroup, and redesign their processes. The umbrella of total quality management (TQM) includes many quality methods, techniques, tools, and approaches. There is no right way for every situation or circumstance. Adaptability and experimentation of several tools is necessary. Process management when properly applied can lead to continuous quality improvements. But some processes simply need to be discarded and new ones developed. This reengineering often results in vertical compression and job redesign and restructuring. Work activities must be designed around processes, not processes around work activities. Reengineering and process management do not stand alone--they support each other. Senior executive leadership and empowerment of workers at all organizational levels is vital for both short-term and long-term success.
Implementation of occupational health service improvements through application of total quality management processes.

PubMed

Thomas, Elizabeth Anne

2011-06-01

The occupational health services department for a manufacturing division of a high-technology firm was redesigned from an outsourced model, in which most services were provided by an outside clinic vendor, to an in-house service model, in which services were provided by an on-site nurse practitioner. The redesign and implementation, accomplished by a cross-functional team using Total Quality Management processes, resulted in a comprehensive occupational health services department that realized significant cost reduction, increased compliance with regulatory and company requirements, and improved employee satisfaction. Implications of this project for occupational health nurses are discussed.
Improving performance through an organizational culture of employee expertise.

PubMed

Jacobs, R L

1996-01-01

Managers can do many things to improve organizational performance, but the accomplishments of the most skillful employees often are most important. This article makes the point that managers should be aware of employee expertise and its relationship to organizational performance. The article also describes the components of an organizational culture of employee expertise. An organizational culture of employee expertise builds on the learning organization metaphor that has frequently appeared in the management literature. How employees develop expertise to do their jobs is emerging as a critical issue for organizations, and managers will likely play a key role in that process.
Improvement of the material and transport component of the system of construction waste management

NASA Astrophysics Data System (ADS)

Kostyshak, Mikhail; Lunyakov, Mikhail

2017-10-01

Relevance of the topic of selected research is conditioned with the growth of construction operations and growth rates of construction and demolition wastes. This article considers modern approaches to the management of turnover of construction waste, sequence of reconstruction or demolition processes of the building, information flow of the complete cycle of turnover of construction and demolition waste, methods for improvement of the material and transport component of the construction waste management system. Performed analysis showed that mechanism of management of construction waste allows to increase efficiency and environmental safety of this branch and regions.
[Process orientation as a tool of strategic approaches to corporate governance and integrated management systems].

PubMed

Sens, Brigitte

2010-01-01

The concept of general process orientation as an instrument of organisation development is the core principle of quality management philosophy, i.e. the learning organisation. Accordingly, prestigious quality awards and certification systems focus on process configuration and continual improvement. In German health care organisations, particularly in hospitals, this general process orientation has not been widely implemented yet - despite enormous change dynamics and the requirements of both quality and economic efficiency of health care processes. But based on a consistent process architecture that considers key processes as well as management and support processes, the strategy of excellent health service provision including quality, safety and transparency can be realised in daily operative work. The core elements of quality (e.g., evidence-based medicine), patient safety and risk management, environmental management, health and safety at work can be embedded in daily health care processes as an integrated management system (the "all in one system" principle). Sustainable advantages and benefits for patients, staff, and the organisation will result: stable, high-quality, efficient, and indicator-based health care processes. Hospitals with their broad variety of complex health care procedures should now exploit the full potential of total process orientation. Copyright © 2010. Published by Elsevier GmbH.
Kaizen: a process improvement model for the business of health care and perioperative nursing professionals.

PubMed

Tetteh, Hassan A

2012-01-01

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

Knowledge Management Capabilities and Organizational Performance: An Investigation into the Effects of Knowledge Infrastructure and Processes on Organizational Performance

ERIC Educational Resources Information Center

Cho, Taejun

2011-01-01

Knowledge is one of the most important assets for surviving in the modern business environment. The effective management of that asset mandates continuous adaptation by organizations, and requires employees to strive to improve the company's work processes. Organizations attempt to coordinate their unique knowledge with traditional means as well…
A Strategy for Improved System Assurance

DTIC Science & Technology

2007-06-20

Quality (Measurements Life Cycle Safety, Security & Others) ISO /IEC 12207 * Software Life Cycle Processes ISO 9001 Quality Management System...14598 Software Product Evaluation Related ISO /IEC 90003 Guidelines for the Application of ISO 9001:2000 to Computer Software IEEE 12207 Industry...Implementation of International Standard ISO /IEC 12207 IEEE 1220 Standard for Application and Management of the System Engineering Process Use in
The Impact of Child and Family Service Reviews on Knowledge Management

ERIC Educational Resources Information Center

Mischen, Pamela A.

2008-01-01

This article uses knowledge management as a framework to analyze the impact of the child and family review process on child protective service agencies. Results of a qualitative analysis of child and family service reviews and program improvement plans indicated that the process has led to an increase in the use of family team meetings and risk…
Systems approach to managing educational quality in the engineering classroom

NASA Astrophysics Data System (ADS)

Grygoryev, Kostyantyn

Today's competitive environment in post-secondary education requires universities to demonstrate the quality of their programs in order to attract financing, and student and academic talent. Despite significant efforts devoted to improving the quality of higher education, systematic, continuous performance measurement and management still have not reached the level where educational outputs and outcomes are actually produced---the classroom. An engineering classroom is a complex environment in which educational inputs are transformed by educational processes into educational outputs and outcomes. By treating a classroom as a system, one can apply tools such as Structural Equation Modeling, Statistical Process Control, and System Dynamics in order to discover cause-and-effect relationships among the classroom variables, control the classroom processes, and evaluate the effect of changes to the course organization, content, and delivery, on educational processes and outcomes. Quality improvement is best achieved through the continuous, systematic application of efforts and resources. Improving classroom processes and outcomes is an iterative process that starts with identifying opportunities for improvement, designing the action plan, implementing the changes, and evaluating their effects. Once the desired objectives are achieved, the quality improvement cycle may start again. The goal of this research was to improve the educational processes and outcomes in an undergraduate engineering management course taught at the University of Alberta. The author was involved with the course, first, as a teaching assistant, and, then, as a primary instructor. The data collected from the course over four years were used to create, first, a static and, then, a dynamic model of a classroom system. By using model output and qualitative feedback from students, changes to the course organization and content were introduced. These changes led to a lower perceived course workload and increased the students' satisfaction with the instructor, but the students' overall satisfaction with the course did not change significantly, and their attitude toward the course subject actually became more negative. This research brought performance measurement to the level of a classroom, created a dynamic model of the classroom system based on the cause-and-effect relationships discovered by using statistical analysis, and used a systematic, continuous improvement approach to modify the course in order to improve selected educational processes and outcomes.
Reengineering of waste management at the Oak Ridge National Laboratory. Volume 1

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

Myrick, T.E.

1997-08-01

A reengineering evaluation of the waste management program at the Oak Ridge National Laboratory (ORNL) was conducted during the months of February through July 1997. The goal of the reengineering was to identify ways in which the waste management process could be streamlined and improved to reduce costs while maintaining full compliance and customer satisfaction. A Core Team conducted preliminary evaluations and determined that eight particular aspects of the ORNL waste management program warranted focused investigations during the reengineering. The eight areas included Pollution Prevention, Waste Characterization, Waste Certification/Verification, Hazardous/Mixed Waste Stream, Generator/WM Teaming, Reporting/Records, Disposal End Points, and On-Sitemore » Treatment/Storage. The Core Team commissioned and assembled Process Teams to conduct in-depth evaluations of each of these eight areas. The Core Team then evaluated the Process Team results and consolidated the 80 process-specific recommendations into 15 overall recommendations. Benchmarking of a commercial nuclear facility, a commercial research facility, and a DOE research facility was conducted to both validate the efficacy of these findings and seek additional ideas for improvement. The outcome of this evaluation is represented by the 15 final recommendations that are described in this report.« less
Development of an Excel-based laboratory information management system for improving workflow efficiencies in early ADME screening.

PubMed

Lu, Xinyan

2016-01-01

There is a clear requirement for enhancing laboratory information management during early absorption, distribution, metabolism and excretion (ADME) screening. The application of a commercial laboratory information management system (LIMS) is limited by complexity, insufficient flexibility, high costs and extended timelines. An improved custom in-house LIMS for ADME screening was developed using Excel. All Excel templates were generated through macros and formulae, and information flow was streamlined as much as possible. This system has been successfully applied in task generation, process control and data management, with a reduction in both labor time and human error rates. An Excel-based LIMS can provide a simple, flexible and cost/time-saving solution for improving workflow efficiencies in early ADME screening.
Continuous improvement in the Industrial and Management Systems Engineering programme at Kuwait University

NASA Astrophysics Data System (ADS)

Aldowaisan, Tariq; Allahverdi, Ali

2016-07-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.
Visit, revamp, and revitalize your business plan: Part 2.

PubMed

Waldron, David

2011-01-01

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

NASA Astrophysics Data System (ADS)

Pries-Heje, Jan; Baskerville, Richard L.

This paper elaborates a design science approach for management planning anchored to the concept of a management design theory. Unlike the notions of design theories arising from information systems, management design theories can appear as a system of technological rules, much as a system of hypotheses or propositions can embody scientific theories. The paper illus trates this form of management design theories with three grounded cases. These grounded cases include a software process improvement study, a user involvement study, and an organizational change study. Collectively these studies demonstrate how design theories founded on technological rules can not only improve the design of information systems, but that these concepts have great practical value for improving the framing of strategic organi zational design decisions about such systems. Each case is either grounded in an empirical sense, that is to say, actual practice, or it is grounded to practices described extensively in the practical literature. Such design theories will help managers more easily approach complex, strategic decisions.
Reducing RN Vacancy Rate: A Nursing Recruitment Office Process Improvement Project.

PubMed

Hisgen, Stephanie A; Page, Nancy E; Thornlow, Deirdre K; Merwin, Elizabeth I

2018-06-01

The aim of this study was to reduce the RN vacancy rate at an academic medical center by improving the hiring process in the Nursing Recruitment Office. Inability to fill RN positions can lead to higher vacancy rates and negatively impact staff and patient satisfaction, quality outcomes, and the organization's bottom line. The Model for Improvement was used to design and implement a process improvement project to improve the hiring process from time of interview through the position being filled. Number of days to interview and check references decreased significantly, but no change in overall time to hire and time to fill positions was noted. RN vacancy rate also decreased significantly. Nurse manager satisfaction with the hiring process increased significantly. Redesigning the recruitment process supported operational efficiencies of the organization related to RN recruitment.
Improving patient safety and optimizing nursing teamwork using crew resource management techniques.

PubMed

West, Priscilla; Sculli, Gary; Fore, Amanda; Okam, Nwoha; Dunlap, Cleveland; Neily, Julia; Mills, Peter

2012-01-01

This project describes the application of the "sterile cockpit rule," a crew resource management (CRM) technique, targeted to improve efficacy and safety for nursing assistants in the performance of patient care duties. Crew resource management techniques have been successfully implemented in the aviation industry to improve flight safety. Application of these techniques can improve patient safety in medical settings. The Veterans Affairs (VA) National Center for Patient Safety conducted a CRM training program in select VA nursing units. One unit developed a novel application of the sterile cockpit rule to create protected time for certified nursing assistants (CNAs) while they collected vital signs and blood glucose data at the beginning of each shift. The typical nursing authority structure was reversed, with senior nurses protecting CNAs from distractions. This process led to improvements in efficiency and communication among nurses, with the added benefit of increased staff morale. Crew resource management techniques can be used to improve efficiency, morale, and patient safety in the healthcare setting.
Design and Verification of Remote Sensing Image Data Center Storage Architecture Based on Hadoop

NASA Astrophysics Data System (ADS)

Tang, D.; Zhou, X.; Jing, Y.; Cong, W.; Li, C.

