The Use of Multi-Criteria Evaluation and Network Analysis in the Area Development Planning Process

DTIC Science & Technology

2013-03-01

layouts. The alternative layout scoring process, base in multi-criteria evaluation, returns a quantitative score for each alternative layout and a...The purpose of this research was to develop improvements to the area development planning process. These plans are used to improve operations within...an installation sub-section by altering the physical layout of facilities. One methodology was developed based on apply network analysis concepts to

The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

ERIC Educational Resources Information Center

Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

2016-01-01

Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

76 FR 41246 - Pesticide Program Dialogue Committee, Pesticide Registration Improvement Act Process Improvement...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... Committee, Pesticide Registration Improvement Act Process Improvement Workgroup; Notice of Public Meeting...) Process Improvement Work Group. EPA plans to meet its ESA consultation obligations through the pesticide... a pesticide during the registration review process. This meeting of the PRIA Process Improvement...

Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam.

PubMed

Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima

2016-12-01

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Advanced planning for ISS payload ground processing

NASA Astrophysics Data System (ADS)

Page, Kimberly A.

2000-01-01

Ground processing at John F. Kennedy Space Center (KSC) is the concluding phase of the payload/flight hardware development process and is the final opportunity to ensure safe and successful recognition of mission objectives. Planning for the ground processing of on-orbit flight hardware elements and payloads for the International Space Station is a responsibility taken seriously at KSC. Realizing that entering into this operational environment can be an enormous undertaking for a payload customer, KSC continually works to improve this process by instituting new/improved services for payload developer/owner, applying state-of-the-art technologies to the advanced planning process, and incorporating lessons learned for payload ground processing planning to ensure complete customer satisfaction. This paper will present an overview of the KSC advanced planning activities for ISS hardware/payload ground processing. It will focus on when and how KSC begins to interact with the payload developer/owner, how that interaction changes (and grows) throughout the planning process, and how KSC ensures that advanced planning is successfully implemented at the launch site. It will also briefly consider the type of advance planning conducted by the launch site that is transparent to the payload user but essential to the successful processing of the payload (i.e. resource allocation, executing documentation, etc.) .

Connection, regulation, and care plan innovation: a case study of four nursing homes.

PubMed

Colón-Emeric, Cathleen S; Lekan-Rutledge, Deborah; Utley-Smith, Queen; Ammarell, Natalie; Bailey, Donald; Piven, Mary L; Corazzini, Kirsten; Anderson, Ruth A

2006-01-01

We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth interviews (n = 122) of 390 staff at all levels were conducted. Qualitative analysis produced a conceptual/thematic description and complexity science concepts were used to produce conceptual insights. We observed that greater levels of staff connection were associated with higher care plan specificity and innovation. Connection of the frontline nursing staff was crucial for (1) implementation of the formal care plan and (2) spontaneous informal care planning responsive to changing resident needs. Although regulations could theoretically improve cognitive diversity and information flow in care planning, we observed instances of regulatory oversight resulting in less specific care plans and abandonment of an effective care planning process. Interventions which improve staff connectedness may improve resident outcomes.

Cooperative optimization of reconfigurable machine tool configurations and production process plan

NASA Astrophysics Data System (ADS)

Xie, Nan; Li, Aiping; Xue, Wei

2012-09-01

The production process plan design and configurations of reconfigurable machine tool (RMT) interact with each other. Reasonable process plans with suitable configurations of RMT help to improve product quality and reduce production cost. Therefore, a cooperative strategy is needed to concurrently solve the above issue. In this paper, the cooperative optimization model for RMT configurations and production process plan is presented. Its objectives take into account both impacts of process and configuration. Moreover, a novel genetic algorithm is also developed to provide optimal or near-optimal solutions: firstly, its chromosome is redesigned which is composed of three parts, operations, process plan and configurations of RMTs, respectively; secondly, its new selection, crossover and mutation operators are also developed to deal with the process constraints from operation processes (OP) graph, otherwise these operators could generate illegal solutions violating the limits; eventually the optimal configurations for RMT under optimal process plan design can be obtained. At last, a manufacturing line case is applied which is composed of three RMTs. It is shown from the case that the optimal process plan and configurations of RMT are concurrently obtained, and the production cost decreases 6.28% and nonmonetary performance increases 22%. The proposed method can figure out both RMT configurations and production process, improve production capacity, functions and equipment utilization for RMT.

Improving the Transportation Planning Process in Small Cities : Volumes 1-3.

DOT National Transportation Integrated Search

1973-11-01

An advance in the state-of-the-art of municipal transportation planning is described. A planning process that fully considers community value and land use was designed by and for the City of Cambridge with the expectation that such a process could al...

Tracking the Short Term Planning (STP) Development Process

NASA Technical Reports Server (NTRS)

Price, Melanie; Moore, Alexander

2010-01-01

Part of the National Aeronautics and Space Administration?s mission is to pioneer the future in space exploration, scientific discovery and aeronautics research is enhanced by discovering new scientific tools to improve life on earth. Sequentially, to successfully explore the unknown, there has to be a planning process that organizes certain events in the right priority. Therefore, the planning support team has to continually improve their processes so the ISS Mission Operations can operate smoothly and effectively. The planning support team consists of people in the Long Range Planning area that develop timelines that includes International Partner?s Preliminary STP inputs all the way through to publishing of the Final STP. Planning is a crucial part of the NASA community when it comes to planning the astronaut?s daily schedule in great detail. The STP Process is in need of improvement, because of the various tasks that are required to be broken down in order to get the overall objective of developing a Final STP done correctly. Then a new project came along in order to store various data in a more efficient database. "The SharePoint site is a Web site that provides a central storage and collaboration space for documents, information, and ideas."

MO-F-CAMPUS-T-02: An Electronic Whiteboard Platform to Manage Treatment Planning Process

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

DiCostanzo, D; Woollard, J; Gupta, N

2015-06-15

Purpose: In an effort to improve patient safety and streamline the radiotherapy treatment planning (TP) process, a software based whiteboard had been developed and put in use in our facility Methods: The electronic whiteboard developed using SQL database (DB) and PHP/JavaScript based web interface, is published via department intranet and login credentials. The DB stores data for each TP process such as patient information, plan type, simulation/start dates, physician, dosimetrist, QA and the current status in planning process. Users interact with the DB per plan and perform status updates in real time as the planning process progresses. All user interactionsmore » with the DB are recorded with timestamps so as to calculate statistical information for TP process management such as contouring times, planning and review times, dosimetry, physics and therapist QA times. External beam and brachytherapy plans are categorized according to complexity (ex: IMRT, 3D, HDR, LDR etc) and treatment types and applicators. Each plan category is assigned specific timelines for each planning process. When a plan approaches or passes the predetermined timeline, users are alerted via color coded graphical cues. When certain process items are not completed in time, pre-determined actions are triggered such as a delay in treatment start date. Results: Our institution has been using the electronic whiteboard for two years. Implementation of pre-determined actions based on the statistical information collected by the whiteboard improved our TP process. For example, the average time for normal tissue contouring decreased from 0.73±1.37 to 0.24±0.33 days. The average time for target volume contouring decreased from 3.2±2.84 to 2.37±2.54 days. This increase in efficiency allows more time for quality assurance processes, improving patient safety. Conclusion: The electronic whiteboard has been an invaluable tool for streamlining our TP processes. It facilitates timely and accurate communication between all parties involved in the TP process increasing patient safety.« less

Improving the Way Higher Education Institutions Study Themselves: Use and Impact of Academic Improvement Systems. Professional File. Number 118, Fall 2010

ERIC Educational Resources Information Center

Bender, Kim K.; Jonson, Jessica L.; Siller, Thomas J.

2010-01-01

Can higher education institutions continue using planning and self-evaluation processes that are decades old without any reform? Several recent monographs urge institutions to embrace continuous improvement processes that engage systematic planning and department self-evaluation across whole campuses, but they do not show institutions how to do…

Introduction of novel 3D-printed superficial applicators for high-dose-rate skin brachytherapy.

PubMed

Jones, Emma-Louise; Tonino Baldion, Anna; Thomas, Christopher; Burrows, Tom; Byrne, Nick; Newton, Victoria; Aldridge, Sarah

Custom-made surface mold applicators often allow more flexibility when carrying out skin brachytherapy, particularly for small treatment areas with high surface obliquity. They can, however, be difficult to manufacture, particularly if there is a lack of experience in superficial high-dose-rate brachytherapy techniques or with limited resources. We present a novel method of manufacturing superficial brachytherapy applicators utilizing three-dimensional (3D)-printing techniques. We describe the treatment planning process and the process of applicator manufacture. The treatment planning process, with the introduction of a pre-plan, allows for an "ideal" catheter arrangement within an applicator to be determined, exploiting varying catheter orientations, heights, and curvatures if required. The pre-plan arrangement is then 3D printed to the exact specifications of the pre-plan applicator design. This results in improved target volume coverage and improved sparing of organs at risk. Using a pre-plan technique for ideal catheter placement followed by automated 3D-printed applicator manufacture has greatly improved the entire process of superficial high-dose-rate brachytherapy treatment. We are able to design and manufacture flexible, well-fitting, superior quality applicators resulting in a more efficient and improved patient pathway and patient experience. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Transportation improvement program : Richland, Ohio : fiscal year 1997-2000

DOT National Transportation Integrated Search

1996-06-01

As part of the Urban Transportation Planning Process, under the Federal Planning regulations (Title 23 U.S.C. and Title 49 U.S.C.), the Metropolitan Planning Organization (MPO) is required to develop and keep current a Transportation Improvement Prog...

Integrated Strategic Planning in a Learning-Centered Community College

ERIC Educational Resources Information Center

Kelley, Susan; Kaufman, Roger

2007-01-01

In learning-centered community colleges, planning, like all processes, must measurably improve learning and learner performance. This article shares Valencia Community College's approach to revising its strategic planning process based on the Organizational Elements Model to: 1) focus strategic planning on learning results that add value for…

Business process modeling for the Virginia Department of Transportation : a demonstration with the integrated six-year improvement program and the statewide transportation improvement program.

DOT National Transportation Integrated Search

2005-01-01

This effort demonstrates business process modeling to describe the integration of particular planning and programming activities of a state highway agency. The motivations to document planning and programming activities are that: (i) resources for co...

Using IT to improve quality at NewYork-Presybterian Hospital: a requirements-driven strategic planning process.

PubMed

Kuperman, Gilad J; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D; Cooper, Mary

2006-01-01

At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality.

Using IT to Improve Quality at NewYork-Presybterian Hospital: A Requirements-Driven Strategic Planning Process

PubMed Central

Kuperman, Gilad J.; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D.; Cooper, Mary

2006-01-01

At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality. PMID:17238381

34 CFR 200.41 - School improvement plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for participating in that professional development; and (iii) Incorporates teacher mentoring...) Within 45 days of receiving a school improvement plan, the LEA must— (i) Establish a peer-review process...

Business process modeling for the Virginia Department of Transportation : a demonstration with the integrated six-year improvement program and the statewide transportation improvement program : executive summary.

DOT National Transportation Integrated Search

2005-01-01

This effort demonstrates business process modeling to describe the integration of particular planning and programming activities of a state highway agency. The motivations to document planning and programming activities are that: (i) resources for co...

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)

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

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2010

2010-01-01

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

SU-F-T-453: Improved Head and Neck SBRT Treatment Planning Using PlanIQ

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

Wang, H; Wang, C; Phan, J

Purpose: Treatment planning for Head and Neck(HN) re-irradiation is a challenge because of ablative doses to target volume and strict critical structure constraints. PlanIQ(Sun Nuclear Corporation) can assess the feasibility of clinical goals and quantitatively measure plan quality. Here, we assess whether incorporation of PlanIQ in our SBRT treatment planning process can improve plan quality and planning efficiency. Methods: From 2013–2015, 35 patients (29 retrospective, 6 prospective) with recurrent HN tumors were treated with SBRT using VMAT treatment plans. The median prescription dose was 45 Gy in 5 fractions. We retrospectively reviewed the treatment plans and physician directives of ourmore » first 29 patients and generated score functions of the dosimetric goals used in our practice and obtained a baseline histogram. We then re-optimized 12 plans that had potential to further reduce organs-at-risk (OAR) doses according to PlanIQ feasibility DVH and plan quality analysis and compared them to the original plans. We applied our new PlanIQ-assisted planning process for our 6 most recently treated patients and evaluated the plan quality and planning efficiency. Results: The mean plan quality metric(PQM) and feasibility adjusted PQM(APQM) scores of our initial 29 treatment plans were 77.1±13.1 and 88.7±11.9, respectively (0–100 scale). The PQM and APQM scores for the 12 optimized plans improved from 75.9±11.0 and 85.1±10.2 to 80.7±9.3 and 90.2±8.0, respectively (p<0.005). Using our newly developed PlanIQ-assisted planning process, the PQM and APQM scores for the 6 most recently treated patients were 93.6±6.5 and 99.1±0.6, respectively. The planning goals were more straightforward to minimize OAR doses during optimization, thus less planning and revision time were used than before. Conclusion: PlanIQ has the potential to provide achievable planning goals and also improve plan quality and planning efficiency.« less

Strategic Planning for Educational Reform and Improvement.