2018-04-01

The data center is a new concept of data processing and application proposed in recent years. It is a new method of processing technologies based on data, parallel computing, and compatibility with different hardware clusters. While optimizing the data storage management structure, it fully utilizes cluster resource computing nodes and improves the efficiency of data parallel application. This paper used mature Hadoop technology to build a large-scale distributed image management architecture for remote sensing imagery. Using MapReduce parallel processing technology, it called many computing nodes to process image storage blocks and pyramids in the background to improve the efficiency of image reading and application and sovled the need for concurrent multi-user high-speed access to remotely sensed data. It verified the rationality, reliability and superiority of the system design by testing the storage efficiency of different image data and multi-users and analyzing the distributed storage architecture to improve the application efficiency of remote sensing images through building an actual Hadoop service system.
Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease.

PubMed

Steuten, Lotte; Vrijhoef, Bert; Van Merode, Frits; Wesseling, Geert-Jan; Spreeuwenberg, Cor

2006-12-01

To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care. Quasi-experimental design with 12-month follow-up. Region of Maastricht (the Netherlands) including university hospital and 16 general practices. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD. Disease management programme. Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.
Managing risks in the project pipeline.

DOT National Transportation Integrated Search

2013-08-01

This research focuses on how to manage the risks of project costs and revenue uncertainties over the long-term, and identifies significant : process improvements to ensure projects are delivered on time and as intended, thus maximizing the miles pave...
Prognostics and health management system for hydropower plant based on fog computing and docker container

NASA Astrophysics Data System (ADS)

Xiao, Jian; Zhang, Mingqiang; Tian, Haiping; Huang, Bo; Fu, Wenlong

2018-02-01

In this paper, a novel prognostics and health management system architecture for hydropower plant equipment was proposed based on fog computing and Docker container. We employed the fog node to improve the real-time processing ability of improving the cloud architecture-based prognostics and health management system and overcome the problems of long delay time, network congestion and so on. Then Storm-based stream processing of fog node was present and could calculate the health index in the edge of network. Moreover, the distributed micros-service and Docker container architecture of hydropower plants equipment prognostics and health management was also proposed. Using the micro service architecture proposed in this paper, the hydropower unit can achieve the goal of the business intercommunication and seamless integration of different equipment and different manufacturers. Finally a real application case is given in this paper.
Army Needs to Improve Controls and Audit Trails for the General Fund Enterprise Business System Acquire-to-Retire Business Process

DTIC Science & Technology

2013-09-13

Event 1.4.4,” August 7, 2012 AAA Attestation Report A-2010-0187- FFM , “General Fund Enterprise Business System - Federal Financial Management...Improvement Act Compliance. Examination of Requirements Through Test Event 1.4.0,” September 14, 2010 AAA Audit Report A-2009-0232- FFM , “General Fund...September 30, 2009 AAA Audit Report A-2009-0231- FFM , “General Fund Enterprise Business System - Federal Financial Management Improvement Act
Simulation modeling for the health care manager.

PubMed

Kennedy, Michael H

2009-01-01

This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.
Demonstrating PQS Effectiveness and Driving Continual Improvement: Evidence-Based Risk Reduction.

PubMed

Ramnarine, Emma; O'Donnell, Kevin

2018-04-18

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

NASA Astrophysics Data System (ADS)

Khisamova, E. D.

2018-05-01

Economical production implies primarily new approaches to culture of management and organization of production and offers a set of tools and techniques that allows reducing losses significantly and making the process cheaper and faster. Economical production tools are simple solutions that allow one to see opportunities for improvement of all aspects of the business, to reduce losses significantly, to constantly improve the whole spectrum of business processes, to increase significantly the transparency and manageability of the organization, to take advantage of the potential of each employee of the company, to increase competitiveness, and to obtain significant economic benefits without making large financial expenditures. Each of economical production tools solves a specific part of the problems, and only application of their combination will allow one to solve the problem or minimize it to acceptable values. The research of the governance process project "Lean Production" permitted studying the methods and tools of lean production and developing measures for their improvement.
Using School Performance Data to Drive School and Education District Office Accountability and Improvement: The Case of Ghana

ERIC Educational Resources Information Center

Prew, Martin; Quaigrain, Kenneth

2010-01-01

This article looks at a school management tool that allows school managers and education district offices to review the performance of their schools and use the broad-based data to undertake orchestrated planning with districts planning delivery based on the needs of schools and in support of school improvement plans. The review process also…

Nursing clinical practice changes to improve self-management in chronic obstructive pulmonary disease.

PubMed

Padilha, J M; Sousa, P A F; Pereira, F M S

2018-03-01

To propose nursing clinical practice changes to improve the development of patient self-management. Chronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates. Control of the disease's progression, the preservation of autonomy in self-care and maintenance of quality of life are extremely challenging for patients to execute in their daily living. However, there is still little evidence to support nursing clinical practice changes to improve the development of self-management. A participatory action research study was performed in a medicine inpatient department and the outpatient unit of a Portuguese hospital. The sample comprised 52 nurses and 99 patients. For data collection, we used interviews, participant observation and content analysis. The main elements of nursing clinical practice that were identified as a focus for improvement measures were the healthcare model, the organization of healthcare and the documentation of a support decision-making process. The specific guidelines, the provision of material to support decision-making and the optimization of information sharing between professionals positively influenced the change process. This change improved the development of self-management skills related to the awareness of the need for 'change', hope, involvement, knowledge and abilities. The implemented changes have improved health-related behaviours and clinical outcomes. To support self-management development skills, an effective nursing clinical practice change is needed. This study has demonstrated the relevance of a portfolio of techniques and tools to help patients adopt healthy behaviours. The involvement and participation of nurses and patients in the conceptualization, implementation and evaluation of policy change are fundamental issues to improve the quality of nursing care and clinical outcomes. © 2017 International Council of Nurses.
Just-In-Time Inventory Management; Application and Recommendations for Naval Hospital, Oakland.

DTIC Science & Technology

1992-12-01

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

PubMed

Jennings, K; Westfall, F

1994-09-01

Since 1988, manufacturing and service industries have been using the Malcolm Baldrige National Quality Award to assess their management processes (for example, leadership, information, and analysis) against critical performance criteria. Recognizing that the typical Baldrige assessment is time intensive and dependent on intensive training, The Pacer Group, a consulting firm in Dayton, Ohio, developed a self-assessment tool based on the Baldrige criteria which provides a snapshot assessment of an organization's management practices. The survey was administered at 25 hospitals within a health care system. Hospitals were able to compare their scores with other hospitals in the system, as well as the scores of a Baldrige award winner. Results were also analyzed on a systemwide basis to identify strengths and weaknesses across the system. For all 25 hospitals, the following areas were identified as strengths: management of process quality, leadership, and customer focus and satisfaction. Weaknesses included lack of employee involvement in the quality planning process, poor design of quality systems, and lack of cross-departmental cooperation. One of the surveyed hospitals launched improvement initiatives in knowledge of improvement tools and methods and in a patient satisfaction focus. A team was formed to improve the human resource management system. Also, a new unit was designed using patient-centered care principles. A team re-evaluated every operation that affected patients on the unit. A survey modeled after the Baldrige Award criteria can be useful in benchmarking an organization's quality improvement practices.
Don't break the chain: importance of supply chain management in the operating room setting.

PubMed

Bilyk, Candis

2008-09-01

Management of supplies within the operating room (OR) has considerable implications for decreasing healthcare costs while maintaining high-quality patient care. This area of healthcare therefore requires more monitoring by end-users including OR management, physicians, and nursing staff. This article is based on understanding supply chain management in the OR setting. Information provided throughout the article can be applied to small or large health care centers. It defines supply chain management and contains a brief overview of supply chain processes. It reviews the benefits of following these processes. The article also includes recommendations for improving the supply chain in the OR.
Development and application of an acceptance testing model

NASA Technical Reports Server (NTRS)

Pendley, Rex D.; Noonan, Caroline H.; Hall, Kenneth R.

1992-01-01

The process of acceptance testing large software systems for NASA has been analyzed, and an empirical planning model of the process constructed. This model gives managers accurate predictions of the staffing needed, the productivity of a test team, and the rate at which the system will pass. Applying the model to a new system shows a high level of agreement between the model and actual performance. The model also gives managers an objective measure of process improvement.
Delivering safe and effective test-result communication, management and follow-up: a mixed-methods study protocol.

PubMed

Dahm, Maria R; Georgiou, Andrew; Westbrook, Johanna I; Greenfield, David; Horvath, Andrea R; Wakefield, Denis; Li, Ling; Hillman, Ken; Bolton, Patrick; Brown, Anthony; Jones, Graham; Herkes, Robert; Lindeman, Robert; Legg, Michael; Makeham, Meredith; Moses, Daniel; Badmus, Dauda; Campbell, Craig; Hardie, Rae-Anne; Li, Julie; McCaughey, Euan; Sezgin, Gorkem; Thomas, Judith; Wabe, Nasir

2018-02-15

The failure to follow-up pathology and medical imaging test results poses patient-safety risks which threaten the effectiveness, quality and safety of patient care. The objective of this project is to: (1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility and accountability; (2) harness health information technology (IT) to inform and monitor test-result management; (3) enhance the contribution of consumers to the establishment of safe and effective test-result management systems. This convergent mixed-methods project triangulates three multistage studies at seven adult hospitals and one paediatric hospital in Australia.Study 1 adopts qualitative research approaches including semistructured interviews, focus groups and ethnographic observations to gain a better understanding of test-result communication and management practices in hospitals, and to identify patient-safety risks which require quality-improvement interventions.Study 2 analyses linked sets of routinely collected healthcare data to examine critical test-result thresholds and test-result notification processes. A controlled before-and-after study across three emergency departments will measure the impact of interventions (including the use of IT) developed to improve the safety and quality of test-result communication and management processes.Study 3 adopts a consumer-driven approach, including semistructured interviews, and the convening of consumer-reference groups and community forums. The qualitative data will identify mechanisms to enhance the role of consumers in test-management governance processes, and inform the direction of the research and the interpretation of findings. Ethical approval has been granted by the South Eastern Sydney Local Health District Human Research Ethics Committee and Macquarie University. Findings will be disseminated in academic, industry and consumer journals, newsletters and conferences. © 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.
Total Quality Management Implementation Plan for Military Personnel Management

DTIC Science & Technology

1989-09-01

2050.. )ATE 3. REPORT TYPE AND DATES CO VERED 4. TITLE AND SUBTITLE 5,rrmir18 . FUNDING NUMBERS Total Quality Management Implementation Plan for...SUBJECT TERMS 15. NUMBER OF PAGES TQM (Total Quality Management ), Military Personnel Management, Continuous Process Improvement 16. PRICE CODE 17. SECURITY...UNCLASSIFIED UNCLASSIFIED UL NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Prescribed by ANSI Std Z39-16 296-102 TOTAL QUALITY MANAGEMENT I
Using Deming To Improve Quality in Colleges and Universities.

ERIC Educational Resources Information Center

Cornesky, Robert A.; And Others

Of all the people known for stressing quality in industry, W. Edwards Deming is the pioneer. He stresses statistical process control (SPC) and a 14-point process for managers to improve quality and productivity. His approach is humanistic and treats people as intelligent human beings who want to do a good job. Twelve administrators in a university…
Leaders in Future and Current Technology Teaming Up to Improve Ethanol

Science.gov Websites

and NREL expertise to: Develop improvements in process throughput and water management for dry mill , Complete an overall process engineering model of the dry mill technology that identifies new ways to and operation of "dry mill" plants that currently produce ethanol from corn starch. Dry
What Is Lean Management in Health Care? Development of an Operational Definition for a Cochrane Systematic Review.