ERIC Educational Resources Information Center

D'Amico, Joseph J.

1988-01-01

Defines strategic planning, outlines its key elements and activities, and summarizes the difficulties of applying a top-down, profit-driven process to education. Explains Strategic Planning for Educational Reform and Improvement (SPERI), a set of manageable, concise procedures for top school administrators. Describes SPERI applications in an…

Coupling the biophysical and social dimensions of wildfire risk to improve wildfire mitigation planning

Treesearch

Alan A. Ager; Jeffrey D. Kline; A. Paige Fisher

2015-01-01

We describe recent advances in biophysical and social aspects of risk and their potential combined contribution to improve mitigation planning on fire-prone landscapes. The methods and tools provide an improved method for defining the spatial extent of wildfire risk to communities compared to current planning processes. They also propose an expanded role for social...

Climate Assessment for Army Enterprise Planning Fact Sheet

DTIC Science & Technology

2017-11-30

decision metric values that affect Army enterprise planning decisions . The payoff of this research improved planning processes for...portions of the processes . 1D. Approach The research approach identified and developed advanced decision metrics that quantified climate...fundamental physical and ecological processes to climate change for each of the decision metrics. Where there is significant interaction among

A cluster randomised controlled trial and process evaluation of a training programme for mental health professionals to enhance user involvement in care planning in service users with severe mental health issues (EQUIP): study protocol for a randomised controlled trial.

PubMed

Bower, Peter; Roberts, Chris; O'Leary, Neil; Callaghan, Patrick; Bee, Penny; Fraser, Claire; Gibbons, Chris; Olleveant, Nicola; Rogers, Anne; Davies, Linda; Drake, Richard; Sanders, Caroline; Meade, Oonagh; Grundy, Andrew; Walker, Lauren; Cree, Lindsey; Berzins, Kathryn; Brooks, Helen; Beatty, Susan; Cahoon, Patrick; Rolfe, Anita; Lovell, Karina

2015-08-13

Involving service users in planning their care is at the centre of policy initiatives to improve mental health care quality in England. Whilst users value care planning and want to be more involved in their own care, there is substantial empirical evidence that the majority of users are not fully involved in the care planning process. Our aim is to evaluate the effectiveness and cost-effectiveness of training for mental health professionals in improving user involvement with the care planning processes. This is a cluster randomised controlled trial of community mental health teams in NHS Trusts in England allocated either to a training intervention to improve user and carer involvement in care planning or control (no training and care planning as usual). We will evaluate the effectiveness of the training intervention using a mixed design, including a 'cluster cohort' sample, a 'cluster cross-sectional' sample and process evaluation. Service users will be recruited from the caseloads of care co-ordinators. The primary outcome will be change in self-reported involvement in care planning as measured by the validated Health Care Climate Questionnaire. Secondary outcomes include involvement in care planning, satisfaction with services, medication side-effects, recovery and hope, mental health symptoms, alliance/engagement, well-being and quality of life. Cost- effectiveness will also be measured. A process evaluation informed by implementation theory will be undertaken to assess the extent to which the training was implemented and to gauge sustainability beyond the time-frame of the trial. It is hoped that the trial will generate data to inform mental health care policy and practice on care planning. ISRCTN16488358 (14 May 2014).

A Model for Long Range Planning for Seminole Community College.

ERIC Educational Resources Information Center

Miner, Norris

A model for long-range planning designed to maximize involvement of college personnel, to improve communication among various areas of the college, to provide a process for evaluation of long-range plans and the planning process, to adjust to changing conditions, to utilize data developed at a level useful for actual operations, and to have…

The effectiveness of CCDSR learning model to improve skills of creating lesson plan and worksheet science process skill (SPS) for pre-service physics teacher

NASA Astrophysics Data System (ADS)

Limatahu, I.; Sutoyo, S.; Wasis; Prahani, B. K.

2018-03-01

In the previous research, CCDSR (Condition, Construction, Development, Simulation, and Reflection) learning model has been developed to improve science process skills for pre-service physics teacher. This research is aimed to analyze the effectiveness of CCDSR learning model towards the improvement skills of creating lesson plan and worksheet of Science Process Skill (SPS) for pre-service physics teacher in academic year 2016/2017. This research used one group pre-test and post-test design on 12 pre-service physics teacher at Physics Education, University of Khairun. Data collection was conducted through test and observation. Creating lesson plan and worksheet SPS skills of pre-service physics teacher measurement were conducted through Science Process Skill Evaluation Sheet (SPSES). The data analysis technique was done by Wilcoxon t-test and n-gain. The CCDSR learning model consists of 5 phases, including (1) Condition, (2) Construction, (3) Development, (4) Simulation, and (5) Reflection. The results showed that there was a significant increase in creating lesson plan and worksheet SPS skills of pre-service physics teacher at α = 5% and n-gain average of moderate category. Thus, the CCDSR learning model is effective for improving skills of creating lesson plan and worksheet SPS for pre-service physics teacher.

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

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

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2012

2012-01-01

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

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

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2011

2011-01-01

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

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

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2006

2006-01-01

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

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.

Conservation Action Planning: Lessons learned from the St. Marys River watershed biodiversity conservation planning process

USGS Publications Warehouse

Patterson, Tamatha A.; Grundel, Ralph

2014-01-01

Conservation Action Planning (CAP) is an adaptive management planning process refined by The Nature Conservancy (TNC) and embraced worldwide as the Open Standards for the Practice of Conservation. The CAP process facilitates open, multi-institutional collaboration on a common conservation agenda through organized actions and quantified results. While specifically designed for conservation efforts, the framework is adaptable and flexible to multiple scales and can be used for any collaborative planning effort. The CAP framework addresses inception; design and development of goals, measures, and strategies; and plan implementation and evaluation. The specific components of the CAP include defining the project scope and conservation targets; assessing the ecological viability; ascertaining threats and surrounding situation; identifying opportunities and designing strategies for action; and implementing actions and monitoring results. In 2007, TNC and a multidisciplinary graduate student team from the University of Michigan's School of Natural Resources and Environment initiated a CAP for the St. Marys River, the connecting channel between Lake Superior and Lake Huron, and its local watershed. The students not only gained experience in conservation planning, but also learned lessons that notably benefited the CAP process and were valuable for any successful collaborative effort—a dedicated core team improved product quality, accelerated the timeline, and provided necessary support for ongoing efforts; an academic approach in preparation for engagement in the planning process brought applicable scientific research to the forefront, enhanced workshop facilitation, and improved stakeholder participation; and early and continuous interactions with regional stakeholders improved cooperation and built a supportive network for collaboration.

Process Evaluation for Improving K12 Program Effectiveness: Case Study of a National Institutes of Health Building Interdisciplinary Research Careers in Women's Health Research Career Development Program.

PubMed

Raymond, Nancy C; Wyman, Jean F; Dighe, Satlaj; Harwood, Eileen M; Hang, Mikow

2018-06-01

Process evaluation is an important tool in quality improvement efforts. This article illustrates how a systematic and continuous evaluation process can be used to improve the quality of faculty career development programs by using the University of Minnesota's Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 program as an exemplar. Data from a rigorous process evaluation incorporating quantitative and qualitative measurements were analyzed and reviewed by the BIRCWH program leadership on a regular basis. Examples are provided of how this evaluation model and processes were used to improve many aspects of the program, thereby improving scholar, mentor, and advisory committee members' satisfaction and scholar outcomes. A rigorous evaluation plan can increase the effectiveness and impact of a research career development plan.

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

PubMed

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

2012-01-01

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

Assessing the impact of the U.S. Endangered Species Act recovery planning guidelines on managing threats for listed species.

PubMed

Troyer, Caitlin M; Gerber, Leah R

2015-10-01

The Endangered Species Act (ESA) of the United States was enacted in 1973 to prevent the extinction of species. Recovery plans, required by 1988 amendments to the ESA, play an important role in organizing these efforts to protect and recover species. To improve the use of science in the recovery planning process, the Society for Conservation Biology (SCB) commissioned an independent review of endangered species recovery planning in 1999. From these findings, the SCB made key recommendations for how management agencies could improve the recovery planning process, after which the U.S. Fish and Wildlife Service and the National Marine Fisheries Service redrafted their recovery planning guidelines. One important recommendation called for recovery plans to make threats a primary focus, including organizing and prioritizing recovery tasks for threat abatement. We sought to determine the extent to which results from the SCB study were incorporated into these new guidelines and whether the SCB recommendations regarding threats manifested in recovery plans written under the new guidelines. Recovery planning guidelines generally incorporated the SCB recommendations, including those for managing threats. However, although recent recovery plans have improved in their treatment of threats, many fail to adequately incorporate threat monitoring. This failure suggests that developing clear guidelines for monitoring should be an important priority in improving ESA recovery planning. © 2015 Society for Conservation Biology.

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. ...

Alaska Statewide Plan for Postsecondary Education, 1986-1990: A Draft for Public Comment. Volume I.

ERIC Educational Resources Information Center

Alaska State Commission on Postsecondary Education, Juneau.

This report, the first statewide master plan for postsecondary education in Alaska, outlines strategies and recommendations to achieve the following planning goals: (1) promote excellence to improve educational service; (2) enhance accountability of the educational process; (3) foster efficiency within the enterprise; and (4) improve access to…

The Team Process: Realizing Effective Group Work and Enhancing School Improvement Plans (S.I.P.).

ERIC Educational Resources Information Center

Beiter, David J.; And Others

The use of the team process in school improvement plans may play a role in how effective the group is in achieving its goals and objectives. Representative efforts and perceptions of the use of teams in local educational agencies were surveyed in multiple measurements, such as interviews, self-assessments, self-perceptions, and observations. The…

Five-Year Plan (FY04-FY-08) for the Manufacturing Technology (ManTech) Program. Supplement to the FY03 - FY07 Plan

DTIC Science & Technology

2003-07-01

magnetorheological (MRF) finishing to reduce surface roughness in half the time of previous processes . Improved image quality directly supports improved...affordably polish the inside surface of small tight free form optics to a finish on the order of 3 angstroms. • Demonstrate cycle time reduction...processes and controls for steel, titanium, and superalloys. FY2007: • Demonstrate an improved superfine finishing for optical components to

Efficiency improvements of offline metrology job creation

NASA Astrophysics Data System (ADS)

Zuniga, Victor J.; Carlson, Alan; Podlesny, John C.; Knutrud, Paul C.

1999-06-01

Progress of the first lot of a new design through the production line is watched very closely. All performance metrics, cycle-time, in-line measurement results and final electrical performance are critical. Rapid movement of this lot through the line has serious time-to-market implications. Having this material waiting at a metrology operation for an engineer to create a measurement job plan wastes valuable turnaround time. Further, efficient use of a metrology system is compromised by the time required to create and maintain these measurement job plans. Thus, having a method to develop metrology job plans prior to the actual running of the material through the manufacture area can significantly improve both cycle time and overall equipment efficiency. Motorola and Schlumberger have worked together to develop and test such a system. The Remote Job Generator (RJG) created job plans for new device sin a manufacturing process from an NT host or workstation, offline. This increases available system tim effort making production measurements, decreases turnaround time on job plan creation and editing, and improves consistency across job plans. Most importantly this allows job plans for new devices to be available before the first wafers of the device arrive at the tool for measurement. The software also includes a database manager which allows updates of existing job plans to incorporate measurement changes required by process changes or measurement optimization. This paper will review the result of productivity enhancements through the increased metrology utilization and decreased cycle time associated with the use of RJG. Finally, improvements in process control through better control of Job Plans across different devices and layers will be discussed.

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.

PLANiTS : structuring and supporting the intelligent transportation systems planning process

DOT National Transportation Integrated Search

1997-01-01

PLANiTS (Planning and Analysis Integration for Intelligent Transportation Systems) is a process-based computer system that supports a series of mutually interdependent steps progressing toward developing and programming transportation improvement pro...

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

Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

PubMed

Saari, Chelsey K

The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

Some Reflections on Strategic Planning in Public Libraries.

ERIC Educational Resources Information Center

Palmour, Vernon E.

1985-01-01

Presents the Public Library Association's planning model for strategic planning in public libraries. The development of the model is explained, the basic steps of the planning process are described, and improvements to the model are suggested. (CLB)

Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions.

PubMed

Trusty, Phillip M; Slesnick, Timothy C; Wei, Zhenglun Alan; Rossignac, Jarek; Kanter, Kirk R; Fogel, Mark A; Yoganathan, Ajit P

2018-04-01

The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.

Factors affecting strategic plan implementation using interpretive structural modeling (ISM).

PubMed

Bahadori, Mohammadkarim; Teymourzadeh, Ehsan; Tajik, Hamidreza; Ravangard, Ramin; Raadabadi, Mehdi; Hosseini, Seyed Mojtaba

2018-06-11

Purpose Strategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM). Design/methodology/approach The authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM. Findings Five main factors affected strategic plan implementation. Although all five variables and factors are top level, "senior manager awareness and participation in the strategic planning process" and "creating and maintaining team participation in the strategic planning process" had maximum drive power. "Organizational structure effects on the strategic planning process" and "Organizational culture effects on the strategic planning process" had maximum dependence power. Practical implications Identifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers. Originality/value The authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

Improving Hospital Discharge Planning for Elderly Patients

PubMed Central

Potthoff, Sandra; Kane, Robert L.; Franco, Sheila J.

1997-01-01

Hospital discharge planning has become increasingly important in an era of prospective payment and managed care. Given the changes in tasks, decisions, and environments involved, it is important to identify how to move such planning from an art to an empirically based decisionmaking process. The authors use a decision-sciences framework to review the state-of-the-art of hospital discharge planning and to suggest methods for improvement. PMID:10345406

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

Incorporating ITS solutions into the metropolitan transportation planning process : overcoming institutional barriers

DOT National Transportation Integrated Search

2000-11-01

There are three conditions that help bring ITS solutions into the metropolitan transportation planning process: Condition 1: Endorsement of ITS by Elected Officials and Transportation Managers Condition 2: Improved Communication and Coordination Acro...

Use of automated rendezvous trajectory planning to improve spacecraft operations efficiency

NASA Technical Reports Server (NTRS)

Mulder, Tom A.

1991-01-01

The current planning process for space shuttle rendezvous with a second Earth-orbiting vehicle is time consuming and costly. It is a labor-intensive, manual process performed pre-mission with the aid of specialized maneuver processing tools. Real-time execution of a rendezvous plan must closely follow a predicted trajectory, and targeted solutions leading up to the terminal phase are computed on the ground. Despite over 25 years of Gemini, Apollo, Skylab, and shuttle vehicle-to-vehicle rendezvous missions flown to date, rendezvous in Earth orbit still requires careful monitoring and cannot be taken for granted. For example, a significant trajectory offset was experienced during terminal phase rendezvous of the STS-32 Long Duration Exposure Facility retrieval mission. Several improvements can be introduced to the present rendezvous planning process to reduce costs, produce more fuel-efficient profiles, and increase the probability of mission success.

A methodology for automatic intensity-modulated radiation treatment planning for lung cancer

NASA Astrophysics Data System (ADS)

Zhang, Xiaodong; Li, Xiaoqiang; Quan, Enzhuo M.; Pan, Xiaoning; Li, Yupeng

2011-07-01

In intensity-modulated radiotherapy (IMRT), the quality of the treatment plan, which is highly dependent upon the treatment planner's level of experience, greatly affects the potential benefits of the radiotherapy (RT). Furthermore, the planning process is complicated and requires a great deal of iteration, and is often the most time-consuming aspect of the RT process. In this paper, we describe a methodology to automate the IMRT planning process in lung cancer cases, the goal being to improve the quality and consistency of treatment planning. This methodology (1) automatically sets beam angles based on a beam angle automation algorithm, (2) judiciously designs the planning structures, which were shown to be effective for all the lung cancer cases we studied, and (3) automatically adjusts the objectives of the objective function based on a parameter automation algorithm. We compared treatment plans created in this system (mdaccAutoPlan) based on the overall methodology with plans from a clinical trial of IMRT for lung cancer run at our institution. The 'autoplans' were consistently better, or no worse, than the plans produced by experienced medical dosimetrists in terms of tumor coverage and normal tissue sparing. We conclude that the mdaccAutoPlan system can potentially improve the quality and consistency of treatment planning for lung cancer.

Modeling efficiency at the process level: an examination of the care planning process in nursing homes.

PubMed

Lee, Robert H; Bott, Marjorie J; Gajewski, Byron; Taunton, Roma Lee

2009-02-01

To examine the efficiency of the care planning process in nursing homes. We collected detailed primary data about the care planning process for a stratified random sample of 107 nursing homes from Kansas and Missouri. We used these data to calculate the average direct cost per care plan and used data on selected deficiencies from the Online Survey Certification and Reporting System to measure the quality of care planning. We then analyzed the efficiency of the assessment process using corrected ordinary least squares (COLS) and data envelopment analysis (DEA). Both approaches suggested that there was considerable inefficiency in the care planning process. The average COLS score was 0.43; the average DEA score was 0.48. The correlation between the two sets of scores was quite high, and there was no indication that lower costs resulted in lower quality. For-profit facilities were significantly more efficient than not-for-profit facilities. Multiple studies of nursing homes have found evidence of inefficiency, but virtually all have had measurement problems that raise questions about the results. This analysis, which focuses on a process with much simpler measurement issues, finds evidence of inefficiency that is largely consistent with earlier studies. Making nursing homes more efficient merits closer attention as a strategy for improving care. Increasing efficiency by adopting well-designed, reliable processes can simultaneously reduce costs and improve quality.

State landscape in public health planning and quality improvement: results of the ASTHO survey.

PubMed

Madamala, Kusuma; Sellers, Katie; Pearsol, Jim; Dickey, Michael; Jarris, Paul E

2010-01-01

Limited data exist on state public health agencies and their use of planning and quality improvement (QI) initiatives. Using the 2007 Association of State and Territorial Health Officials (ASTHO) State Public Health Survey, this article describes how state public health agencies perform tasks related to planning, performance management (PM), and QI. While 82 percent of respondents report having a QI process in place, only 9.8 percent have it fully implemented departmentwide. Seventy-six percent reported having a PM process in place, with 16 percent (n = 8) having it fully implemented departmentwide. A state health improvement plan was used by 80.4 percent of respondents, with 56.9 percent of respondents completing the plan more than 3 years ago. More than two-thirds (68.2%) of the respondents developed the plan by using results of their state health assessment. Analysis of state health department level planning, PM, and QI initiatives can inform states' efforts to ready themselves to meet the proposed national voluntary accreditation standards of the Public Health Accreditation Board.

Report: Improved Acquisition Planning Will Help EPA Reduce Hundreds of Millions of Dollars in High-Risk Contracts

EPA Pesticide Factsheets

Report #18-P-0038, November 15, 2017. Without improving its acquisition planning process, the EPA may continue to spend hundreds of millions of dollars on high-risk contracts that waste taxpayer resources.

Customers First: Using Process Improvement To Improve Service Quality and Efficiency.

ERIC Educational Resources Information Center

Larson, Catherine A.

1998-01-01

Describes steps in a process-improvement project for reserve book services at the University of Arizona Library: (1) plan--identify process boundaries and customer requirements, gather/analyze data, prioritize problems; (2) do--encourage divergent thinking, reach convergent thinking, find solutions; (3) check--pilot solutions, compare costs; and…

Participatory System Dynamics Modeling: Increasing Stakeholder Engagement and Precision to Improve Implementation Planning in Systems.

PubMed

Zimmerman, Lindsey; Lounsbury, David W; Rosen, Craig S; Kimerling, Rachel; Trafton, Jodie A; Lindley, Steven E

2016-11-01

Implementation planning typically incorporates stakeholder input. Quality improvement efforts provide data-based feedback regarding progress. Participatory system dynamics modeling (PSD) triangulates stakeholder expertise, data and simulation of implementation plans prior to attempting change. Frontline staff in one VA outpatient mental health system used PSD to examine policy and procedural "mechanisms" they believe underlie local capacity to implement evidence-based psychotherapies (EBPs) for PTSD and depression. We piloted the PSD process, simulating implementation plans to improve EBP reach. Findings indicate PSD is a feasible, useful strategy for building stakeholder consensus, and may save time and effort as compared to trial-and-error EBP implementation planning.

[Redesigning the hospital discharge process].

PubMed

Martínez-Ramos, M; Flores-Pardo, E; Uris-Sellés, J

2016-01-01

The aim of this article is to show that the redesign and planning process of hospital discharge advances the departure time of the patient from a hospital environment. Quasi-experimental study conducted from January 2011 to April 2013, in a local hospital. The cases analysed were from medical and surgical nursing units. The process was redesigned to coordinate all the professionals involved in the process. The hospital discharge improvement process improvement was carried out by forming a working group, the analysis of retrospective data, identifying areas for improvement, and its redesign. The dependent variable was the time of patient administrative discharge. The sample was classified as pre-intervention, inter-intervention, and post-intervention, depending on the time point of the study. The final sample included 14,788 patients after applying the inclusion and exclusion criteria. The mean discharge release time decreased significantly by 50 min between pre-intervention and post-intervention periods. The release time in patients with planned discharge was one hour and 25 min less than in patients with unplanned discharge. Process redesign is a useful strategy to improve the process of hospital discharge. Besides planning the discharge, it is shown that the patient leaving the hospital before 12 midday is a key factor. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Kennedy Space Center Orion Processing Team Planning for Ground Operations

NASA Technical Reports Server (NTRS)

Letchworth, Gary; Schlierf, Roland

2011-01-01

Topics in this presentation are: Constellation Ares I/Orion/Ground Ops Elements Orion Ground Operations Flow Orion Operations Planning Process and Toolset Overview, including: 1 Orion Concept of Operations by Phase 2 Ops Analysis Capabilities Overview 3 Operations Planning Evolution 4 Functional Flow Block Diagrams 5 Operations Timeline Development 6 Discrete Event Simulation (DES) Modeling 7 Ground Operations Planning Document Database (GOPDb) Using Operations Planning Tools for Operability Improvements includes: 1 Kaizen/Lean Events 2 Mockups 3 Human Factors Analysis

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.

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2012 CFR

2012-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2013 CFR

2013-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2014 CFR

2014-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2011 CFR

2011-07-01

... minimizing the use of natural resources, and by improving planning and decision-making processes to avoid...) Integrating the NEPA process in the early stages of planning to ensure that decisions reflect environmental... site. The exclusion applies only if: (i) The structure and proposed use comply with local planning and...

SU-E-T-760: Tolerance Design for Site-Specific Range in Proton Patient QA Process Using the Six Sigma Model

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

Lah, J; Shin, D; Kim, G

Purpose: To show how tolerance design and tolerancing approaches can be used to predict and improve the site-specific range in patient QA process in implementing the Six Sigma. Methods: In this study, patient QA plans were selected according to 6 site-treatment groups: head &neck (94 cases), spine (76 cases), lung (89 cases), liver (53 cases), pancreas (55 cases), and prostate (121 cases), treated between 2007 and 2013. We evaluated a model of the Six Sigma that determines allowable deviations in design parameters and process variables in patient-specific QA, where possible, tolerance may be loosened, then customized if it necessary tomore » meet the functional requirements. A Six Sigma problem-solving methodology is known as DMAIC phases, which are used stand for: Define a problem or improvement opportunity, Measure process performance, Analyze the process to determine the root causes of poor performance, Improve the process by fixing root causes, Control the improved process to hold the gains. Results: The process capability for patient-specific range QA is 0.65 with only ±1 mm of tolerance criteria. Our results suggested the tolerance level of ±2–3 mm for prostate and liver cases and ±5 mm for lung cases. We found that customized tolerance between calculated and measured range reduce that patient QA plan failure and almost all sites had failure rates less than 1%. The average QA time also improved from 2 hr to less than 1 hr for all including planning and converting process, depth-dose measurement and evaluation. Conclusion: The objective of tolerance design is to achieve optimization beyond that obtained through QA process improvement and statistical analysis function detailing to implement a Six Sigma capable design.« less

Advance care planning in a community setting.

PubMed

Connolly, Josaleen; Milligan, Stuart; Stevens, Elaine; Jackson, Susan; Rooney, Kevin

2015-02-10

To evaluate the effects of implementing an advance care planning process within pilot sites in North Ayrshire in 2010, focusing on people with palliative care needs. Data were collected from participants in advance care planning training using a questionnaire. Semi-structured interviews were conducted and an audit of documentation was undertaken. Thirty nine questionnaires were returned, a response rate of 16%. Twenty four out of 25 (96%) participants rated the training as having improved their understanding of the advance care planning process. The general consensus in interviews was that advance care planning is a worthwhile process. Participants reported patients achieving their preferred place of end of life care and greater consultation regarding hospitalisation. Within the pilot sites, advance care planning training enhanced the ability of professionals to implement the advance care planning process and record the wishes of patients and residents.

Strategic planning as a focus for continuous improvement. A case study

NASA Technical Reports Server (NTRS)

Oneill, John W.; Gordon-Winkler, Lyn

1992-01-01

What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

Strategic planning as a focus for continuous improvement. A case study

NASA Astrophysics Data System (ADS)

Oneill, John W.; Gordon-Winkler, Lyn

What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

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,…

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…

Effects of planning strategies on writing dynamics and final texts.