PubMed

Rotter, Thomas; Plishka, Christopher; Lawal, Adegboyega; Harrison, Liz; Sari, Nazmi; Goodridge, Donna; Flynn, Rachel; Chan, James; Fiander, Michelle; Poksinska, Bonnie; Willoughby, Keith; Kinsman, Leigh

2018-01-01

Industrial improvement approaches such as Lean management are increasingly being adopted in health care. Synthesis is necessary to ensure these approaches are evidence based and requires operationalization of concepts to ensure all relevant studies are included. This article outlines the process utilized to develop an operational definition of Lean in health care. The literature search, screening, data extraction, and data synthesis processes followed the recommendations outlined by the Cochrane Collaboration. Development of the operational definition utilized the methods prescribed by Kinsman et al. and Wieland et al. This involved extracting characteristics of Lean, synthesizing similar components to establish an operational definition, applying this definition, and updating the definition to address shortcomings. We identified two defining characteristics of Lean health-care management: (1) Lean philosophy, consisting of Lean principles and continuous improvement, and (2) Lean activities, which include Lean assessment activities and Lean improvement activities. The resulting operational definition requires that an organization or subunit of an organization had integrated Lean philosophy into the organization's mandate, guidelines, or policies and utilized at least one Lean assessment activity or Lean improvement activity. This operational definition of Lean management in health care will act as an objective screening criterion for our systematic review. To our knowledge, this is the first evidence-based operational definition of Lean management in health care.
[Work organisation improvement methods applied to activities of Blood Transfusion Establishments (BTE): Lean Manufacturing, VSM, 5S].

PubMed

Bertholey, F; Bourniquel, P; Rivery, E; Coudurier, N; Follea, G

2009-05-01

Continuous improvement of efficiency as well as new expectations from customers (quality and safety of blood products) and employees (working conditions) imply constant efforts in Blood Transfusion Establishments (BTE) to improve work organisations. The Lean method (from "Lean" meaning "thin") aims at identifying wastages in the process (overproduction, waiting, over-processing, inventory, transport, motion) and then reducing them in establishing a mapping of value chain (Value Stream Mapping). It consists in determining the added value of each step of the process from a customer perspective. Lean also consists in standardizing operations while implicating and responsabilizing all collaborators. The name 5S comes from the first letter of five operations of a Japanese management technique: to clear, rank, keep clean, standardize, make durable. The 5S method leads to develop the team working inducing an evolution of the way in the management is performed. The Lean VSM method has been applied to blood processing (component laboratory) in the Pays de la Loire BTE. The Lean 5S method has been applied to blood processing, quality control, purchasing, warehouse, human resources and quality assurance in the Rhône-Alpes BTE. The experience returns from both BTE shows that these methods allowed improving: (1) the processes and working conditions from a quality perspective, (2) the staff satisfaction, (3) the efficiency. These experiences, implemented in two BTE for different processes, confirm the applicability and usefulness of these methods to improve working organisations in BTE.
Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services.

PubMed

Alleyne, Jo; Jumaa, Mansour Olawale

2007-03-01

The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and leadership in the workplace. 1. Management and leadership interventions and approaches have significantly influenced the participants' capacity to improve the quality of services provided to their patients. 2. Using various techniques, tools, methods and frameworks presented at the sessions increased participants' confidence to perform. 3. A structured approach like the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model makes implementing change more practical and manageable within a turbulent care environment. The process of Stakeholder Mapping and Management made getting agreement to do things differently much easier. Generally it is clear that many nurses and midwives, according to the participants, have to carry out management and leadership activities in their day-to-day practice. The traditional boundary between the private, the public and the voluntary sector management is increasingly becoming blurred. It is conclusive that the district nurses on this innovative programme demonstrated how they were making sense of patterns from the past, planning for the future and facilitating the clinical nursing leadership processes today to improve quality patient services tomorrow. Their improved capacity to manage change and lead people was demonstrated, for example, through their questioning attitudes about the dominance of general practitioners. They did this, for example, by initiating and leading case conferences with the multi-disciplinary teams. It became evident from this study that to use group clinical supervision with an executive co-coaching approach for the implementation and to sustain quality service demand that 'good nursing' is accepted as being synonymous with 'good management'. This is the future of 'new nursing'.
Use of failure mode effect analysis (FMEA) to improve medication management process.

PubMed

Jain, Khushboo

2017-03-13

Purpose Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self-reliable by ensuring prevention of errors and/or error detection at subsequent stages. The purpose of this paper is to use failure mode effect analysis (FMEA), a systematic proactive tool, to identify the likelihood and the causes for the process to fail at various steps and prioritise them to devise risk reduction strategies to improve patient safety. Design/methodology/approach The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. FMEA tool was used. Corrective actions were developed based on the prioritised failure modes which were implemented and monitored. Findings The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37 per cent) followed by administration errors (29 per cent) indicating the need to identify the causes and effects of their occurrence. In all, 11 failure modes were identified out of which major five were prioritised based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40 per cent (average) and around 60 per cent reduction in the RPN of prioritised failure modes. Research limitations/implications FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing FMEA but also for implementing the corrective actions. Practical implications FMEA is an effective proactive risk-assessment tool and is a continuous process which can be continued in phases. The corrective actions taken resulted in reduction in RPN, subjected to further evaluation and usage by others depending on the facility type. Originality/value The application of the tool helped the hospital in identifying failures in medication management process, thereby prioritising and correcting them leading to improvement.
Current Status and Problems in Certification of Sustainable Forest Management in China

NASA Astrophysics Data System (ADS)

Zhao, Jingzhu; Xie, Dongming; Wang, Danyin; Deng, Hongbing

2011-12-01

Forest certification is a mechanism involving the regulation of trade of forest products in order to protect forest resources and improve forest management. Although China had a late start in adopting this process, the country has made good progress in recent years. As of July 31, 2009, 17 forest management enterprises and more than one million hectares of forests in China have been certified by the Forest Stewardship Council (FSC). Several major factors affect forest certification in China. The first set is institutional in nature. Forest management in China is based on centralized national plans and therefore lacks flexibility. A second factor is public awareness. The importance and value of forest certification are not widely understood and thus consumers do not make informed choices regarding certified forest products. The third major factor is the cost of certification. Together these factors have constrained the development of China's forest certification efforts. However, the process does have great potential. According to preliminary calculations, if 50% of China's commercial forests were certified, the economic cost of forest certification would range from US0.66-86.63 million while the economic benefits for the forestry business sector could exceed US150 million. With continuing progress in forest management practices and the development of international trade in forest products, it becomes important to improve the forest certification process in China. This can be achieved by improving the forest management system, constructing and perfecting market access mechanisms for certificated forest products, and increasing public awareness of environmental protection, forest certification, and their interrelationship.
Current status and problems in certification of sustainable forest management in China.

PubMed

Zhao, Jingzhu; Xie, Dongming; Wang, Danyin; Deng, Hongbing

2011-12-01

Forest certification is a mechanism involving the regulation of trade of forest products in order to protect forest resources and improve forest management. Although China had a late start in adopting this process, the country has made good progress in recent years. As of July 31, 2009, 17 forest management enterprises and more than one million hectares of forests in China have been certified by the Forest Stewardship Council (FSC). Several major factors affect forest certification in China. The first set is institutional in nature. Forest management in China is based on centralized national plans and therefore lacks flexibility. A second factor is public awareness. The importance and value of forest certification are not widely understood and thus consumers do not make informed choices regarding certified forest products. The third major factor is the cost of certification. Together these factors have constrained the development of China's forest certification efforts. However, the process does have great potential. According to preliminary calculations, if 50% of China's commercial forests were certified, the economic cost of forest certification would range from US$0.66-86.63 million while the economic benefits for the forestry business sector could exceed US$150 million. With continuing progress in forest management practices and the development of international trade in forest products, it becomes important to improve the forest certification process in China. This can be achieved by improving the forest management system, constructing and perfecting market access mechanisms for certificated forest products, and increasing public awareness of environmental protection, forest certification, and their interrelationship.
Space system production cost benefits from contemporary philosophies in management and manufacturing

NASA Technical Reports Server (NTRS)

Rosmait, Russell L.

1991-01-01

The cost of manufacturing space system hardware has always been expensive. The Engineering Cost Group of the Program Planning office at Marshall is attempting to account for cost savings that result from new technologies in manufacturing and management. The objective is to identify and define contemporary philosophies in manufacturing and management. The seven broad categories that make up the areas where technological advances can assist in reducing space system costs are illustrated. Included within these broad categories is a list of the processes or techniques that specifically provide the cost savings within todays design, test, production and operations environments. The processes and techniques listed achieve savings in the following manner: increased productivity; reduced down time; reduced scrap; reduced rework; reduced man hours; and reduced material costs. In addition, it should be noted that cost savings from production and processing improvements effect 20 to 40 pct. of production costs whereas savings from management improvements effects 60 to 80 of production cost. This is important because most efforts in reducing costs are spent trying to reduce cost in the production.
Building a Framework in Improving Drought Monitoring and Early Warning Systems in Africa

NASA Astrophysics Data System (ADS)

Tadesse, T.; Wall, N.; Haigh, T.; Shiferaw, A. S.; Beyene, S.; Demisse, G. B.; Zaitchik, B.

2015-12-01

Decision makers need a basic understanding of the prediction models and products of hydro-climatic extremes and their suitability in time and space for strategic resource and development planning to develop mitigation and adaptation strategies. Advances in our ability to assess and predict climate extremes (e.g., droughts and floods) under evolving climate change suggest opportunity to improve management of climatic/hydrologic risk in agriculture and water resources. In the NASA funded project entitled, "Seasonal Prediction of Hydro-Climatic Extremes in the Greater Horn of Africa (GHA) under Evolving Climate Conditions to Support Adaptation Strategies," we are attempting to develop a framework that uses dialogue between managers and scientists on how to enhance the use of models' outputs and prediction products in the GHA as well as improve the delivery of this information in ways that can be easily utilized by managers. This process is expected to help our multidisciplinary research team obtain feedback on the models and forecast products. In addition, engaging decision makers is essential in evaluating the use of drought and flood prediction models and products for decision-making processes in drought and flood management. Through this study, we plan to assess information requirements to implement a robust Early Warning Systems (EWS) by engaging decision makers in the process. This participatory process could also help the existing EWSs in Africa and to develop new local and regional EWSs. In this presentation, we report the progress made in the past two years of the NASA project.
Report of the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology Colorectal Polyp Working Group: the development of a complex colorectal polyp minimum dataset.

PubMed

Chattree, A; Barbour, J A; Thomas-Gibson, S; Bhandari, P; Saunders, B P; Veitch, A M; Anderson, J; Rembacken, B J; Loughrey, M B; Pullan, R; Garrett, W V; Lewis, G; Dolwani, S; Rutter, M D

2017-01-01

The management of large non-pedunculated colorectal polyps (LNPCPs) is complex, with widespread variation in management and outcome, even amongst experienced clinicians. Variations in the assessment and decision-making processes are likely to be a major factor in this variability. The creation of a standardized minimum dataset to aid decision-making may therefore result in improved clinical management. An official working group of 13 multidisciplinary specialists was appointed by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) to develop a minimum dataset on LNPCPs. The literature review used to structure the ACPGBI/BSG guidelines for the management of LNPCPs was used by a steering subcommittee to identify various parameters pertaining to the decision-making processes in the assessment and management of LNPCPs. A modified Delphi consensus process was then used for voting on proposed parameters over multiple voting rounds with at least 80% agreement defined as consensus. The minimum dataset was used in a pilot process to ensure rigidity and usability. A 23-parameter minimum dataset with parameters relating to patient and lesion factors, including six parameters relating to image retrieval, was formulated over four rounds of voting with two pilot processes to test rigidity and usability. This paper describes the development of the first reported evidence-based and expert consensus minimum dataset for the management of LNPCPs. It is anticipated that this dataset will allow comprehensive and standardized lesion assessment to improve decision-making in the assessment and management of LNPCPs. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.
Assessment of Inaugural Two-Year NPM Guidance Process

EPA Pesticide Factsheets

Assessment intended to facilitate discussions among EPA Headquarters, Regional and state staff and management -- to identify opportunities to improve the two-year process for the FY 2018-2019 NPM Guidance development.