PubMed

Limpo, Teresa; Alves, Rui A

2018-06-12

Expert writing involves the interaction among three cognitively demanding processes: planning, translating, and revising. To manage the cognitive load brought on by these processes, writers frequently use strategies. Here, we examined the effects of planning strategies on writing dynamics and final texts. Before writing an argumentative text with the triple-task technique, 63 undergraduates were asked either to elaborate an outline with the argumentative structure embedded (structure-based planning condition), to provide a written list of ideas for the text (list-based planning condition), or to do a non-writing-related filler task (no planning condition). Planning showed no effects on the length of the pre-writing pause and cognitive effort, but influenced writing processes occurrences. Compared to participants in the no-planning condition, those in the planning conditions showed a later activation of revising. Moreover, participants in the structure-based condition were mainly focused on translating in the beginning and middle of composition, whereas their peers tended to distribute their attention among all processes. Planning ahead of writing also resulted in texts with longer words, produced at a higher rate. Only the structure-based planning strategy led to an increase in the number of argumentation elements as well as in essays' persuasiveness and overall quality. There was, however, no indication that these improvements in final texts were associated with changes in the dynamics of writing. Overall, the use of structure-based plans seems to be an effective and efficient way of improving undergraduates' argumentative writing. Copyright © 2018 Elsevier B.V. All rights reserved.

Special event planning for the emergency manager.

PubMed

Gaynor, Peter T

2009-11-01

In the domain of emergency management and homeland security there is a lack of a formal planning process at the local level when it comes to special event planning. The unique nature of special event planning demands an understanding of the planning process for both traditional and non-traditional planning partners. This understanding will make certain that local governments apply due diligence when planning for the safety of the public. This paper offers a practical roadmap for planning at the local level. It will address those 'special events' that are beyond routine local events but not of a sufficient scale to be granted National Special Security Event status. Due to the infrequency of 'special events' in most communities, it is imperative that deliberate planning takes place. Upon conclusion, the reader will be able to construct a planning process tailored to the needs of their community, guide both traditional and non-traditional planning partners through the planning process, determine priorities, explore alternatives, plan for contingencies, conduct a confirmation brief, facilitate operations and assemble an after-action report and improvement plan.

A Mixed-Methods Approach to Understanding Community Participation in Community Health Needs Assessments.

PubMed

Pennel, Cara L; McLeroy, Kenneth R; Burdine, James N; Matarrita-Cascante, David; Wang, Jia

Nonprofit hospitals are exempt from paying taxes. To maintain this status, they must provide benefit to the community they serve. In an attempt to improve accountability to these communities and the federal government, the Patient Protection and Affordable Care Act of 2010 includes a provision that requires all nonprofit hospitals to conduct a community health needs assessment (CHNA) and implement strategies to address identified health priorities every 3 years. This Act's provision, operationalized by a regulation developed and enforced by the Internal Revenue Service, mandates the involvement of public health agencies and other community stakeholders in the completion of the CHNA. To better understand community participation in nonprofit hospital-directed community health assessment and health improvement planning activities. Using a 2-phased, mixed-methods study design, we (1) conducted content analysis of 95 CHNA/implementation plan reports and (2) interviewed hospital and health system key informants, consultants, and community stakeholders involved in CHNA and planning processes. Community participation was assessed in terms of types of stakeholders involved and the depth of their involvement. Our findings suggest that many hospitals engaged and involved community stakeholders in certain aspects of the assessment process, but very few engaged a broad array of community stakeholder and community members in meaningful participation throughout the CHNA and health improvement planning process. Vast improvements in community participation and collaborative assessment and planning can be made in future CHNAs. On the basis of the findings, recommendations are made for further research. Practice implications include expanding community engagement and participation by stakeholder and activity type and using a common community health improvement model that better aligns hospital CHNA processes and implementation strategies with other organizations and agencies.

ITS/CVO strategic & business plan for the state of Georgia

DOT National Transportation Integrated Search

1998-05-01

This document records the State of Georgias strategic and tactical plans for employing ITS/CVO technology to improve its Commercial Vehicle Administration (CVA) functions. The process by which this plan was developed included a detailed assessment...

Building Consistency between Title, Problem Statement, Purpose, & Research Questions to Improve the Quality of Research Plans and Reports

ERIC Educational Resources Information Center

Newman, Isadore; Covrig, Duane M.

2013-01-01

Consistency in the title, problem, purpose, and research question improve the logic and transparency of research. When these components of research are aligned research design and planning are more coherent and research reports are more readable. This article reviews the process for checking for and improving consistency. Numerous examples of…

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.

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

Planning Alcoholism Services; Participant Workbook.

ERIC Educational Resources Information Center

National Inst. on Alcohol Abuse and Alcoholism (DHEW/PHS), Rockville, MD.

This workbook is designed to build or improve the basic planning skills needed by persons responsible for program planning in alcohol service agencies. An understanding of the generic planning process in the development or expansion of community alcoholism-realted services can be acquired through the use of this guide. The workbook attempts to…

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

Market and plan characteristics related to HMO quality and improvement.

PubMed

Scanlon, Dennis P; Swaminathan, Shailender; Chernew, Michael; Lee, Woolton

2006-12-01

Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.

Improving TOGAF ADM 9.1 Migration Planning Phase by ITIL V3 Service Transition

NASA Astrophysics Data System (ADS)

Hanum Harani, Nisa; Akhmad Arman, Arry; Maulana Awangga, Rolly

2018-04-01

Modification planning of business transformation involving technological utilization required a system of transition and migration planning process. Planning of system migration activity is the most important. The migration process is including complex elements such as business re-engineering, transition scheme mapping, data transformation, application development, individual involvement by computer and trial interaction. TOGAF ADM is the framework and method of enterprise architecture implementation. TOGAF ADM provides a manual refer to the architecture and migration planning. The planning includes an implementation solution, in this case, IT solution, but when the solution becomes an IT operational planning, TOGAF could not handle it. This paper presents a new model framework detail transitions process of integration between TOGAF and ITIL. We evaluated our models in field study inside a private university.

Healthcare Strategic Planning as Part of National and Regional Development in the Israeli Galilee: A Case Study of the Planning Process.

PubMed

Peled, Ronit; Schenirer, Jerry

2009-10-01

This article describes a systematic process of geographic and strategic planning for healthcare services as a part of a regional development plan in the Israeli Galilee. The planning process consisted of three stages: (a) assessment of needs, demand and existing resources; (b) prioritisation of initiatives; and (c) scheduling of theoretical priorities. For many years the region has suffered from inequities and inequalities regarding the availability and accessibility of a regional healthcare system, resulting in high mortality and morbidity rates and low quality of life. The aim of the healthcare strategic plan was to suggest initiatives and actions to be taken in order to improve healthcare provision and the health and wellbeing of local residents.

Multimodal system planning technique : an analytical approach to peak period operation

DOT National Transportation Integrated Search

1995-11-01

The multimodal system planning technique described in this report is an improvement of the methodology used in the Dallas System Planning Study. The technique includes a spreadsheet-based process to identify the costs of congestion, construction, and...

Constellation Mission Operation Working Group: ESMO Maneuver Planning Process Review

NASA Technical Reports Server (NTRS)

Moyer, Eric

2015-01-01

The Earth Science Mission Operation (ESMO) Project created an Independent Review Board to review our Conjunction Risk evaluation process and Maneuver Planning Process to identify improvements that safely manages mission conjunction risks, maintains ground track science requirements, and minimizes overall hours expended on High Interest Events (HIE). The Review Board is evaluating the current maneuver process which requires support by multiple groups. In the past year, there have been several changes to the processes although many prior and new concerns exist. This presentation will discuss maneuver process reviews and Board comments, ESMO assessment and path foward, ESMO future plans, recent changes and concerns.

Strategic Planning: A (Site) Sight-Based Approach to Curriculum and Staff Development.

ERIC Educational Resources Information Center

Johnson, Daniel P.

The purpose of (Colorado's) Clear Creek School District's strategic planning process has been to develop basic district-wide parameters to promote instructional improvement through a process of shared leadership. The approach is termed "sight-based" to indicate the school district's commitment to connecting curriculum and…

Automated IMRT planning with regional optimization using planning scripts

PubMed Central

Wong, Eugene; Bzdusek, Karl; Lock, Michael; Chen, Jeff Z.

2013-01-01

Intensity‐modulated radiation therapy (IMRT) has become a standard technique in radiation therapy for treating different types of cancers. Various class solutions have been developed for simple cases (e.g., localized prostate, whole breast) to generate IMRT plans efficiently. However, for more complex cases (e.g., head and neck, pelvic nodes), it can be time‐consuming for a planner to generate optimized IMRT plans. To generate optimal plans in these more complex cases which generally have multiple target volumes and organs at risk, it is often required to have additional IMRT optimization structures such as dose limiting ring structures, adjust beam geometry, select inverse planning objectives and associated weights, and additional IMRT objectives to reduce cold and hot spots in the dose distribution. These parameters are generally manually adjusted with a repeated trial and error approach during the optimization process. To improve IMRT planning efficiency in these more complex cases, an iterative method that incorporates some of these adjustment processes automatically in a planning script is designed, implemented, and validated. In particular, regional optimization has been implemented in an iterative way to reduce various hot or cold spots during the optimization process that begins with defining and automatic segmentation of hot and cold spots, introducing new objectives and their relative weights into inverse planning, and turn this into an iterative process with termination criteria. The method has been applied to three clinical sites: prostate with pelvic nodes, head and neck, and anal canal cancers, and has shown to reduce IMRT planning time significantly for clinical applications with improved plan quality. The IMRT planning scripts have been used for more than 500 clinical cases. PACS numbers: 87.55.D, 87.55.de PMID:23318393

A knowledge-based approach to improving optimization techniques in system planning

NASA Technical Reports Server (NTRS)

Momoh, J. A.; Zhang, Z. Z.

1990-01-01

A knowledge-based (KB) approach to improve mathematical programming techniques used in the system planning environment is presented. The KB system assists in selecting appropriate optimization algorithms, objective functions, constraints and parameters. The scheme is implemented by integrating symbolic computation of rules derived from operator and planner's experience and is used for generalized optimization packages. The KB optimization software package is capable of improving the overall planning process which includes correction of given violations. The method was demonstrated on a large scale power system discussed in the paper.

Transportation improvement program and air quality conformity determination federal fiscal years 2008-2011

DOT National Transportation Integrated Search

2007-01-01

In order to be eligible for federal funds, urbanized areas are required to maintain a continuing, cooperative, and comprehensive (3C) transportation planning process that results in plans and programs consistent with the planning objectives of the me...

Managing Uncertainty: Thinking and Planning Strategically.

ERIC Educational Resources Information Center

Lorenzo, Albert L.

1993-01-01

Argues that rapid change and tight resources demand reality-based planning, rather than planning models that ignore internal and external customers or emphasize process over product. Describes the Strategic Guidance Model (SGM) which provides colleges with strategic visioning, organizational assessment, environmental scanning, quality improvement,…

Improving cardiac operating room to intensive care unit handover using a standardised handover process.

PubMed

Gleicher, Yehoshua; Mosko, Jeffrey David; McGhee, Irene

2017-01-01

Handovers from the cardiovascular operating room (CVOR) to the cardiovascular intensive care unit (CVICU) are complex processes involving the transfer of information, equipment and responsibility, at a time when the patient is most vulnerable. This transfer is typically variable in structure, content and execution. This variability can lead to the omission and miscommunication of critical information leading to patient harm. We set out to improve the quality of patient handover from the CVOR to the CVICU by introducing a standardised handover protocol. This study is an interventional time-series study over a 4-month period at an adult cardiac surgery centre. A standardised handover protocol was developed using quality improvement methodologies. The protocol included a handover content checklist and introduction of a formal 'sterile cockpit' timeout. Implementation of the protocol was refined using monthly iterative Plan-Do-Study-Act. The primary outcome was the quality of handovers, measured by a Handover Score, comprising handover content, teamwork and patient care planning indicators. Secondary outcomes included handover duration, adherence to the standardised handover protocol and handover team satisfaction surveys. 37 handovers were observed (6 pre intervention and 31 post intervention). The mean handover score increased from 6.5 to 14.0 (maximum 18 points). Specific improvements included fewer handover interruptions and more frequent postoperative patient care planning. Average handover duration increased slightly from 2:40 to 2:57 min. Caregivers noted improvements in teamwork, content received and patient care planning. The majority (>95%) agreed that the intervention was a valuable addition to the CVOR to CVICU handover process. Implementation of a standardised handover protocol for postcardiac surgery patients was associated with fewer interruptions during handover, more reliable transfer of critical content and improved patient care planning.

A systematic strategic planning process focused on improved community engagement by an academic health center: the University of Kansas Medical Center's story.

PubMed

Cook, David C; Nelson, Eve-Lynn; Ast, Cori; Lillis, Teresa

2013-05-01

A growing number of academic health centers (AHCs) are considering approaches to expand collaboration with their communities in order to address complex and multisystem health concerns. In 2010, internal leaders at the University of Kansas Medical Center undertook a strategic planning process to enhance both community engagement activities and the scholarship resulting from these engagement activities. The authors describe the strategic planning process, recommendations, and actions associated with elevating community engagement within the AHC's mission and priorities. The strategic planning process included conducting an inventory of community engagement activities within the AHC; analyzing strengths, weaknesses, opportunities, and threats for community engagement work; and identifying goals and strategies to improve future community engagement activities and scholarship. The resulting road map for enhancing community engagement at their institution through 2015 consists of four main strategies: emphasize scholarship in community engagement, revise organizational structures to better facilitate community engagement, prioritize current engagement activities to ensure appropriate use of resources, and enhance communication of engagement initiatives to further develop stakeholder relationships.The authors also discuss implementation of the plan to date and highlight lessons learned that may inform other AHCs as they enhance and expand similar endeavors.