A real-time dashboard for managing pathology processes.

PubMed

Halwani, Fawaz; Li, Wei Chen; Banerjee, Diponkar; Lessard, Lysanne; Amyot, Daniel; Michalowski, Wojtek; Giffen, Randy

2016-01-01

The Eastern Ontario Regional Laboratory Association (EORLA) is a newly established association of all the laboratory and pathology departments of Eastern Ontario that currently includes facilities from eight hospitals. All surgical specimens for EORLA are processed in one central location, the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital (TOH), where the rapid growth and influx of surgical and cytology specimens has created many challenges in ensuring the timely processing of cases and reports. Although the entire process is maintained and tracked in a clinical information system, this system lacks pre-emptive warnings that can help management address issues as they arise. Dashboard technology provides automated, real-time visual clues that could be used to alert management when a case or specimen is not being processed within predefined time frames. We describe the development of a dashboard helping pathology clinical management to make informed decisions on specimen allocation and tracking. The dashboard was designed and developed in two phases, following a prototyping approach. The first prototype of the dashboard helped monitor and manage pathology processes at the DPLM. The use of this dashboard helped to uncover operational inefficiencies and contributed to an improvement of turn-around time within The Ottawa Hospital's DPML. It also allowed the discovery of additional requirements, leading to a second prototype that provides finer-grained, real-time information about individual cases and specimens. We successfully developed a dashboard that enables managers to address delays and bottlenecks in specimen allocation and tracking. This support ensures that pathology reports are provided within time frame standards required for high-quality patient care. Given the importance of rapid diagnostics for a number of diseases, the use of real-time dashboards within pathology departments could contribute to improving the quality of patient care beyond EORLA's.
Developing a Three Processes Framework to Analyze Hydrologic Performance of Urban Stormwater Management in a Watershed Scale

NASA Astrophysics Data System (ADS)

Lyu, H.; Ni, G.; Sun, T.

2016-12-01

Urban stormwater management contributes to recover water cycle to a nearly natural situation. It is a challenge for analyzing the hydrologic performance in a watershed scale, since the measures are various of sorts and scales and work in different processes. A three processes framework is developed to simplify the urban hydrologic process on the surface and evaluate the urban stormwater management. The three processes include source utilization, transfer regulation and terminal detention, by which the stormwater is controlled in order or discharged. Methods for analyzing performance are based on the water controlled proportions by each process, which are calculated using USEPA Stormwater Management Model. A case study form Beijing is used to illustrate how the performance varies under a set of designed events of different return periods. This framework provides a method to assess urban stormwater management as a whole system considering the interaction between measures, and to examine if there is any weak process of an urban watershed to be improved. The results help to make better solutions of urban water crisis.
Issues in NASA Program and Project Management. Special Edition: A Collection of Papers on NASA Procedures and Guidance 7120.5A. Volume 14

NASA Technical Reports Server (NTRS)

Hoffman, Edward J. (Editor); Lawbaugh, William M. (Editor)

1998-01-01

A key aspect of NASA's new Strategic Management System is improving the way we plan, approve, execute and evaluate our programs and projects. To this end, NASA has developed the NASA Program and Project Management processes and Requirements-NASA Procedures and Guidelines (NPG) 7120.5A, which formally documents the "Provide Aerospace Products and Capabilities" crosscutting process, and defines the processes and requirements that are responsive to the Program/Project Management-NPD 7120.4A. The Program/Project Management-NPD 7120.4A, issued November 14, 1996, provides the policy for managing programs and projects in a new way that is aligned with the new NASA environment. An Agencywide team has spent thousands of hours developing the NASA Program and Project Management Processes and Requirements-NPG 7120.5A. We have created significant flexibility, authority and discretion for the program and project managers to exercise and carry out their duties, and have delegated the responsibility and the accountability for their programs and projects.
If two heads are better than one, why do I have bruises on my forehead? Managing the group process.

PubMed

Miner, F C

1991-01-01

Managers are using groups more frequently for solving complex organizational problems because of numerous organizational and environmental factors. Yet, many managers see group decision-making meetings as more of a problem than a solution. This article discusses situations where groups should and should not be used and recommends specific skills a leader can use to improve the effectiveness of group decision making. Emphasis is placed on managing the group process to achieve a satisfactory outcome. An exercise to test the validity of the suggestions is provided.
Overview of the Integrated Programs for Aerospace Vehicle Design (IPAD) project

NASA Technical Reports Server (NTRS)

Venneri, S. L.

1983-01-01

To respond to national needs for improved productivity in engineering design and manufacturing, a NASA supported joint industry/government project is underway denoted Integrated Programs for Aerospace Vehicle Design (IPAD). The objective is to improve engineering productivity through better use of computer technology. It focuses on development of data base management technology and associated software for integrated company wide management of engineering and manufacturing information. Results to date on the IPAD project include an in depth documentation of a representative design process for a large engineering project, the definition and design of computer aided design software needed to support that process, and the release of prototype software to manage engineering information. This paper provides an overview of the IPAD project and summarizes progress to date and future plans.
Decision support for patient care: implementing cybernetics.

PubMed

Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A

2004-01-01

The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.
Using ecological production functions to link ecological processes to ecosystem services.

EPA Science Inventory

Ecological production functions (EPFs) link ecosystems, stressors, and management actions to ecosystem services (ES) production. Although EPFs are acknowledged as being essential to improve environmental management, their use in ecological risk assessment has received relatively ...
Effective and Innovative Practices for Stronger Facilities Management.

ERIC Educational Resources Information Center

Banick, Sarah

2002-01-01

Describes the five winners of the APPA's Effective & Innovative Practices Award. These facilities management programs and processes were recognized for enhancing service delivery, lowering costs, increasing productivity, improving customer service, generating revenue, or otherwise benefiting the educational institution. (EV)
Improving Recall Using Database Management Systems: A Learning Strategy.

ERIC Educational Resources Information Center

Jonassen, David H.

1986-01-01

Describes the use of microcomputer database management systems to facilitate the instructional uses of learning strategies relating to information processing skills, especially recall. Two learning strategies, cross-classification matrixing and node acquisition and integration, are highlighted. (Author/LRW)
5 CFR 850.101 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

....101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... processing system created by the Office of Personnel Management's (OPM's) Retirement Systems Modernization (RSM) initiative. RSM is OPM's strategic initiative to improve the quality and timeliness of services...
The cost management organization: the next step for materiel management.

PubMed

Schuweiler, R C

1997-06-01

With Materiel Management's transition over the last decade from simple logistics to analysis and cost management, it has gained recognition as a key part of the management team responsible for supplies, equipment, standards, and associated processes to identify, purchase, store, distribute, issue, and dispose of supplies and equipment. The materiel manager's job consists of putting the right product in the right place at the right time and in the right quantity at the best total delivered cost. In this context, Materiel Management has made powerful impacts to lower costs associated with: Distribution--costs have been lowered by actively adopting advanced supply channel management techniques such as primary suppliers, JIT, stockless programs, case cart/custom kit/procedure based delivery systems, modified stockless programs as well as margin management through cost plus, flat fee, or margins paid per activity. Cost of goods--lowered through aggregated purchasing in the forms of regional and national purchasing alliances and local capitation or other gain/risk share programs. Internal process costs--lowered by out-sourcing and/or integrating supplier processes and personnel into operations via partnership approaches. We have also reduced transactional costs through EDI transaction sets and the emerging use of the inter and intranet/electronic commerce, procurement cards, and evaluated receipt settlement processes. De-layering--We have lowered the operating costs of Materiel Management overhead by re-design/re-engineering, resulting in reduced management and greater front line authority. Quality--We have learned to identify and respond to customer and supplier needs by using quality improvement tools and ongoing measurement and monitoring techniques. Through this we have identified the waste of non-beneficial products and services. We have adopted supplier certification measurers to ensure quality is built into processes and outcomes. With so much already accomplished, it should be easy to rest on these laurels and simply operate. However, we believe that this is just a beginning. A new generation of highly educated leaders are emerging and taking advantage of the contributions of pioneers who laid the ground work. These new leaders will have advanced management, statistics, and behavioral sciences skills. They will be analysts and organizational motivators. Their goal will be to improve financial and clinical performance measured by real time process and performance data. The new leaders will have information at their fingertips thanks to significant leaps forward in data collection, automated continuous replenishment processes, and software designed for better management of clinical and cost outcomes. This article documents significant Materiel management accomplishments and conceptualizes cost management processes. The cost management organization is the logical evolution in our efforts for better outcomes in healthcare Materiel management.
SPD-based Logistics Management Model of Medical Consumables in Hospitals.

PubMed

Liu, Tongzhu; Shen, Aizong; Hu, Xiaojian; Tong, Guixian; Gu, Wei; Yang, Shanlin

2016-10-01

With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China.
Small Steps, Big Reward: Quality Improvement through Pilot Groups.

ERIC Educational Resources Information Center

Bindl, Jim; Schuler, Jim

1988-01-01

Because of a need for quality improvement, Wisconsin Power and Light trained two six-person pilot groups in statistical process control, had them apply that knowledge to actual problems, and showed management the dollars-and-cents savings that come from quality improvement. (JOW)
Initial Perceptions of Open Higher Education Students with Learner Management Systems

ERIC Educational Resources Information Center

Altunoglu, Asu

2017-01-01

Learner management systems (LMS) are used in open education as a means of managing and recording e-learning facilities as well as improving student engagement. Students benefit from them to become active participants in the decision-making process of their own learning. This study aims to investigate the initial perceptions of students…
Managing Risk on the Final Frontier

NASA Technical Reports Server (NTRS)

Lengyel, David M.; Newman, J. S.

2009-01-01

The National Aeronautics and Space Administration (NASA). Exploration Systems Mission Directorate (ESMD) has combined the Continuous Risk Management (CRM) discipline with innovative knowledge management (KM) practices to more effectively enable the accomplishment of work. CRM enables proactive problem identification and problem solving in the complex world of rocket science. while KM is used to improve this process.
Methods for evaluating information in managing the enterprise on the basis of a hybrid three-tier system

NASA Astrophysics Data System (ADS)

Vasil'ev, V. A.; Dobrynina, N. V.

2017-01-01

The article presents data on the influence of information upon the functioning of complex systems in the process of ensuring their effective management. Ways and methods for evaluating multidimensional information that reduce time and resources, improve the validity of the studied system management decisions, were proposed.
Streamlining the Online Course Development Process by Using Project Management Tools

ERIC Educational Resources Information Center

Abdous, M'hammed; He, Wu

2008-01-01

Managing the design and production of online courses is challenging. Insufficient instructional design and inefficient management often lead to issues such as poor course quality and course delivery delays. In an effort to facilitate, streamline, and improve the overall design and production of online courses, this article discusses how we…
Leveraging Human Resource Development Expertise to Improve Supply Chain Managers' Skills and Competencies

ERIC Educational Resources Information Center

Ellinger, Alexander E.; Ellinger, Andrea D.