A Model Schedule for a Capital Improvement Program.

ERIC Educational Resources Information Center

Oates, Arnold D.; Burch, A. Lee

The Model Schedule for a Capital Improvement Program described in this paper encourages school leaders to consider a more holistic view of the planning process. It is intended to assist those responsible for educational facility planning, who must assure that all important and relevant tasks are accomplished in a timely manner. The model's six…

IRQN award paper: Operational rounds: a practical administrative process to improve safety and clinical services in radiology.

PubMed

Donnelly, Lane F; Dickerson, Julie M; Lehkamp, Todd W; Gessner, Kevin E; Moskovitz, Jay; Hutchinson, Sally

2008-11-01

As part of a patient safety program in the authors' department of radiology, operational rounds have been instituted. This process consists of radiology leaders' visiting imaging divisions at the site of imaging and discussing frontline employees' concerns about patient safety, the quality of care, and patient and family satisfaction. Operational rounds are executed at a time to optimize the number of attendees. Minutes that describe the issues identified, persons responsible for improvement, and updated improvement plan status are available to employees online. Via this process, multiple patient safety and other issues have been identified and remedied. The authors believe that the process has improved patient safety, the quality of care, and the efficiency of operations. Since the inception of the safety program, the mean number of days between serious safety events involving radiology has doubled. The authors review the background around such walk rounds, describe their particular program, and give multiple illustrative examples of issues identified and improvement plans put in place.

How can the rehabilitation planning process at the workplace be improved? A qualitative study from employers' perspective.

PubMed

Larsson, Agneta; Gard, Gunvor

2003-09-01

Employers in Sweden are by law responsible for planning and controlling the working environment situation in their companies and for ensuring that any need for rehabilitation is noted as soon as possible and that action is taken. This includes developing a plan for rehabilitation. The aim of this study is to describe employers' experiences of the work rehabilitation planning process at the workplace, and how it can be improved with a focus on quality and cost-effectiveness. Qualitative interviews were performed with 10 employers of employee/s that had participated in vocational rehabilitation at a rehabilitation center in the North of Sweden. The results showed that employers were interested in detecting work rehabilitation needs and in taking action early. Rehabilitation at the workplace could be improved by development of routines, improved work relations and work technique, and environment in-service training at the workplace. Prevention was perceived as a prerequisite for a good result of rehabilitation. Attention to social and geographic conditions is needed. Organizational and financial limitations exist.

Current and planned numerical development for improving computing performance for long duration and/or low pressure transients

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

Faydide, B.

1997-07-01

This paper presents the current and planned numerical development for improving computing performance in case of Cathare applications needing real time, like simulator applications. Cathare is a thermalhydraulic code developed by CEA (DRN), IPSN, EDF and FRAMATOME for PWR safety analysis. First, the general characteristics of the code are presented, dealing with physical models, numerical topics, and validation strategy. Then, the current and planned applications of Cathare in the field of simulators are discussed. Some of these applications were made in the past, using a simplified and fast-running version of Cathare (Cathare-Simu); the status of the numerical improvements obtained withmore » Cathare-Simu is presented. The planned developments concern mainly the Simulator Cathare Release (SCAR) project which deals with the use of the most recent version of Cathare inside simulators. In this frame, the numerical developments are related with the speed up of the calculation process, using parallel processing and improvement of code reliability on a large set of NPP transients.« less

Nursing informatics, outcomes, and quality improvement.

PubMed

Charters, Kathleen G

2003-08-01

Nursing informatics actively supports nursing by providing standard language systems, databases, decision support, readily accessible research results, and technology assessments. Through normalized datasets spanning an entire enterprise or other large demographic, nursing informatics tools support improvement of healthcare by answering questions about patient outcomes and quality improvement on an enterprise scale, and by providing documentation for business process definition, business process engineering, and strategic planning. Nursing informatics tools provide a way for advanced practice nurses to examine their practice and the effect of their actions on patient outcomes. Analysis of patient outcomes may lead to initiatives for quality improvement. Supported by nursing informatics tools, successful advance practice nurses leverage their quality improvement initiatives against the enterprise strategic plan to gain leadership support and resources.

Succession planning: a call to action for nurse executives.

PubMed

Trepanier, Sylvain; Crenshaw, Jeannette T

2013-10-01

To discuss the organisational benefits of strategic succession planning in acute care hospital settings as a responsibility of chief nurse executives. A formal succession planning process is crucial to the financial and operational viability and sustainability of acute care hospitals. A succession plan is an essential business strategy that promotes effective leadership transition and continuity while maintaining productivity. Nursing and business literature were reviewed; reports contrasting institutions with and without succession plans were examined; and, operational implications were considered. It is imperative that chief nurse executives respond to the business benefits of an effective succession planning programme, identify common barriers and solutions, and implement best practices for a successful strategic succession planning programme. A strategic succession planning programme may offer many benefits to an acute care hospital, including improved retention rates, increased staff engagement and enhanced financial performance. Considering the ageing nursing workforce and the potential increase in demand for nursing services in the near future, nurse executives and other nurse leaders must actively engage in a formal succession planning process. A formal succession planning programme will help to provide strategic leadership continuity, operational effectiveness and improved quality of care. © 2013 John Wiley & Sons Ltd.

A strategic planning methodology for aircraft redesign

NASA Astrophysics Data System (ADS)

Romli, Fairuz Izzuddin

Due to a progressive market shift to a customer-driven environment, the influence of engineering changes on the product's market success is becoming more prominent. This situation affects many long lead-time product industries including aircraft manufacturing. Derivative development has been the key strategy for many aircraft manufacturers to survive the competitive market and this trend is expected to continue in the future. Within this environment of design adaptation and variation, the main market advantages are often gained by the fastest aircraft manufacturers to develop and produce their range of market offerings without any costly mistakes. This realization creates an emphasis on the efficiency of the redesign process, particularly on the handling of engineering changes. However, most activities involved in the redesign process are supported either inefficiently or not at all by the current design methods and tools, primarily because they have been mostly developed to improve original product development. In view of this, the main goal of this research is to propose an aircraft redesign methodology that will act as a decision-making aid for aircraft designers in the change implementation planning of derivative developments. The proposed method, known as Strategic Planning of Engineering Changes (SPEC), combines the key elements of the product redesign planning and change management processes. Its application is aimed at reducing the redesign risks of derivative aircraft development, improving the detection of possible change effects propagation, increasing the efficiency of the change implementation planning and also reducing the costs and the time delays due to the redesign process. To address these challenges, four research areas have been identified: baseline assessment, change propagation prediction, change impact analysis and change implementation planning. Based on the established requirements for the redesign planning process, several methods and tools that are identified within these research areas have been abstracted and adapted into the proposed SPEC method to meet the research goals. The proposed SPEC method is shown to be promising in improving the overall efficiency of the derivative aircraft planning process through two notional aircraft system redesign case studies that are presented in this study.

Evaluation tools to support ITS planning process : development of a sketch planning tool in FSUTMS/cube environment.

DOT National Transportation Integrated Search

2008-12-15

Intelligent Transportation Systems (ITS) planning requires the use of tools to assess the performance of ITS deployment alternatives relative to each other and to other types of transportation system improvement alternatives. This research project in...

18 CFR 708.3 - Policy, objectives, and standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... improved popular understanding of official studies, planning processes, and decisions. (3) In order for... participation section of the Master Plan—Plan of Study shall be developed consistent with the guidelines... Master Plan shall aim for the highest achievable standards of objectivity and thoroughness consistent...

18 CFR 708.3 - Policy, objectives, and standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... improved popular understanding of official studies, planning processes, and decisions. (3) In order for... participation section of the Master Plan—Plan of Study shall be developed consistent with the guidelines... Master Plan shall aim for the highest achievable standards of objectivity and thoroughness consistent...

18 CFR 708.3 - Policy, objectives, and standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... improved popular understanding of official studies, planning processes, and decisions. (3) In order for... participation section of the Master Plan—Plan of Study shall be developed consistent with the guidelines... Master Plan shall aim for the highest achievable standards of objectivity and thoroughness consistent...

MAPP in action in San Antonio, Texas.

PubMed

Shields, Kathleen M; Pruski, Charles E

2005-01-01

San Antonio was selected as an official Mobilizing for Action through Planning and Partnerships (MAPP) demonstration site by National Association of County and City Officials in 2000. The San Antonio Metropolitan Health District, under the leadership of Dr Fernando A. Guerra, agreed to facilitate the process. The MAPP process provided the San Antonio Metropolitan Health District, the local public health authority, a defined process for community health improvement, as well as a mechanism to help bridge the gap between public health and the community. The San Antonio Metropolitan Health District organized a Core Planning Team to lead the MAPP process in April 2001. By October 2002, the Core Planning Team was expanded to a full community working group named the Alliance for Community Health in San Antonio and Bexar County (Alliance). The Alliance identified six strategic issues, which eventually became the basis of the San Antonio Community Health Improvement Plan. The strategic issues are Public Policy, Data Tracking, Healthy Lifestyles, Promoting a Sense of Community, Access to Care, and Safe Environment. San Antonio's MAPP experience has been successful in bringing together the public health system partners, and establishing public health priorities collectively. The MAPP process has resulted in the development of many new initiatives, and, most important, has opened the door to many partnership opportunities in the future. The work of the Alliance, through the MAPP process, has helped to leverage resources for public health improvement in San Antonio, and has the potential to effect positive change in public health in the future.

Development Instrument’s Learning of Physics Through Scientific Inquiry Model Based Batak Culture to Improve Science Process Skill and Student’s Curiosity

NASA Astrophysics Data System (ADS)

Nasution, Derlina; Syahreni Harahap, Putri; Harahap, Marabangun

2018-03-01

This research aims to: (1) developed a instrument’s learning (lesson plan, worksheet, student’s book, teacher’s guide book, and instrument test) of physics learning through scientific inquiry learning model based Batak culture to achieve skills improvement process of science students and the students’ curiosity; (2) describe the quality of the result of develop instrument’s learning in high school using scientific inquiry learning model based Batak culture (lesson plan, worksheet, student’s book, teacher’s guide book, and instrument test) to achieve the science process skill improvement of students and the student curiosity. This research is research development. This research developed a instrument’s learning of physics by using a development model that is adapted from the development model Thiagarajan, Semmel, and Semmel. The stages are traversed until retrieved a valid physics instrument’s learning, practical, and effective includes :(1) definition phase, (2) the planning phase, and (3) stages of development. Test performed include expert test/validation testing experts, small groups, and test classes is limited. Test classes are limited to do in SMAN 1 Padang Bolak alternating on a class X MIA. This research resulted in: 1) the learning of physics static fluid material specially for high school grade 10th consisted of (lesson plan, worksheet, student’s book, teacher’s guide book, and instrument test) and quality worthy of use in the learning process; 2) each component of the instrument’s learning meet the criteria have valid learning, practical, and effective way to reach the science process skill improvement and curiosity in students.

Planning effectiveness may grow on fault trees.

PubMed

Chow, C W; Haddad, K; Mannino, B

1991-10-01

The first step of a strategic planning process--identifying and analyzing threats and opportunities--requires subjective judgments. By using an analytical tool known as a fault tree, healthcare administrators can reduce the unreliability of subjective decision making by creating a logical structure for problem solving and decision making. A case study of 11 healthcare administrators showed that an analysis technique called prospective hindsight can add to a fault tree's ability to improve a strategic planning process.

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...

Empowering Families during the Early Intervention Planning Process

ERIC Educational Resources Information Center

Byington, Teresa A.; Whitby, Peggy J. S.

2011-01-01

Parents play important roles as advocates for their child with a disability. Advocacy is the process of striving to improve the quality of life for someone else. The Individuals With Disabilities Education Act (IDEA) requires parents and professionals to work together to design a service delivery plan for children with disabilities. An…

Development of a business plan for women's health services, using Malcolm Baldrige Performance Excellence Criteria.

PubMed

Caramanica, L; Maxwell, S; Curry, S

2000-06-01

A new process for business planning at Hartford Hospital was needed to achieve critical business results. This article describes the Hospital's use of the Malcolm Baldrige Performance Excellence Criteria as a way to standardize and improve business planning. Women's Health Services is one of Hartford Hospital's "centers for excellence" and one of the first to use these criteria to improve its service. Staff learned how to build their business plan upon a set of core values and concepts such as customer-driven quality, leadership that sets high expectations, continuous improvement and learning, valuing employees, faster response to market demands, management by fact, and a long-range view of the future.

MO-B-BRB-01: Optimize Treatment Planning Process in Clinical Environment

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

Feng, W.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-00: Optimizing the Treatment Planning Process

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

NONE

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

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

Kapur, A.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

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.

An Action Plan for Improving Mediocre or Stagnant Student Achievement

ERIC Educational Resources Information Center

Redmond, Kimberley B.

2013-01-01

Although all of the schools in the target school system adhere to a school improvement process, achievement scores remain mediocre or stagnant within the overseas school in Italy that serves children of United States armed service members. To address this problem, this study explored the target school's improvement process to discover how…

The road to business process improvement--can you get there from here?