2014-01-01

Purpose: There is an ongoing shortage of talented supply chain managers with the necessary skills and business-related competencies to manage increasingly complex and strategically important supply chain processes. The purpose of this paper is to propose that organizations can create and maintain competitive advantage by leveraging the expertise…
Using Pilots to Assess the Value and Approach of CMMI Implementation

NASA Technical Reports Server (NTRS)

Godfrey, Sara; Andary, James; Rosenberg, Linda

2002-01-01

At Goddard Space Flight Center (GSFC), we have chosen to use Capability Maturity Model Integrated (CMMI) to guide our process improvement program. Projects at GSFC consist of complex systems of software and hardware that control satellites, operate ground systems, run instruments, manage databases and data and support scientific research. It is a challenge to launch a process improvement program that encompasses our diverse systems, yet is manageable in terms of cost effectiveness. In order to establish the best approach for improvement, our process improvement effort was divided into three phases: 1) Pilot projects; 2) Staged implementation; and 3) Sustainment and continual improvement. During Phase 1 the focus of the activities was on a baselining process, using pre-appraisals in order to get a baseline for making a better cost and effort estimate for the improvement effort. Pilot pre-appraisals were conducted from different perspectives so different approaches for process implementation could be evaluated. Phase 1 also concentrated on establishing an improvement infrastructure and training of the improvement teams. At the time of this paper, three pilot appraisals have been completed. Our initial appraisal was performed in a flight software area, considering the flight software organization as the organization. The second appraisal was done from a project perspective, focusing on systems engineering and acquisition, and using the organization as GSFC. The final appraisal was in a ground support software area, again using GSFC as the organization. This paper will present our initial approach, lessons learned from all three pilots and the changes in our approach based on the lessons learned.
A Behavioral Framework for Managing Massive Airline Flight Disruptions through Crisis Management, Organization Development, and Organization Learning

NASA Astrophysics Data System (ADS)

Larsen, Tulinda Deegan

In this study the researcher provides a behavioral framework for managing massive airline flight disruptions (MAFD) in the United States. Under conditions of MAFD, multiple flights are disrupted throughout the airline's route network, customer service is negatively affected, additional costs are created for airlines, and governments intervene. This study is different from other studies relating to MAFD that have focused on the operational, technical, economic, financial, and customer service impacts. The researcher argues that airlines could improve the management of events that led to MAFD by applying the principles of crisis management where the entire organization is mobilized, rather than one department, adapting organization development (OD) interventions to implement change and organization learning (OL) processes to create culture of innovation, resulting in sustainable improvement in customer service, cost reductions, and mitigation of government intervention. At the intersection of crisis management, OD, and OL, the researcher has developed a new conceptual framework that enhances the resiliency of individuals and organizations in responding to unexpected-yet-recurring crises (e.g., MAFD) that impact operations. The researcher has adapted and augmented Lalonde's framework for managing crises through OD interventions by including OL processes. The OD interventions, coupled with OL, provide a framework for airline leaders to manage more effectively events that result in MAFD with the goal of improving passenger satisfaction, reducing costs, and preventing further government intervention. Further research is warranted to apply this conceptual framework to unexpected-yet-recurring crises that affect operations in other industries.

Hospital management contracts: institutional and community perspectives.

PubMed Central

Wheeler, J R; Zuckerman, H S

1984-01-01

Previous studies have shown that external management by contract can improve the performance of managed hospitals. This article presents a conceptual framework which develops specific hypotheses concerning improved hospital operating efficiency, increased ability to meet hospital objectives, and increased ability to meet community objectives. Next, changes in the process and structure of management under contractual arrangements, based on observations from two not-for-profit hospital systems, are described. Finally, the effects of these management changes over time on hospital and community objectives are presented. These effects suggest progressive stages in the development of management contracts. The first stage focuses on stabilizing hospital financial performance. Stage two involves recruitment and retention efforts to secure necessary personnel. In the third stage, attention shifts to strategic planning and marketing. PMID:6490378
Application of SNMP on CATV

NASA Astrophysics Data System (ADS)

Huang, Hong-bin; Liu, Wei-ping; Chen, Shun-er; Zheng, Liming

2005-02-01

A new type of CATV network management system developed by universal MCU, which supports SNMP, is proposed in this paper. From the point of view in both hardware and software, the function and method of every modules inside the system, which include communications in the physical layer, protocol process, data process, and etc, are analyzed. In our design, the management system takes IP MAN as data transmission channel and every controlled object in the management structure has a SNMP agent. In the SNMP agent developed, there are four function modules, including physical layer communication module, protocol process module, internal data process module and MIB management module. In the paper, the structure and function of every module are designed and demonstrated while the related hardware circuit, software flow as well as the experimental results are tested. Furthermore, by introducing RTOS into the software programming, the universal MCU procedure can conducts such multi-thread management as fast Ethernet controller driving, TCP/IP process, serial port signal monitoring and so on, which greatly improves efficiency of CPU.
Efficient LIDAR Point Cloud Data Managing and Processing in a Hadoop-Based Distributed Framework

NASA Astrophysics Data System (ADS)

Wang, C.; Hu, F.; Sha, D.; Han, X.

2017-10-01

Light Detection and Ranging (LiDAR) is one of the most promising technologies in surveying and mapping city management, forestry, object recognition, computer vision engineer and others. However, it is challenging to efficiently storage, query and analyze the high-resolution 3D LiDAR data due to its volume and complexity. In order to improve the productivity of Lidar data processing, this study proposes a Hadoop-based framework to efficiently manage and process LiDAR data in a distributed and parallel manner, which takes advantage of Hadoop's storage and computing ability. At the same time, the Point Cloud Library (PCL), an open-source project for 2D/3D image and point cloud processing, is integrated with HDFS and MapReduce to conduct the Lidar data analysis algorithms provided by PCL in a parallel fashion. The experiment results show that the proposed framework can efficiently manage and process big LiDAR data.
Analysis of the risk management decisionmaking processes and the decision support systems in the wildland fire agencies

Treesearch

Patrick Withen

2007-01-01

This paper offers an analysis of the strengths, weaknesses, opportunities, and threats in the risk management process, decision support systems (DSSs), and other types of decisionmaking, including recognition primed decisionmaking, bricolage with the goal of improving DSSs and decisionmaking. DSSs may be thought of as any technology or knowledge that is used as an aid...
Innovation and forest industry: domesticating the pine forests of the southern United States,1920–1999

Treesearch

John A. Stanturf; Robert C. Kellison; F.S. Broerman; Stephen B. Jones

2003-01-01

The history of forest management in the southern United States has been a process of intensification and the pine forests of the Coastal Plain can be regarded as in the early stage of crop domestication. Silviculture research into tree improvement and other aspects of plantation establishment and management has been critical to the domestication process, which began in...
Texas Solar Collaboration Action Plan

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

Winland, Chris

2013-02-14

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

PubMed Central

Lee, Heung Ki; Jung, Jaehee

2014-01-01

Resource management of the main memory and process handler is critical to enhancing the system performance of a web server. Owing to the transaction delay time that affects incoming requests from web clients, web server systems utilize several web processes to anticipate future requests. This procedure is able to decrease the web generation time because there are enough processes to handle the incoming requests from web browsers. However, inefficient process management results in low service quality for the web server system. Proper pregenerated process mechanisms are required for dealing with the clients' requests. Unfortunately, it is difficult to predict how many requests a web server system is going to receive. If a web server system builds too many web processes, it wastes a considerable amount of memory space, and thus performance is reduced. We propose an adaptive web process manager scheme based on the analysis of web log mining. In the proposed scheme, the number of web processes is controlled through prediction of incoming requests, and accordingly, the web process management scheme consumes the least possible web transaction resources. In experiments, real web trace data were used to prove the improved performance of the proposed scheme. PMID:25197692
Project Communication in Functions, Process and Project-Oriented Industiral Companies

NASA Astrophysics Data System (ADS)

Samáková, Jana; Koltnerová, Kristína; Rybanský, Rudolf

2012-12-01

The article is focused on the project communication management. Industrial enterprises, which use project management must constantly search the new ways for improving. One of the possibilities is the change of management from a functional oriented to the projectoriented or process-oriented. Process-oriented and project-oriented companies have better project communication management during the all project life cycle. Communication in the project is a very important factor. According to the arguments of several authors, one of the biggest problem is that threaten the success of the project is just the communication. In each project is an important pillar - and that is communication. Only on the base of communication can the project move forward and achieve the target.
Professional commitment to changing chronic illness care: results from disease management programmes.

PubMed

Lemmens, Karin; Strating, Mathilde; Huijsman, Robbert; Nieboer, Anna

2009-08-01

The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation. Quasi-experimental design with 1 year follow-up after intervention. Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals. All participating primary care professionals (n = 52). COPD management programme. Professional commitment, organizational context and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation. COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.
Mozambique's journey toward accreditation of the National Tuberculosis Reference Laboratory.

PubMed

Viegas, Sofia O; Azam, Khalide; Madeira, Carla; Aguiar, Carmen; Dolores, Carolina; Mandlaze, Ana P; Chongo, Patrina; Masamha, Jessina; Cirillo, Daniela M; Jani, Ilesh V; Gudo, Eduardo S

2017-01-01

Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL) in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation. The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL's process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board. Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique to achieve ISO 15189 accreditation. From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan.
Selecting information technology for physicians' practices: a cross-sectional study.

PubMed

Eden, Karen Beekman

2002-04-05

Many physicians are transitioning from paper to electronic formats for billing, scheduling, medical charts, communications, etc. The primary objective of this research was to identify the relationship (if any) between the software selection process and the office staff's perceptions of the software's impact on practice activities. A telephone survey was conducted with office representatives of 407 physician practices in Oregon who had purchased information technology. The respondents, usually office managers, answered scripted questions about their selection process and their perceptions of the software after implementation. Multiple logistic regression revealed that software type, selection steps, and certain factors influencing the purchase were related to whether the respondents felt the software improved the scheduling and financial analysis practice activities. Specifically, practices that selected electronic medical record or practice management software, that made software comparisons, or that considered prior user testimony as important were more likely to have perceived improvements in the scheduling process than were other practices. Practices that considered value important, that did not consider compatibility important, that selected managed care software, that spent less than 10,000 dollars, or that provided learning time (most dramatic increase in odds ratio, 8.2) during implementation were more likely to perceive that the software had improved the financial analysis process than were other practices. Perhaps one of the most important predictors of improvement was providing learning time during implementation, particularly when the software involves several practice activities. Despite this importance, less than half of the practices reported performing this step.
Evaluating the effectiveness of implementing quality management practices in the medical industry.

PubMed

Yeh, T-M; Lai, H-P

2015-01-01

To discuss the effectiveness of 30 quality management practices (QMP) including Strategic Management, Balanced ScoreCard, Knowledge Management, and Total Quality Management in the medical industry. A V-shaped performance evaluation matrix is applied to identify the top ten practices that are important but not easy to use or implement. Quality Function Deployment (QFD) is then utilized to find key factors to improve the implementation of the top ten tools. The questionnaires were sent to the nursing staff and administrators in a hospital through e-mail and posts. A total of 250 copies were distributed and 217 copies were valid. The importance, easiness, and achievement (i.e., implementation level) of 30 quality management practices were used. Key factors for QMP implementation were sequenced in order of importance as top management involvement, inter-department communication and coordination, teamwork, hospital-wide participation, education and training, consultant professionalism, continuous internal auditing, computerized process, and incentive compensation. Top management can implement the V-shaped performance matrix to determine whether quality management practices need improvement and if so, utilize QFD to find the key factors for improvement.
A Brief Study of Software Engineering Professional Continuing Education in DoD Acquisition

DTIC Science & Technology

2010-04-01

Lifecycle Processes (IEEE 12207 ) (810) 37% 61% 2% Guide to the Software Engineering Body of K l d (SWEBOK) (804) 67% 31% 2% now e ge Software...Engineering-Software Measurement Process ( ISO /IEC 15939) (797) 55% 44% 2% Capability Maturity Model Integration (806) 17% 81% 2% Six Sigma Process...Improvement (804) 7% 91% 1% ISO 9000 Quality Management Systems (803) 10% 89% 1% 28 Conclusions Significant problem areas R i tequ remen s Management Very
A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life.