PubMed

Gilberto, P A

1995-11-01

Historically, "improvements" within the organization have been frequently attained through automation by building and installing computer systems. Material requirements planning (MRP), manufacturing resource planning II (MRP II), just-in-time (JIT), computer aided design (CAD), computer aided manufacturing (CAM), electronic data interchange (EDI), and various other TLAs (three-letter acronyms) have been used as the methods to attain business objectives. But most companies have found that installing computer software, cleaning up their data, and providing every employee with training on how to best use the systems have not resulted in the level of business improvements needed. The software systems have simply made management around the problems easier but did little to solve the basic problems. The missing element in the efforts to improve the performance of the organization has been a shift in focus from individual department improvements to cross-organizational business process improvements. This article describes how the Electric Boat Division of General Dynamics Corporation, in conjunction with the Data Systems Division, moved its focus from one of vertical organizational processes to horizontal business processes. In other words, how we got rid of the dinosaurs.

23 CFR 450.306 - Scope of the metropolitan transportation planning process.

Code of Federal Regulations, 2011 CFR

2011-04-01

... transportation improvements and State and local planned growth and economic development patterns; (6) Enhance the... transportation system development, land use, employment, economic development, human and natural environment, and... CFR part 940. (g) Preparation of the coordinated public transit-human services transportation plan, as...

Effectiveness of Needs-oriented Hospital Discharge Planning for Caregivers of Patients With Schizophrenia.

PubMed

Lin, Li-En; Lo, Su-Chen; Liu, Chieh-Yu; Chen, Shing-Chia; Wu, Wen-Cheng; Liu, Wen-I

2018-04-01

Hospital discharge planning for clients with schizophrenia reduces client rehospitalization rates and improves their medication adherence. The effectiveness of caregiver participation in hospital discharge planning has seldom been explored. The purpose of this study was to examine the effectiveness of caregiver participation in hospital discharge planning for clients with schizophrenia in reducing caregiver burden and improving health status. A quasi-experimental research design was adopted. The research location was in a psychiatric hospital in Northern Taiwan. The target population was caregivers of inpatients with schizophrenia. Nurses served as care coordinators and provided six-step hospital discharge planning services to caregivers. Structured questionnaires were employed to measure caregiver burden and health status. Intervention effect was tested using analysis of covariance in which outcome measure at pretest and selected demographic variables were treated as covariates. A total of 114 caregivers completed pretest and posttest evaluations, with 57 people in each group. A significant difference was found between the experimental and the control group regarding the caregiver burden and health status (P<0.001) The caregiver burden and health status of the experimental group improved more significantly compared with the control group. The caregiver-involved discharge planning process developed in this study effectively reduced the burden placed on caregivers and improved their health status. Mental health nurses can serve as the main care coordinators for assessment, planning, referral and provision of the required services. Caregiver-involved hospital discharge planning should become part of the routine care process. Copyright © 2017 Elsevier Inc. All rights reserved.

Strategies for Promoting Gatekeeper Course Success among Students Needing Remediation: Research Report for the Virginia Community College System

ERIC Educational Resources Information Center

Roksa, Josipa; Jenkins, Davis; Jaggars, Shanna Smith; Zeidenberg, Matthew; Cho, Sung-Woo

2009-01-01

The Virginia Community College System (VCCS) is engaged in a strategic planning process to improve performance beyond the goals in "Dateline 2009," the system's current vision and plan. A key objective is to encourage colleges to improve retention and academic success for students, particularly the substantial numbers who arrive…

Researchers Apply Lesson Study: A Cycle of Lesson Planning, Implementation, and Revision

ERIC Educational Resources Information Center

Regan, Kelley S.; Evmenova, Anya S.; Kurz, Leigh Ann; Hughes, Melissa D.; Sacco, Donna; Ahn, Soo Y.; MacVittie, Nichole; Good, Kevin; Boykin, Andrea; Schwartzer, Jessica; Chirinos, David S.

2016-01-01

Scripted lesson plans and/or professional development alone may not be sufficient to encourage teachers to reflect on the quality of their teaching and improve their teaching. One learning tool that teachers may use to improve their teaching is Lesson Study (LS). LS is a collaborative process involving educators, based on concepts of iteration and…

Can the Integration of a PLE in an E-Portfolio Platform Improve Generic Competences?

ERIC Educational Resources Information Center

Galván-Fernández, Cristina; Rubio-Hurtado, María José; Martínez-Olmo, Francesc; Rodríguez-Illera, José Luis

2017-01-01

The study analyzes the improvement in generic competences through e-portfolio/PLE platform and didactic planning. The new version of the platform, Digital Folder, contains utilities for students and teachers and some PLE components that help the learning process through e-portfolios. Didactic planning is compared for students from the University…

Knowledge enabled plan of care and documentation prototype.

PubMed

DaDamio, Rebecca; Gugerty, Brian; Kennedy, Rosemary

2006-01-01

There exist significant challenges in integrating the plan of care into documentation and point of care operational processes. A plan of care is often a static artifact that meets regulatory standards with limited influence on supporting goal-directed care delivery processes. Although this prototype is applicable to many clinical disciplines, we will highlight nursing processes in demonstrating a knowledge-driven computerized solution that fully integrates the plan of care within documentation. The knowledge-driven solution reflects evidenced-based practice; is an effective tool for managing problems, orders/interventions, and the patient's progress towards expected outcomes; meets regulatory standards; and drives quality and process improvement. The knowledge infrastructure consists of fully represented terminology, structured clinical expressions utilizing the controlled terminology and clinical knowledge representing evidence-based practice.

UAV path planning using artificial potential field method updated by optimal control theory

NASA Astrophysics Data System (ADS)

Chen, Yong-bo; Luo, Guan-chen; Mei, Yue-song; Yu, Jian-qiao; Su, Xiao-long

2016-04-01

The unmanned aerial vehicle (UAV) path planning problem is an important assignment in the UAV mission planning. Based on the artificial potential field (APF) UAV path planning method, it is reconstructed into the constrained optimisation problem by introducing an additional control force. The constrained optimisation problem is translated into the unconstrained optimisation problem with the help of slack variables in this paper. The functional optimisation method is applied to reform this problem into an optimal control problem. The whole transformation process is deduced in detail, based on a discrete UAV dynamic model. Then, the path planning problem is solved with the help of the optimal control method. The path following process based on the six degrees of freedom simulation model of the quadrotor helicopters is introduced to verify the practicability of this method. Finally, the simulation results show that the improved method is more effective in planning path. In the planning space, the length of the calculated path is shorter and smoother than that using traditional APF method. In addition, the improved method can solve the dead point problem effectively.

An Optimized Trajectory Planning for Welding Robot

NASA Astrophysics Data System (ADS)

Chen, Zhilong; Wang, Jun; Li, Shuting; Ren, Jun; Wang, Quan; Cheng, Qunchao; Li, Wentao

2018-03-01

In order to improve the welding efficiency and quality, this paper studies the combined planning between welding parameters and space trajectory for welding robot and proposes a trajectory planning method with high real-time performance, strong controllability and small welding error. By adding the virtual joint at the end-effector, the appropriate virtual joint model is established and the welding process parameters are represented by the virtual joint variables. The trajectory planning is carried out in the robot joint space, which makes the control of the welding process parameters more intuitive and convenient. By using the virtual joint model combined with the B-spline curve affine invariant, the welding process parameters are indirectly controlled by controlling the motion curve of the real joint. To solve the optimal time solution as the goal, the welding process parameters and joint space trajectory joint planning are optimized.

Application of genetic algorithm in integrated setup planning and operation sequencing

NASA Astrophysics Data System (ADS)

Kafashi, Sajad; Shakeri, Mohsen

2011-01-01

Process planning is an essential component for linking design and manufacturing process. Setup planning and operation sequencing is two main tasks in process planning. Many researches solved these two problems separately. Considering the fact that the two functions are complementary, it is necessary to integrate them more tightly so that performance of a manufacturing system can be improved economically and competitively. This paper present a generative system and genetic algorithm (GA) approach to process plan the given part. The proposed approach and optimization methodology analyses the TAD (tool approach direction), tolerance relation between features and feature precedence relations to generate all possible setups and operations using workshop resource database. Based on these technological constraints the GA algorithm approach, which adopts the feature-based representation, optimizes the setup plan and sequence of operations using cost indices. Case study show that the developed system can generate satisfactory results in optimizing the setup planning and operation sequencing simultaneously in feasible condition.

MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

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

Chang, J.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

Strategic Planning in an Educational Development Centre: Motivation, Management, and Messiness

ERIC Educational Resources Information Center

Albon, Simon P.; Iqbal, Isabeau; Pearson, Marion L.

2016-01-01

Strategic planning in universities is frequently positioned as vital for clarifying future directions, providing a coherent basis for decision-making, establishing priorities, and improving organizational performance. Models for successful strategic planning abound and often present the process as linear and straightforward. In this essay, we…

External Strategic Planning Conference.

ERIC Educational Resources Information Center

Los Angeles Community Coll. District, CA. Office of Research and Planning.

In response to a community reputation that has grown increasingly negative, the Los Angeles Community College District (LACCD) devised a strategic plan in 1998 to improve its programs and services and assure the educational success of its students. The planning process involved several steps: (1) revisiting the district mission statement; (2)…

Planning-related motor processes underlie mental practice and imitation learning.

PubMed

Bach, Patric; Allami, Bassem Khalaf; Tucker, Mike; Ellis, Rob

2014-06-01

It is still controversial whether mental practice-the internal rehearsal of movements to improve later performance-relies on processes engaged during physical motor performance and, if so, which processes these are. We report data from 5 experiments, in which participants mentally practiced complex rhythms with either feet or hands while using the same or different body parts to respond to unrelated sounds. We found that responses were impaired for those body parts that were concurrently used in mental practice, suggesting a binding of body-part-specific motor processes to action plans. This result was found when participants mentally trained to memorize the rhythms, to merely improve their performance, when mental practice and execution directly followed one another and when separated by a different task. Finally, it was found irrespective of whether participants practiced on the basis of a symbolic rhythm description and when they practiced by watching somebody perform the rhythms (imitation learning). The effect was eliminated only when the requirement for mental practice was eliminated from the task while keeping visual stimulation identical. These data link mental practice not to execution but planning related motor processes and reveal that these planning processes underlie both mental practice and imitation learning. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Measuring Business Process Learning with Enterprise Resource Planning Systems to Improve the Value of Education

ERIC Educational Resources Information Center

Monk, Ellen F.; Lycett, Mark

2016-01-01

Enterprise Resource Planning Systems (ERP) are very large and complex software packages that run every aspect of an organization. Increasingly, ERP systems are being used in higher education as one way to teach business processes, essential knowledge for students competing in today's business environment. Past research attempting to measure…

Improvements to Strategic Planning and Implementation through Enhanced Correlation with Decision-Making Frameworks

ERIC Educational Resources Information Center

McCready, John W.

2010-01-01

The purpose of this study was to examine use of decision-making tools and feedback in strategic planning in order to develop a rigorous process that would promote the efficiency of strategic planning for acquisitions in the United States Coast Guard (USCG). Strategic planning is critical to agencies such as the USCG in order to be effective…

Reflecting on Talk: A Mentor Teacher's Gradual Release in Co-Planning

ERIC Educational Resources Information Center

Pylman, Stacey

2016-01-01

The goal of this case study was to explore how a mentor teacher used video-recorded co-planning sessions to reflect on and improve one's mentoring practice. Findings reveal ways in which the mentor used talk in co-planning sessions to model one's thinking process and to gradually release planning responsibility to engage the intern in learning 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.

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.

Using COPE To Improve Quality of Care: The Experience of the Family Planning Association of Kenya.

ERIC Educational Resources Information Center

Bradley, Janet

1998-01-01

COPE (Client-Oriented, Provider-Efficient) methodology, a self-assessment tool that has been used in 35 countries around the world, was used to improve the quality of care in family planning clinics in Kenya. COPE involves a process that legitimately invests power with providers and clinic-level staff. It gives providers more control over their…

The Willowbrook futures project: a longitudinal analysis of person-centered planning.

PubMed

Holburn, Steve; Jacobson, John W; Schwartz, Allen A; Flory, Michael J; Vietze, Peter M

2004-01-01

We conducted a longitudinal comparative evaluation of person-centered planning processes and outcomes for 20 individuals with intellectual disabilities and problem behavior (former residents of Willowbrook) and a matched contrast group, who received traditional interdisciplinary service planning (ISP). At the inception of the study, all participants were living in one of four other developmental centers (institutions) in New York City. Process and outcome data obtained from questionnaires completed by team members approximately every 8 months at four time periods showed that the rate of improvement in both person-centered planning process and outcomes for the intervention group was significantly greater than that of the comparison group. Eighteen of 19 person-centered planning participants moved to community living arrangements, as did 5 of 18 in the contrast group.

Safe teleoperation based on flexible intraoperative planning for robot-assisted laser microsurgery.

PubMed

Mattos, Leonardo S; Caldwell, Darwin G

2012-01-01

This paper describes a new intraoperative planning system created to improve precision and safety in teleoperated laser microsurgeries. It addresses major safety issues related to real-time control of a surgical laser during teleoperated procedures, which are related to the reliability and robustness of the telecommunication channels. Here, a safe solution is presented, consisting in a new planning system architecture that maintains the flexibility and benefits of real-time teleoperation and keeps the surgeon in control of all surgical actions. The developed system is based on our virtual scalpel system for robot-assisted laser microsurgery, and allows the intuitive use of stylus to create surgical plans directly over live video of the surgical field. In this case, surgical plans are defined as graphic objects overlaid on the live video, which can be easily modified or replaced as needed, and which are transmitted to the main surgical system controller for subsequent safe execution. In the process of improving safety, this new planning system also resulted in improved laser aiming precision and improved capability for higher quality laser procedures, both due to the new surgical plan execution module, which allows very fast and precise laser aiming control. Experimental results presented herein show that, in addition to the safety improvements, the new planning system resulted in a 48% improvement in laser aiming precision when compared to the previous virtual scalpel system.

SU-F-T-231: Improving the Efficiency of a Radiotherapy Peer-Review System for Quality Assurance

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

Hsu, S; Basavatia, A; Garg, M

Purpose: To improve the efficiency of a radiotherapy peer-review system using a commercially available software application for plan quality evaluation and documentation. Methods: A commercial application, FullAccess (Radialogica LLC, Version 1.4.4), was implemented in a Citrix platform for peer-review process and patient documentation. This application can display images, isodose lines, and dose-volume histograms and create plan reports for peer-review process. Dose metrics in the report can also be benchmarked for plan quality evaluation. Site-specific templates were generated based on departmental treatment planning policies and procedures for each disease site, which generally follow RTOG protocols as well as published prospective clinicalmore » trial data, including both conventional fractionation and hypo-fractionation schema. Once a plan is ready for review, the planner exports the plan to FullAccess, applies the site-specific template, and presents the report for plan review. The plan is still reviewed in the treatment planning system, as that is the legal record. Upon physician’s approval of a plan, the plan is packaged for peer review with the plan report and dose metrics are saved to the database. Results: The reports show dose metrics of PTVs and critical organs for the plans and also indicate whether or not the metrics are within tolerance. Graphical results with green, yellow, and red lights are displayed of whether planning objectives have been met. In addition, benchmarking statistics are collected to see where the current plan falls compared to all historical plans on each metric. All physicians in peer review can easily verify constraints by these reports. Conclusion: We have demonstrated the improvement in a radiotherapy peer-review system, which allows physicians to easily verify planning constraints for different disease sites and fractionation schema, allows for standardization in the clinic to ensure that departmental policies are maintained, and builds a comprehensive database for potential clinical outcome evaluation.« less

Medical imaging and registration in computer assisted surgery.

PubMed

Simon, D A; Lavallée, S

1998-09-01

Imaging, sensing, and computing technologies that are being introduced to aid in the planning and execution of surgical procedures are providing orthopaedic surgeons with a powerful new set of tools for improving clinical accuracy, reliability, and patient outcomes while reducing costs and operating times. Current computer assisted surgery systems typically include a measurement process for collecting patient specific medical data, a decision making process for generating a surgical plan, a registration process for aligning the surgical plan to the patient, and an action process for accurately achieving the goals specified in the plan. Some of the key concepts in computer assisted surgery applied to orthopaedics with a focus on the basic framework and underlying technologies is outlined. In addition, technical challenges and future trends in the field are discussed.

Use of Process Improvement Tools in Radiology.

PubMed

Rawson, James V; Kannan, Amogha; Furman, Melissa

2016-01-01

Process improvement techniques are common in manufacturing and industry. Over the past few decades these principles have been slowly introduced in select health care settings. This article reviews the Plan, Do, Study, and Act cycle, Six Sigma, the System of Profound Knowledge, Lean, and the theory of constraints. Specific process improvement tools in health care and radiology are presented in the order the radiologist is likely to encounter them in an improvement project. Copyright © 2015 Mosby, Inc. All rights reserved.

The Development of Innovative Climates in Educational Organizations.

ERIC Educational Resources Information Center

Miles, Matthew B.

The actualization of educational improvements in school systems necessitates an innovative climate. A schematic diagram shows seven functions as constituting the planning and inventing process for educational improvement. Of these seven functions, four are developmental and adaptation processes, and three provide for the routinization of building…

Initial Intervention Outcomes of the Dependable Strengths Project.

ERIC Educational Resources Information Center

McMurrer, James E., Jr.

Dependable Strengths Articulation Process (DSAP) is a self-development process designed to facilitate positive self-constructions and improved personal functioning. This study examined the effectiveness of DSAP interventions. Participants (N=30) were college graduates who had expressed a desire to improve their educational and career planning and…

Improvement Guides for I.A. Curriculum

ERIC Educational Resources Information Center

Ritz, John M.; Wright, Lawrence S.

1977-01-01

Describes a project to revise "The Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12", originally prepared in 1973. Four figures from the guide are included: (1) model of a field objective, (2) curriculum planning model, (3) instructional development process, and (4) process for developing objectives. (MF)

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

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.

Institutional Effectiveness Plan: Assessing Effectiveness To Improve Service and Increase Accountability.

ERIC Educational Resources Information Center

Quinley, John W.; And Others

This institutional effectiveness plan for Central Piedmont Community College (CPCC) is designed to serve as the blueprint by which assessment activities are undertaken and results disseminated throughout the college. First, Chapter One provides an overview of CPCC's self-study planning process, indicating that a 33-member task force comprised of…

Putting Learning into Library Planning

ERIC Educational Resources Information Center

Bennett, Scott

2015-01-01

This essay notes the emergence of learning as a key factor in academic library planning. It argues for an improved, learning-oriented planning process by noting the dangers that arise from the priority usually given to fixing dysfunctional space and from the traps of mistaking the "things" of learning for learning itself and of thinking…

Strategic Management Plan. FY11

DTIC Science & Technology

2010-12-30

process flows . Many of the improvements sought in this SMP require us to think about our business operations from an end-to-end perspective because the...underlying processes cut across many of our traditional organizations and functional business areas. The 15 end-to-end process flows that were...Redeployment/ Retrograde • Environmental Liabilities • Hire-to-Retire (H2R) • Market-to-Prospect (M2P) • Order-to- Cash (O2C) • Plan-to-Stock

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

PubMed

Nelson, E C; Caldwell, C; Quinn, D; Rose, R

1991-03-01

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Patient-focused goal planning process and outcome after spinal cord injury rehabilitation: quantitative and qualitative audit.

PubMed

Byrnes, Michelle; Beilby, Janet; Ray, Patricia; McLennan, Renee; Ker, John; Schug, Stephan

2012-12-01

To evaluate the process and outcome of a multidisciplinary inpatient goal planning rehabilitation programme on physical, social and psychological functioning for patients with spinal cord injury. Clinical audit: quantitative and qualitative analyses. Specialist spinal injury unit, Perth, Australia. Consecutive series of 100 newly injured spinal cord injury inpatients. MAIN MEASURE(S): The Needs Assessment Checklist (NAC), patient-focused goal planning questionnaire and goal planning progress form. The clinical audit of 100 spinal cord injured patients revealed that 547 goal planning meetings were held with 8531 goals stipulated in total. Seventy-five per cent of the goals set at the first goal planning meeting were achieved by the second meeting and the rate of goal achievements at subsequent goal planning meetings dropped to 56%. Based on quantitative analysis of physical, social and psychological functioning, the 100 spinal cord injury patients improved significantly from baseline to discharge. Furthermore, qualitative analysis revealed benefits consistently reported by spinal cord injury patients of the goal planning rehabilitation programme in improvements to their physical, social and psychological adjustment to injury. The findings of this clinical audit underpin the need for patient-focused goal planning rehabilitation programmes which are tailored to the individual's needs and involve a comprehensive multidisciplinary team.

Acquisition of business intelligence from human experience in route planning

NASA Astrophysics Data System (ADS)

Bello Orgaz, Gema; Barrero, David F.; R-Moreno, María D.; Camacho, David

2015-04-01

The logistic sector raises a number of highly challenging problems. Probably one of the most important ones is the shipping planning, i.e. plan the routes that the shippers have to follow to deliver the goods. In this article, we present an artificial intelligence-based solution that has been designed to help a logistic company to improve its routes planning process. In order to achieve this goal, the solution uses the knowledge acquired by the company drivers to propose optimised routes. Hence, the proposed solution gathers the experience of the drivers, processes it and optimises the delivery process. The solution uses data mining to extract knowledge from the company information systems and prepares it for analysis with a case-based reasoning (CBR) algorithm. The CBR obtains critical business intelligence knowledge from the drivers experience that is needed by the planner. The design of the routes is done by a genetic algorithm that, given the processed information, optimises the routes following several objectives, such as minimise the distance or time. Experimentation shows that the proposed approach is able to find routes that improve, on average, the routes made by the human experts.

Program of arithmetic improvement by means of cognitive enhancement: an intervention in children with special educational needs.

PubMed

Deaño, Manuel Deaño; Alfonso, Sonia; Das, Jagannath Prasad

2015-03-01

This study reports the cognitive and arithmetic improvement of a mathematical model based on the program PASS Remedial Program (PREP), which aims to improve specific cognitive processes underlying academic skills such as arithmetic. For this purpose, a group of 20 students from the last four grades of Primary Education was divided into two groups. One group (n=10) received training in the program and the other served as control. Students were assessed at pre and post intervention in the PASS cognitive processes (planning, attention, simultaneous and successive processing), general level of intelligence, and arithmetic performance in calculus and solving problems. Performance of children from the experimental group was significantly higher than that of the control group in cognitive process and arithmetic. This joint enhancement of cognitive and arithmetic processes was a result of the operationalization of training that promotes the encoding task, attention and planning, and learning by induction, mediation and verbalization. The implications of this are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

The role of water vapor in climate. A strategic research plan for the proposed GEWEX water vapor project (GVaP)

NASA Technical Reports Server (NTRS)

Starr, D. OC. (Editor); Melfi, S. Harvey (Editor)

1991-01-01

The proposed GEWEX Water Vapor Project (GVaP) addresses fundamental deficiencies in the present understanding of moist atmospheric processes and the role of water vapor in the global hydrologic cycle and climate. Inadequate knowledge of the distribution of atmospheric water vapor and its transport is a major impediment to progress in achieving a fuller understanding of various hydrologic processes and a capability for reliable assessment of potential climatic change on global and regional scales. GVap will promote significant improvements in knowledge of atmospheric water vapor and moist processes as well as in present capabilities to model these processes on global and regional scales. GVaP complements a number of ongoing and planned programs focused on various aspects of the hydrologic cycle. The goal of GVaP is to improve understanding of the role of water vapor in meteorological, hydrological, and climatological processes through improved knowledge of water vapor and its variability on all scales. A detailed description of the GVaP is presented.

Clinical implementation of a knowledge based planning tool for prostate VMAT.

PubMed

Powis, Richard; Bird, Andrew; Brennan, Matthew; Hinks, Susan; Newman, Hannah; Reed, Katie; Sage, John; Webster, Gareth

2017-05-08

A knowledge based planning tool has been developed and implemented for prostate VMAT radiotherapy plans providing a target average rectum dose value based on previously achievable values for similar rectum/PTV overlap. The purpose of this planning tool is to highlight sub-optimal clinical plans and to improve plan quality and consistency. A historical cohort of 97 VMAT prostate plans was interrogated using a RayStation script and used to develop a local model for predicting optimum average rectum dose based on individual anatomy. A preliminary validation study was performed whereby historical plans identified as "optimal" and "sub-optimal" by the local model were replanned in a blinded study by four experienced planners and compared to the original clinical plan to assess whether any improvement in rectum dose was observed. The predictive model was then incorporated into a RayStation script and used as part of the clinical planning process. Planners were asked to use the script during planning to provide a patient specific prediction for optimum average rectum dose and to optimise the plan accordingly. Plans identified as "sub-optimal" in the validation study observed a statistically significant improvement in average rectum dose compared to the clinical plan when replanned whereas plans that were identified as "optimal" observed no improvement when replanned. This provided confidence that the local model can identify plans that were suboptimal in terms of rectal sparing. Clinical implementation of the knowledge based planning tool reduced the population-averaged mean rectum dose by 5.6Gy. There was a small but statistically significant increase in total MU and femoral head dose and a reduction in conformity index. These did not affect the clinical acceptability of the plans and no significant changes to other plan quality metrics were observed. The knowledge-based planning tool has enabled substantial reductions in population-averaged mean rectum dose for prostate VMAT patients. This suggests plans are improved when planners receive quantitative feedback on plan quality against historical data.