PubMed

Kidd, Tara; Carey, Nicola; Mold, Freda; Westwood, Sue; Miklaucich, Maria; Konstantara, Emmanouela; Sterr, Annette; Cooke, Debbie

2017-01-01

Self-management interventions have become increasingly popular in the management of long-term health conditions; however, little is known about their impact on psychological well-being in people with Multiple Sclerosis (MS). To examine the effectiveness of self-management interventions on improving depression, anxiety and health related quality of life in people with MS. A structured literature search was conducted for the years 2000 to 2016. The review process followed the PRISMA guidelines, and is registered with PROSPERO (no. CRD42016033925). The review identified 10 RCT trials that fulfilled selection criteria and quality appraisal. Self-management interventions improved health-related quality of life in 6 out of 7 studies, with some evidence of improvement in depression and anxiety symptoms. Although the results are promising more robust evaluation is required in order to determine the effectiveness of self-management interventions on depression, anxiety and quality of life in people with MS. Evaluation of the data was impeded by a number of methodological issues including incomplete content and delivery information for the intervention and the exclusion of participants representing the disease spectrum. Recommendations are made for service development and research quality improvement.
The Role of the Facilitator on Total Quality Management Teams.

ERIC Educational Resources Information Center

Eakin, William L.

1993-01-01

As Total Quality Management teams work to improve organizational processes, several types of facilitators emerge: the director, the workhorse, and the cheerleader. Experience at the University of Kansas illustrates how different facilitator styles can affect team learning. (MSE)
Strategies for Hard Times in Higher Education.

ERIC Educational Resources Information Center

Desfosses, Louis R.

1996-01-01

Planning and management strategies used in the private sector have practical applications for higher education in a period of systemic and organizational stress. Promising strategies include organizational delayering; employee empowerment; boundless thinking, problem-solving teams; accelerated processes; quality management and improvement; and…
Report: EPA Needs to Improve Its Information Technology Audit Follow-Up Processes

EPA Pesticide Factsheets

Report #16-P-0100, March 10, 2016. The EPA’s audit follow-up oversight for offices reviewed did not ensure that agreed-to corrective actions were managed effectively in the agency’s Management Audit Tracking System (MATS).
Benchmarking the perioperative process: II. Introducing anesthesia clinical pathways to improve processes and outcomes and to reduce nursing labor intensity in ambulatory orthopedic surgery.

PubMed

Williams, B A; DeRiso, B M; Engel, L B; Figallo, C M; Anders, J W; Sproul, K A; Ilkin, H; Harner, C D; Fu, F H; Nagarajan, N J; Evans, J H; Watkins, W D

1998-11-01

(1) To introduce anesthesia clinical pathways as a management tool to improve the quality of care; (2) to use the Procedural Times Glossary published by the Association of Anesthesia Clinical Directors (AACD) as a template for data collection and analysis; and (3) to determine the effects of anesthesia clinical pathways on surgical processes, outcomes, and costs in common ambulatory orthopedic surgery. Hospital database and patient chart review of consecutive patients undergoing anterior cruciate ligament reconstruction (ACLR) during academic years (AY) 1995-1996 and 1996-1997. Patient data from AY 1995-1996, during which no intraoperative anesthesia clinical pathways existed, served as historical controls. Data from AY 1996-1997, during which intraoperative anesthesia clinical pathways were used, served as the treatment group. Regional anesthesia options were routinely offered to patients in the clinical pathway. Ambulatory surgery center in a teaching hospital. The records of 503 ASA physical status I and II patients were reviewed. 1996-1997 patients underwent clinical pathway anesthesia care in which the intraoperative and postoperative anesthesia process was standardized with respect to symptom management, drugs, and equipment used. 1995-1996 patients did not have a standardized intraoperative and postoperative anesthetic course with respect to the management of common symptoms or to specific drugs and supplies used. Intervals described in the AACD Procedural Times Glossary, anesthesia drug and supply costs, and patient outcome variables (postoperative nursing interventions required and unexpected admissions), as influenced by the use of the anesthesia clinical pathway, were measured. Clinical pathway anesthesia care of ACLR in 1996-1997, which actively incorporated regional anesthesia options, reduced pharmacy and materials cost variability; slightly increased turnover time; improved intraoperative anesthesia and surgical efficiency, recovery times, and unexpected admission rates; and decreased the number of required nursing interventions for common postoperative symptoms. Clinical pathway patient management systems in anesthesia care are likely to produce useful outcome data of current practice patterns when compared with historical controls. This management tool may be useful in simultaneously containing costs and improving process efficiency and patient outcomes.
Quality Risk Management: Putting GMP Controls First.

PubMed

O'Donnell, Kevin; Greene, Anne; Zwitkovits, Michael; Calnan, Nuala

2012-01-01

This paper presents a practical way in which current approaches to quality risk management (QRM) may be improved, such that they better support qualification, validation programs, and change control proposals at manufacturing sites. The paper is focused on the treatment of good manufacturing practice (GMP) controls during QRM exercises. It specifically addresses why it is important to evaluate and classify such controls in terms of how they affect the severity, probability of occurrence, and detection ratings that may be assigned to potential failure modes or negative events. It also presents a QRM process that is designed to directly link the outputs of risk assessments and risk control activities with qualification and validation protocols in the GMP environment. This paper concerns the need for improvement in the use of risk-based principles and tools when working to ensure that the manufacturing processes used to produce medicines, and their related equipment, are appropriate. Manufacturing processes need to be validated (or proven) to demonstrate that they can produce a medicine of the required quality. The items of equipment used in such processes need to be qualified, in order to prove that they are fit for their intended use. Quality risk management (QRM) tools can be used to support such qualification and validation activities, but their use should be science-based and subject to as little subjectivity and uncertainty as possible. When changes are proposed to manufacturing processes, equipment, or related activities, they also need careful evaluation to ensure that any risks present are managed effectively. This paper presents a practical approach to how QRM may be improved so that it better supports qualification, validation programs, and change control proposals in a more scientific way. This improved approach is based on the treatment of what are called good manufacturing process (GMP) controls during those QRM exercises. A GMP control can be considered to be any control that is put in place to assure product quality and regulatory compliance. This improved approach is also based on how the detectability of risks is assessed. This is important because when producing medicines, it is not always good practice to place a high reliance upon detection-type controls in the absence of an adequate level of assurance in the manufacturing process that leads to the finished medicine.
DOD Financial Management: Improvement Needed in DOD Components’ Implementation of Audit Readiness Effort

DTIC Science & Technology

2011-09-01

DOD Financial Management Abbreviations AFB Air Force Base COSO Committee of Sponsoring Organizations of the Treadway... Management and mismanagement.11 All of DOD’s programs on GAO’s High- Risk List relate to its business operations, including systems and processes... Management maintains audit readiness through risk -based periodic testing of internal controls utilizing the OMB Circular No. A-123, Appendix A

Improving quality of care using a diabetes registry and disease management services in an integrated delivery network.

PubMed

Campion, Francis X; Tully, George L; Barrett, Jo-Ann; Andre, Paulo; Sweeney, Ann

2005-08-01

Disease management for chronic conditions is a call for collaboration among all parties of the health care system. The Caritas Christi Health Care System established a unified American Diabetes Association (ADA) recognized outpatient diabetes self-management education program (DSME) in each of its six hospital communities and has established an Internet data portal with managed care organizations to improve preventive care for thousands of patients with diabetes. This article describes the stepwise process of building the successful Caritas Diabetes Care Program and the central role of the Caritas Diabetes Registry over a 5-year period.
Disease management as a performance improvement strategy.

PubMed

McClatchey, S

2001-11-01

Disease management is a strategy of organizing care and services for a patient population across the continuum. It is characterized by a population database, interdisciplinary and interagency collaboration, and evidence-based clinical information. The effectiveness of a disease management program has been measured by a combination of clinical, financial, and quality of life outcomes. In early 1997, driven by a strategic planning process that established three Centers of Excellence (COE), we implemented disease management as the foundation for a new approach to performance improvement utilizing five key strategies. The five implementation strategies are outlined, in addition to a review of the key elements in outcome achievement.
The NCC project: A quality management perspective

NASA Technical Reports Server (NTRS)

Lee, Raymond H.

1993-01-01

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

PubMed Central

Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.

2010-01-01

CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.
The importance of activity-based methods in radiology and the technology that now makes this possible.

PubMed

Monge, Paul

2006-01-01

Activity-based methods serve as a dynamic process that has allowed many other industries to reduce and control their costs, increase productivity, and streamline their processes while improving product quality and service. The method could serve the healthcare industry in an equally beneficial way. Activity-based methods encompass both activity based costing (ABC) and activity-based management (ABM). ABC is a cost management approach that links resource consumption to activities that an enterprise performs, and then assigns those activities and their associated costs to customers, products, or product lines. ABM uses the resource assignments derived in ABC so that operation managers can improve their departmental processes and workflows. There are three fundamental problems with traditional cost systems. First, traditional systems fail to reflect the underlying diversity of work taking place within an enterprise. Second, it uses allocations that are, for the most part, arbitrary Single step allocations fail to reflect the real work-the activities being performed and the associate resources actually consumed. Third, they only provide a cost number that, standing alone, does not provide any guidance on how to improve performance by lowering cost or enhancing throughput.
[Failure mode and effects analysis to improve quality in clinical trials].

PubMed

Mañes-Sevilla, M; Marzal-Alfaro, M B; Romero Jiménez, R; Herranz-Alonso, A; Sanchez Fresneda, M N; Benedi Gonzalez, J; Sanjurjo-Sáez, M

The failure mode and effects analysis (FMEA) has been used as a tool in risk management and quality improvement. The objective of this study is to identify the weaknesses in processes in the clinical trials area, of a Pharmacy Department (PD) with great research activity, in order to improve the safety of the usual procedures. A multidisciplinary team was created to analyse each of the critical points, identified as possible failure modes, in the development of clinical trial in the PD. For each failure mode, the possible cause and effect were identified, criticality was calculated using the risk priority number and the possible corrective actions were discussed. Six sub-processes were defined in the development of the clinical trials in PD. The FMEA identified 67 failure modes, being the dispensing and prescription/validation sub-processes the most likely to generate errors. All the improvement actions established in the AMFE were implemented in the Clinical Trials area. The FMEA is a useful tool in proactive risk management because it allows us to identify where we are making mistakes and analyze the causes that originate them, to prioritize and to adopt solutions to risk reduction. The FMEA improves process safety and quality in PD. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Measurement of time processing ability and daily time management in children with disabilities.

PubMed

Janeslätt, Gunnel; Granlund, Mats; Kottorp, Anders

2009-01-01

Improvement is needed in methods for planning and evaluating interventions designed to facilitate daily time management for children with intellectual disability, Asperger syndrome, or other developmental disorders. The aim of this study was to empirically investigate the hypothesized relation between children's time processing ability (TPA), daily time management, and self-rated autonomy. Such a relationship between daily time management and TPA may support the idea that TPA is important for daily time management and that children with difficulties in TPA might benefit from intervention aimed at improving daily time management. Participants were children aged 6 to 11 years with dysfunctions such as attention-deficit/hyperactivity disorder, autism, or physical or intellectual disabilities (N = 118). TPA was measured with the instrument KaTid. All data were transformed to interval measures using applications of Rasch models and then further analysed with correlation and regression analysis. The results demonstrate a moderate significant relation between the parents' ratings of daily time management and TPA of the children, and between the self-rating of autonomy and TPA. There was also a significant relation between self-ratings of autonomy and the parents' rating of the children's daily time management. Parents' ratings of their children's daily time management explain 25% of the variation in TPA, age of the children explains 22%, while the child's self-rating of autonomy can explain 9% of the variation in TPA. The three variables together explain 38% of the variation in TPA. The results indicate the viability of the instrument for assessing TPA also in children with disabilities and that the ability measured by KaTid is relevant for daily time management. TPA seems to be a factor for children's daily time management that needs to be taken into consideration when planning and evaluating interventions designed to facilitate everyday functioning for children with cognitive impairments. The findings add to the increasing knowledge base about children with time processing difficulties and contribute to better methods aimed at improving these children's daily time management. Further research is needed to examine if there are differences in TPA related to specific diagnosis or other child characteristics.
Six Lessons We Learned Applying Six Sigma

NASA Technical Reports Server (NTRS)

Carroll, Napoleon; Casleton, Christa H.

2005-01-01

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

PubMed

de Andrade Junior, Milton Aurelio Uba; Zanghelini, Guillherme Marcelo; Soares, Sebastião Roberto

2017-05-01

Because the consumption of materials is generally higher than their recovery rate, improving municipal solid waste (MSW) management is fundamental for increasing the efficiency of natural resource use and consumption in urban areas. More broadly, the characteristics of a MSW management system influence the end-of-life (EOL) impacts of goods consumed by households. We aim to indicate the extent to which greenhouse gas emissions from a MSW management system can be reduced by increasing waste paper recycling. We also address the stakeholders' contribution for driving transition towards an improved scenario. Life cycle assessment (LCA) addresses the EOL impacts of the paper industry, driven by the characteristics of MSW management in Florianópolis, Brazil, by varying the level of stakeholders' commitment through different recycling scenarios. The results show that 41% of the climate change impacts from waste paper management could be reduced when increasing the waste paper recycling rates and reducing waste paper landfilling. To achieve such emissions reduction, the industry contribution to the MSW management system would have to increase from 17% in the business-as-usual scenario to 74% in the target scenario. We were able to measure the differences in stakeholders' contribution by modelling the MSW management system processes that are under the industry's responsibility separately from the processes that are under the government's responsibility, based on the Brazilian legal framework. The conclusions indicate that LCA can be used to support policy directions on reducing the impacts of MSW management by increasing resource recovery towards a circular economy.
The process of managerial control in quality improvement initiatives.

PubMed

Slovensky, D J; Fottler, M D

1994-11-01

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

PubMed

Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

2009-01-01

Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.
Continuous improvement in managing R&D: A TQM approach at SkogForsk, Sweden

Treesearch

Magnus Larsson

1999-01-01

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

PubMed

Rask, Kimberly; Parmelee, Patricia A; Taylor, Jo A; Green, Diane; Brown, Holly; Hawley, Jonathan; Schild, Laura; Strothers, Harry S; Ouslander, Joseph G

2007-03-01

To evaluate the feasibility and effectiveness of a falls management program (FMP) for nursing homes (NHs). A quality improvement project with data collection throughout FMP implementation. NHs in Georgia owned and operated by a single nonprofit organization. All residents of participating NHs. A convenience sample of 19 NHs implemented the FMP. The FMP is a multifaceted quality improvement and culture change intervention. Key components included organizational leadership buy-in and support, a designated facility-based falls coordinator and interdisciplinary team, intensive education and training, and ongoing consultation and oversight by advanced practice nurses with expertise in falls management. Process-of-care documentation using a detailed 24-item audit tool and fall and physical restraint use rates derived from quality improvement software currently used in all Georgia NHs (MyInnerView). Care process documentation related to the assessment and management of fall risk improved significantly during implementation of the FMP. Restraint use decreased substantially during the project period, from 7.9% to 4.4% in the intervention NHs (a relative reduction of 44%), and decreased in the nonintervention NHs from 7.0% to 4.9% (a relative reduction of 30%). Fall rates remained stable in the intervention NHs (17.3 falls/100 residents per month at start and 16.4 falls/100 residents per month at end), whereas fall rates increased 26% in the NHs not implementing the FMP (from 15.0 falls/100 residents/per month to 18.9 falls/100 residents per month). Implementation was associated with significantly improved care process documentation and a stable fall rate during a period of substantial reduction in the use of physical restraints. In contrast, fall rates increased in NHs owned by the same organization that did not implement the FMP. The FMP may be a helpful tool for NHs to manage fall risk while attempting to reduce physical restraint use in response to the Centers for Medicare and Medicaid Services quality initiatives.
Effects of Self-Management Support on Structure, Process, and Outcomes Among Vulnerable Patients With Diabetes

PubMed Central

Schillinger, Dean; Handley, Margaret; Wang, Frances; Hammer, Hali

2009-01-01

OBJECTIVE Despite the importance of self-management support (SMS), few studies have compared SMS interventions, involved diverse populations, or entailed implementation in safety net settings. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model. RESEARCH DESIGN AND METHODS A total of 339 outpatients with poorly controlled diabetes from county-run clinics were enrolled in a three-arm trial. Participants, more than half of whom spoke limited English, were uninsured, and/or had less than a high school education, were randomly assigned to usual care, interactive weekly automated telephone self-management support with nurse follow-up (ATSM), or monthly group medical visits with physician and health educator facilitation (GMV). We measured 1-year changes in structure (Patient Assessment of Chronic Illness Care [PACIC]), communication processes (Interpersonal Processes of Care [IPC]), and outcomes (behavioral, functional, and metabolic). RESULTS Compared with the usual care group, the ATSM and GMV groups showed improvements in PACIC, with effect sizes of 0.48 and 0.50, respectively (P < 0.01). Only the ATSM group showed improvements in IPC (effect sizes 0.40 vs. usual care and 0.25 vs. GMV, P < 0.05). Both SMS arms showed improvements in self-management behavior versus the usual care arm (P < 0.05), with gains being greater for the ATSM group than for the GMV group (effect size 0.27, P = 0.02). The ATSM group had fewer bed days per month than the usual care group (−1.7 days, P = 0.05) and the GMV group (−2.3 days, P < 0.01) and less interference with daily activities than the usual care group (odds ratio 0.37, P = 0.02). We observed no differences in A1C change. CONCLUSIONS Patient-centered SMS improves certain aspects of diabetes care and positively influences self-management behavior. ATSM seems to be a more effective communication vehicle than GMV in improving behavior and quality of life. PMID:19131469
Improving data collection, documentation, and workflow in a dementia screening study

PubMed Central

Read, Kevin B.; LaPolla, Fred Willie Zametkin; Tolea, Magdalena I.; Galvin, James E.; Surkis, Alisa

2017-01-01

Background A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies’ data collection, entry, and processing workflows. Case Presentation The librarians’ role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. Conclusions NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library’s broader user community. PMID:28377680
Improving the Interagency Conflict Assessment Framework (ICAF) with Intellectual Habits

DTIC Science & Technology

2012-06-08

27 Figure 4. Parson’s Fundamental Matrix of Explanation of Action .................................32 Figure...peace building process. Reconciliation, which is the process by which relationships are built between conflicting groups, must manage three paradoxes
Iterative development of visual control systems in a research vivarium.

PubMed

Bassuk, James A; Washington, Ida M

2014-01-01

The goal of this study was to test the hypothesis that reintroduction of Continuous Performance Improvement (CPI) methodology, a lean approach to management at Seattle Children's (Hospital, Research Institute, Foundation), would facilitate engagement of vivarium employees in the development and sustainment of a daily management system and a work-in-process board. Such engagement was implemented through reintroduction of aspects of the Toyota Production System. Iterations of a Work-In-Process Board were generated using Shewhart's Plan-Do-Check-Act process improvement cycle. Specific attention was given to the importance of detecting and preventing errors through assessment of the following 5 levels of quality: Level 1, customer inspects; Level 2, company inspects; Level 3, work unit inspects; Level 4, self-inspection; Level 5, mistake proofing. A functioning iteration of a Mouse Cage Work-In-Process Board was eventually established using electronic data entry, an improvement that increased the quality level from 1 to 3 while reducing wasteful steps, handoffs and queues. A visual workplace was realized via a daily management system that included a Work-In-Process Board, a problem solving board and two Heijunka boards. One Heijunka board tracked cage changing as a function of a biological kanban, which was validated via ammonia levels. A 17% reduction in cage changing frequency provided vivarium staff with additional time to support Institute researchers in their mutual goal of advancing cures for pediatric diseases. Cage washing metrics demonstrated an improvement in the flow continuum in which a traditional batch and queue push system was replaced with a supermarket-type pull system. Staff engagement during the improvement process was challenging and is discussed. The collective data indicate that the hypothesis was found to be true. The reintroduction of CPI into daily work in the vivarium is consistent with the 4P Model of the Toyota Way and selected Principles that guide implementation of the Toyota Production System.
Iterative Development of Visual Control Systems in a Research Vivarium

PubMed Central

Bassuk, James A.; Washington, Ida M.

2014-01-01

The goal of this study was to test the hypothesis that reintroduction of Continuous Performance Improvement (CPI) methodology, a lean approach to management at Seattle Children’s (Hospital, Research Institute, Foundation), would facilitate engagement of vivarium employees in the development and sustainment of a daily management system and a work-in-process board. Such engagement was implemented through reintroduction of aspects of the Toyota Production System. Iterations of a Work-In-Process Board were generated using Shewhart’s Plan-Do-Check-Act process improvement cycle. Specific attention was given to the importance of detecting and preventing errors through assessment of the following 5 levels of quality: Level 1, customer inspects; Level 2, company inspects; Level 3, work unit inspects; Level 4, self-inspection; Level 5, mistake proofing. A functioning iteration of a Mouse Cage Work-In-Process Board was eventually established using electronic data entry, an improvement that increased the quality level from 1 to 3 while reducing wasteful steps, handoffs and queues. A visual workplace was realized via a daily management system that included a Work-In-Process Board, a problem solving board and two Heijunka boards. One Heijunka board tracked cage changing as a function of a biological kanban, which was validated via ammonia levels. A 17% reduction in cage changing frequency provided vivarium staff with additional time to support Institute researchers in their mutual goal of advancing cures for pediatric diseases. Cage washing metrics demonstrated an improvement in the flow continuum in which a traditional batch and queue push system was replaced with a supermarket-type pull system. Staff engagement during the improvement process was challenging and is discussed. The collective data indicate that the hypothesis was found to be true. The reintroduction of CPI into daily work in the vivarium is consistent with the 4P Model of the Toyota Way and selected Principles that guide implementation of the Toyota Production System. PMID:24736460
Model medication management process in Australian nursing homes using business process modeling.

PubMed

Qian, Siyu; Yu, Ping

2013-01-01

One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.
The Finnish healthcare services lean management.

PubMed

Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna

2018-02-05

Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

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

PubMed

Simpson, Roy L

2004-08-01

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

PubMed

Dieter, Peter Erich

2009-07-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International.The traditional teacher- and discipline-centred curriculum was displaced by a student-centred, interdisciplinary and integrative curriculum, which has been named Dresden Integrative Patient/Problem-Oriented Learning (DIPOL). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany.The students play a very important strategic role in all processes. They are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. The Faculty Development program, including a reform in medical education, the establishment of the Quality Management program and the certification, resulted in an improvement of the quality and output of medical education and was accompanied in an improvement of the quality and output of basic sciences and clinical research and interdisciplinary patient care.
Reinventing The Design Process: Teams and Models

NASA Technical Reports Server (NTRS)

Wall, Stephen D.

1999-01-01

The future of space mission designing will be dramatically different from the past. Formerly, performance-driven paradigms emphasized data return with cost and schedule being secondary issues. Now and in the future, costs are capped and schedules fixed-these two variables must be treated as independent in the design process. Accordingly, JPL has redesigned its design process. At the conceptual level, design times have been reduced by properly defining the required design depth, improving the linkages between tools, and managing team dynamics. In implementation-phase design, system requirements will be held in crosscutting models, linked to subsystem design tools through a central database that captures the design and supplies needed configuration management and control. Mission goals will then be captured in timelining software that drives the models, testing their capability to execute the goals. Metrics are used to measure and control both processes and to ensure that design parameters converge through the design process within schedule constraints. This methodology manages margins controlled by acceptable risk levels. Thus, teams can evolve risk tolerance (and cost) as they would any engineering parameter. This new approach allows more design freedom for a longer time, which tends to encourage revolutionary and unexpected improvements in design.
Workflow computing. Improving management and efficiency of pathology diagnostic services.

PubMed

Buffone, G J; Moreau, D; Beck, J R

1996-04-01

Traditionally, information technology in health care has helped practitioners to collect, store, and present information and also to add a degree of automation to simple tasks (instrument interfaces supporting result entry, for example). Thus commercially available information systems do little to support the need to model, execute, monitor, coordinate, and revise the various complex clinical processes required to support health-care delivery. Workflow computing, which is already implemented and improving the efficiency of operations in several nonmedical industries, can address the need to manage complex clinical processes. Workflow computing not only provides a means to define and manage the events, roles, and information integral to health-care delivery but also supports the explicit implementation of policy or rules appropriate to the process. This article explains how workflow computing may be applied to health-care and the inherent advantages of the technology, and it defines workflow system requirements for use in health-care delivery with special reference to diagnostic pathology.
The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management.

PubMed

Koritzky, Gilly; Rice, Chantelle; Dieterle, Camille; Bechara, Antoine

2015-01-01

Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n = 12) had lower recency scores than unsuccessful ones (n = 32; p = 0.006). Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.
A retrospective review of how nonconformities are expressed and finalized in external inspections of health-care facilities.

PubMed

Hovlid, Einar; Høifødt, Helge; Smedbråten, Bente; Braut, Geir Sverre

2015-09-23

External inspections are widely used in health care as a means of improving the quality of care. However, the way external inspections affect the involved organization is poorly understood. A better understanding of these processes is important to improve our understanding of the varying effects of external inspections in different organizations. In turn, this can contribute to the development of more effective ways of conducting inspections. The way the inspecting organization states their grounds for noncompliant behavior and subsequently follows up to enforce the necessary changes can have implications for the inspected organization's change process. We explore how inspecting organizations express and state their grounds for noncompliant behavior and how they follow up to enforce improvements. We conducted a retrospective review, in which we performed a content analysis of the documents from 36 external inspections in Norway. Our analysis was guided by Donabedian's structure, process, and outcome model. Deficiencies in the management system in combination with clinical work processes was considered as nonconformity by the inspecting organizations. Two characteristic patterns were identified in the way observations led to a statement of nonconformity: one in which it was clearly demonstrated how deficiencies in the management system could affect clinical processes, and one in which this connection was not demonstrated. Two characteristic patterns were also identified in the way the inspecting organization followed up and finalized their inspection: one in which the inspection was finalized solely based on the documented changes in structural deficiencies addressed in the nonconformity statement, and one based on the documented changes in structural and process deficiencies addressed in the nonconformity statement. External inspections are performed to improve the quality of care. To accomplish this aim, we suggest that nonconformities should be grounded by observations that clearly demonstrate how deficiencies in the management system might affect the clinical processes, and that the inspection should be finalized based on documented changes in both structural and process deficiencies addressed in the nonconformity statement.
Evaluating a Chronic Disease Management Improvement Collaboration: Lessons in Design and Implementation Fundamentals.

PubMed

Phillips, Kaye; Amar, Claudia; Elicksen-Jensen, Keesa

2016-01-01

For the Canadian Foundation for Healthcare Improvement (CFHI), the Atlantic Healthcare Collaboration (AHC) was a pivotal opportunity to build upon its experience and expertise in delivering regional change management training and to apply and refine its evaluation and performance measurement approach. This paper reports on its evaluation principles and approach, as well as the lessons learned as CFHI diligently coordinated and worked with improvement project (IP) teams and a network of stakeholders to design and undertake a suite of evaluative activities. The evaluation generated evidence and learnings about various elements of chronic disease prevention and management (CDPM) improvement processes, individual and team capacity building and the role and value of CFHI in facilitating tailored learning activities and networking among teams, coaches and other AHC stakeholders.
HR Manager Leadership in Quality Improvement in a College Environment

ERIC Educational Resources Information Center

Sharabi, Moshe

2010-01-01

Purpose: The purpose of this paper is to present the influence of the human resource (HR) manager on the quality of service in an academic college, and the human resource management (HRM) outcomes of the process. Design/methodology/approach: The paper relates to a customer satisfaction survey. More than 120 questionnaires were completed by the…
Strategies for Meeting High Standards: Quality Management and the Baldrige Criteria in Education. Lessons from the States.

ERIC Educational Resources Information Center

Barth, John; Burk, Zona Sharp; Serfass, Richard; Harms, Barbara Ann; Houlihan, G. Thomas; Anderson, Gerald; Farley, Raymond P.; Rigsby, Ken; O'Rourke, John

This document, one of a series of reports, focuses on the adoption of principles of quality management, originally developed by W. Edwards Deming, and the Baldrige Criteria for use in education. These processes and tools for systemic organizational management, when comprehensively applied, produce performance excellence and continuous improvement.…
Models and Procedures for Improving the Planning, Management, and Evaluation of Cooperative Education Programs. Final Report. Volume I.

ERIC Educational Resources Information Center

Blaschke, Charles L.; Steiger, JoAnn

This report of a project to design a set of training guidelines for planning, managing, and evaluating cooperative education programs describes briefly the procedures used in developing the guidelines and model; discusses the various components of the planning, management, and evaluation process; and presents guidelines and criteria for designing…
Improving compliance with diabetes clinical practice guidelines in military medical treatment facilities.

PubMed

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

2010-01-01

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

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

The productivity of the copyright registration process, which is administered by the Copyright Office within the Library of Congress, can be improved by streamlining the workflow, reducing and streamlining the handling of correspondence, measuring productivity/performance, increasing the use of automation, improving records management, and…
Process-based costing.

PubMed

Lee, Robert H; Bott, Marjorie J; Forbes, Sarah; Redford, Linda; Swagerty, Daniel L; Taunton, Roma Lee

2003-01-01

Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria. Process-based costing has 4 steps: developing a flowchart, estimating resource use, valuing resources, and calculating direct costs. To illustrate the technique, this article uses it to cost the care planning process in 3 long-term care facilities. We conclude that process-based costing is easy to implement; generates reliable, valid data; and allows nursing managers to assess the costs of new or modified processes.
A quality improvement approach to capacity building in low- and middle-income countries.

PubMed

Bardfield, Joshua; Agins, Bruce; Akiyama, Matthew; Basenero, Apollo; Luphala, Patience; Kaindjee-Tjituka, Francina; Natanael, Salomo; Hamunime, Ndapewa

2015-07-01

To describe the HEALTHQUAL framework consisting of the following three components: performance measurement, quality improvement and the quality management program, representing an adaptive approach to building capacity in national quality management programs in low and middle-income countries. We present a case study from Namibia illustrating how this approach is adapted to country context. HEALTHQUAL partners with Ministries of Health to build knowledge and expertise in modern improvement methods, including data collection, analysis and reporting, process analysis and the use of data to implement quality improvement projects that aim to improve systems and processes of care. Clinical performance measures are selected in each country by the Ministry of Health on the basis of national guidelines. Patient records are sampled using a standardized statistical table to achieve a minimum confidence interval of 90%, with a spread of ±8% in participating facilities. Data are routinely reviewed to identify gaps in patient care, and aggregated to produce facility mean scores that are trended over time. A formal organizational assessment is conducted at facility and national levels to review the implementation progress. Aggregate mean rates of performance for 10 of 11 indicators of HIV care improved for adult HIV-positive patients between 2008 and 2013. Quality improvement is an approach to capacity building and health systems strengthening that offers adaptive methodology. Synergistic implementation of elements of a national quality program can lead to improvements in care, in parallel with systematic capacity development for measurement, improvement and quality management throughout the healthcare delivery system.
Engineering Quality Software: 10 Recommendations for Improved Software Quality Management

DTIC Science & Technology

2010-04-27

lack of user involvement • Inadequate Software Process Management & Control By Contractors • No “Team” of Vendors and users; little SME participation...1990 Quality Perspectives • Process Quality ( CMMI ) • Product Quality (ISO/IEC 2500x) – Internal Quality Attributes – External Quality Attributes... CMMI /ISO 9000 Assessments – Capture organizational knowledge • Identify best practices, lessons learned Know where you are, and where you need to be
Assessment of Aberdeen Proving Ground - Army Contracting Command, Contract Management Processes

DTIC Science & Technology

2014-12-01

order to enact improvement to public procurement systems (2008). The Balance Scorecard approach is presented by Niven as “a carefully selected set of...organizational performance. The framework analyzes four areas of emphasis: the customer, internal processes, learning and growth and financial (Niven, 2003...performance management (Cavanagh et al., 1999). The contract score card developed by Cullen looks further past the balance scorecard approach by
Software Process Improvement Journey: IBM Australia Application Management Services

DTIC Science & Technology

2005-03-01

learned from its successes and mistakes and then applied that learning to the next project . 28 CMU/SEI-2005-TR...worldwide re- quirements for project management and quality; it was the organization’s staff members who played a part in the development of the ...environ- ment and that it involves personnel from a variety of areas, ideally not part of the group that developed the technology or process
Total Quality Management in Higher Education: Applying Deming's Fourteen Points.

ERIC Educational Resources Information Center

Masters, Robert J.; Leiker, Linda

1992-01-01

This article presents guidelines to aid administrators of institutions of higher education in applying the 14 principles of Total Quality Management. The principles stress understanding process improvements, handling variation, fostering prediction, and using psychology to capitalize on human resources. (DB)
Managing Process Improvement: A Guidebook for Implementing Change Version 01.00.06

DTIC Science & Technology

1993-12-01

and Competitive Position. Cambridge, 1982 Massachusetts: Massachusetts Institute of Technology. Egan, Gerard Change-Agent Skills B: Managing ... Innovation & Change. San 1988 Diego, California: Pfeiffer & Company. Fowler, Priscilla, and Software Engineering Group Guide. CMU/SEI-90-TR-24. Stan Rifkin
Improving transportation systems management and operations (TSM&O), capability maturity model workshop white paper : business processes.

DOT National Transportation Integrated Search

2015-04-01

Research done through the Second Strategic Highway Research Program (SHRP 2) determined that agencies with the most effective transportation systems management and operations (TSM&O) activities were differentiated not by budgets or technical skills a...

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