SU-G-TeP4-06: An Integrated Application for Radiation Therapy Treatment Plan Directives, Management, and Reporting

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

Matuszak, M; Anderson, C; Lee, C

Purpose: With electronic medical records, patient information for the treatment planning process has become disseminated across multiple applications with limited quality control and many associated failure modes. We present the development of a single application with a centralized database to manage the planning process. Methods: The system was designed to replace current functionalities of (i) static directives representing the physician intent for the prescription and planning goals, localization information for delivery, and other information, (ii) planning objective reports, (iii) localization and image guidance documents and (iv) the official radiation therapy prescription in the medical record. Using the Eclipse Scripting Applicationmore » Programming Interface, a plug-in script with an associated domain-specific SQL Server database was created to manage the information in (i)–(iv). The system’s user interface and database were designed by a team of physicians, clinical physicists, database experts, and software engineers to ensure usability and robustness for clinical use. Results: The resulting system has been fully integrated within the TPS via a custom script and database. Planning scenario templates, version control, approvals, and logic-based quality control allow this system to fully track and document the planning process as well as physician approval of tradeoffs while improving the consistency of the data. Multiple plans and prescriptions are supported along with non-traditional dose objectives and evaluation such as biologically corrected models, composite dose limits, and management of localization goals. User-specific custom views were developed for the attending physician review, physicist plan checks, treating therapists, and peer review in chart rounds. Conclusion: A method was developed to maintain cohesive information throughout the planning process within one integrated system by using a custom treatment planning management application that interfaces directly with the TPS. Future work includes quantifying the improvements in quality, safety and efficiency that are possible with the routine clinical use of this system. Supported in part by NIH-P01-CA-059827.« less

Identify involved agencies addressing safety when freight centers are planned and developed : project summary.

DOT National Transportation Integrated Search

2017-01-01

This project aimed to improve coordination and : cooperation among various entities in the : planning process for developing safer and more : efficient connections between intermodal : facilities and the highway network. Coordination : and cooperatio...

Implement balanced scorecard to translate strategic plan into actionable objectives.

PubMed

2004-09-01

Faced with challenges ranging from declining reimbursement to staff shortages, health care organizations--integrated delivery systems, physician group practices, disease management providers, and others--increasingly are turning to general business models to map out step-by-step action plans for performance measurement and process improvement. Creating a "balanced scorecard" is an obvious starting point for assessing and improving clinical and financial performance.

Application of the Ecosystem Diagnosis and Treatment Method to the Grande Ronde Model Watershed project : Final Report.

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

Mobrand, Lars Erik; Lestelle, Lawrence C.

In the spring of 1994 a technical planning support project was initiated by the Grande Ronde Model Watershed Board of Directors (Board) with funding from the Bonneville Power Administration. The project was motivated by a need for a science based method for prioritizing restoration actions in the basin that would promote effectiveness and accountability. In this section the authors recall the premises for the project. The authors also present a set of recommendations for implementing a watershed planning process that incorporates a science-based framework to help guide decision making. This process is intended to assist the Grande Ronde Model Watershedmore » Board in its effort to plan and implement watershed improvement measures. The process would also assist the Board in coordinating its efforts with other entities in the region. The planning process is based on an approach for developing an ecosystem management strategy referred to as the Ecosystem Diagnosis and Treatment (EDT) method (Lichatowich et al. 1995, Lestelle et al. 1996). The process consists of an on-going planning cycle. Included in this cycle is an assessment of the ability of the watershed to support and sustain natural resources and other economic and societal values. This step in the process, which the authors refer to as the diagnosis, helps guide the development of actions (also referred to as treatments) aimed at improving the conditions of the watershed to achieve long-term objectives. The planning cycle calls for routinely reviewing and updating, as necessary, the basis for the diagnosis and other analyses used by the Board in adopting actions for implementation. The recommendations offered here address this critical need to habitually update the information used in setting priorities for action.« less

Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya

PubMed Central

Cleary, Susan; Molyneux, Sassy; English, Mike

2017-01-01

Abstract This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation of decisions), and proceduralist (stakeholder engagement and empowerment, transparency, use of evidence, revisions, enforcement, and incorporating community values) conditions. PMID:27679522

Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya.

PubMed

Barasa, Edwine W; Cleary, Susan; Molyneux, Sassy; English, Mike

2017-04-01

This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation of decisions), and proceduralist (stakeholder engagement and empowerment, transparency, use of evidence, revisions, enforcement, and incorporating community values) conditions. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

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.

A plan for application system verification tests: The value of improved meteorological information, volume 1. [economic consequences of improved meteorological information

NASA Technical Reports Server (NTRS)

1976-01-01

The framework within which the Applications Systems Verification Tests (ASVTs) are performed and the economic consequences of improved meteorological information demonstrated is described. This framework considers the impact of improved information on decision processes, the data needs to demonstrate the economic impact of the improved information, the data availability, the methodology for determining and analyzing the collected data and demonstrating the economic impact of the improved information, and the possible methods of data collection. Three ASVTs are considered and program outlines and plans are developed for performing experiments to demonstrate the economic consequences of improved meteorological information. The ASVTs are concerned with the citrus crop in Florida, the cotton crop in Mississippi and a group of diverse crops in Oregon. The program outlines and plans include schedules, manpower estimates and funding requirements.

Statistical process control: a practical application for hospitals.

PubMed

VanderVeen, L M

1992-01-01

A six-step plan based on using statistics was designed to improve quality in the central processing and distribution department of a 223-bed hospital in Oakland, CA. This article describes how the plan was implemented sequentially, starting with the crucial first step of obtaining administrative support. The QI project succeeded in overcoming beginners' fear of statistics and in training both managers and staff to use inspection checklists, Pareto charts, cause-and-effect diagrams, and control charts. The best outcome of the program was the increased commitment to quality improvement by the members of the department.

Stark County Area Transportation Study - Transportation Improvement Program 1997-2000

DOT National Transportation Integrated Search

1996-05-01

The Transportation Improvement Program (TIP) is the schedule of highway and transit improvements recommended for implementation within the next four years. It is, therefore, the end product of the transportation planning process. The TIP originates f...

Leadership and effective succession planning in health-system pharmacy departments.

PubMed

Ellinger, Lara Kathryn; Trapskin, Philip J; Black, Raymond; Kotis, Despina; Alexander, Earnest

2014-04-01

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution's strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department's strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments.

Leadership and Effective Succession Planning in Health-System Pharmacy Departments

PubMed Central

Trapskin, Philip J.; Black, Raymond; Kotis, Despina; Alexander, Earnest

2014-01-01

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution’s strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department’s strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments. PMID:24958944

The implementation of the integrated design process in the hole-plan system

NASA Astrophysics Data System (ADS)

Ruy, Won-Sun; Ko, Dae-Eun; Yang, Young-Soon

2012-12-01

All current shipyards are using the customized CAD/CAM programs in order to improve the design quality and increase the design efficiency. Even though the data structures for ship design and construction are almost completed, the implementation related to the ship design processes are still in progress so that it has been the main causes of the bottleneck and delay during the middle of design process. In this study, we thought that the hole-plan system would be a good example which is remained to be improved. The people of outfitting division who don't have direct authority to edit the structural panels, should request the hull design division to install the holes for the outfitting equipment. For acceptance, they should calculate the hole position, determine the hole type, and find the intersected contour of panel. After consideration of the hull people, the requested holes are manually installed on the hull structure. As the above, many processes are needed such as communication and discussion between the divisions, drawings for hole-plan, and the consideration for the structural or production compatibility. However this iterative process takes a lot of working time and requires mental pressure to the related people and cross-division conflict. This paper will handle the hole-plan system in detail to automate the series of process and minimize the human efforts and time-consumption.

Environmental impact assessment in urban transport planning: Exploring process-related barriers in Spanish practice

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

Soria-Lara, Julio A., E-mail: j.a.sorialara@uva.nl; Bertolini, Luca, E-mail: l.bertolini@uva.nl; Brömmelstroet, Marco te, E-mail: M.C.G.teBrommelstroet@uva.nl

The effectiveness of EIA for evaluating transport planning projects is increasingly being questioned by practitioners, institutions and scholars. The academic literature has traditionally focused more on solving content-related problems with EIA (i.e. the measurement of environmental effects) than on process-related issues (i.e. the role of EIA in the planning process and the interaction between key actors). Focusing only on technical improvements is not sufficient for rectifying the effectiveness problems of EIA. In order to address this knowledge gap, the paper explores how EIA is experienced in the Spanish planning context and offers in-depth insight into EIA process-related issues in themore » field of urban transport planning. From the multitude of involved actors, the research focuses on exploring the perceptions of the two main professional groups: EIA developers and transport planners. Through a web-based survey we assess the importance of process-related barriers to the effective use of EIA in urban transport planning. The analyses revealed process issues based fundamentally on unstructured stakeholders involvement and an inefficient public participation - Highlights: • Qualitative research on perceptions of EIA participants on EIA processes. • Web-based survey with different participants (EIA-developers; transport planners). • It was seen an inefficient participation of stakeholders during the EIA processes.« less

A New Vision for Integrated Breast Care.

DTIC Science & Technology

1999-09-01

management with recommendations for strategic information systems use and overall process improvements. " Wrote the business plan for a physician group... business and marketing plans for physician network expansion. Performed market research and internal operational and strategic analyses. Identified...Berkeley Master of Business Administration (MBA) May 1994 • Concentration: Marketing and Strategic Planning * Event Chairman, MBA Challenge for Charity

Multiple-use management of upland hardwood forests

Treesearch

Frederick A. Dorrell

1971-01-01

In recent years the National Forests have experienced much controversy over multiple-use management Because of this, the Forest Service is examining ways to improve the multiple-use planning process. One of the new approaches involves a special plan for eight National Forests in the South and Central Appalachian Mountains, in which planning is done by interdisciplinary...

Futures Research and the Strategic Planning Process: Implications for Higher Education. ASHE-ERIC Higher Education Research Report No. 9, 1984.

ERIC Educational Resources Information Center

Morrison, James L.; And Others

The use of futures research to improve a college's ability to deal with changes brought about by social, economic, political, and technological developments is discussed, with attention to new planning strategies and forecasting methods. While traditional long-range planning tracks and forecasts the institution's internal development, strategic…

Vermont State Board of Education Department of Education Strategic Plan

ERIC Educational Resources Information Center

Vermont Department of Education, 2005

2005-01-01

Section 180 of Title 16 requires the State Board of Education (Board) to "adopt through a public process a statewide strategic education plan to describe how the agency will help school boards to improve student performance." The Vermont State Board of Education and Commissioner Richard H. Cate drafted a plan that was adopted by the…

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…

Planning, Management and Evaluation. Advanced Institutional Development Program (AIDP) Two-year College Consortium, Vol. 1, No. 1.

ERIC Educational Resources Information Center

McManis, Gerald L.

The purpose of this manual is to offer assistance to colleges and universities involved with, or interested in, improvement in their fundamental administrative process in a manner compatible with the Planning, Management and Evaluation System (PME) approach articulated by the United States Office of Education. Planning is defined as that…

Sustained reductions in time to antibiotic delivery in febrile immunocompromised children: results of a quality improvement collaborative.

PubMed

Dandoy, Christopher E; Hariharan, Selena; Weiss, Brian; Demmel, Kathy; Timm, Nathan; Chiarenzelli, Janis; Dewald, Mary Katherine; Kennebeck, Stephanie; Langworthy, Shawna; Pomales, Jennifer; Rineair, Sylvia; Sandfoss, Erin; Volz-Noe, Pamela; Nagarajan, Rajaram; Alessandrini, Evaline

2016-02-01

Timely delivery of antibiotics to febrile immunocompromised (F&I) paediatric patients in the emergency department (ED) and outpatient clinic reduces morbidity and mortality. The aim of this quality improvement initiative was to increase the percentage of F&I patients who received antibiotics within goal in the clinic and ED from 25% to 90%. Using the Model of Improvement, we performed Plan-Do-Study-Act cycles to design, test and implement high-reliability interventions to decrease time to antibiotics. Pre-arrival interventions were tested and implemented, followed by post-arrival interventions in the ED. Many processes were spread successfully to the outpatient clinic. The Chronic Care Model was used, in addition to active family engagement, to inform and improve processes. The study period was from January 2010 to January 2015. Pre-arrival planning improved our F&I time to antibiotics in the ED from 137 to 88 min. This was sustained until October 2012, when further interventions including a pre-arrival huddle decreased the median time to <50 min. Implementation of the various processes to the clinic delivery system increased the mean percentage of patients receiving antibiotics within 60 min to >90%. In September 2014, we implemented a rapid response team to improve reliable venous access in the ED, which increased our mean percentage of patients receiving timely antibiotics to its highest rate (95%). This stepwise approach with pre-arrival planning using the Chronic Care Model, followed by standardisation of processes, created a sustainable improvement of timely antibiotic delivery in F&I patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Atlas and feature based 3D pathway visualization enhancement for skull base pre-operative fast planning from head CT

NASA Astrophysics Data System (ADS)

Aghdasi, Nava; Li, Yangming; Berens, Angelique; Moe, Kris S.; Bly, Randall A.; Hannaford, Blake

2015-03-01

Minimally invasive neuroendoscopic surgery provides an alternative to open craniotomy for many skull base lesions. These techniques provides a great benefit to the patient through shorter ICU stays, decreased post-operative pain and quicker return to baseline function. However, density of critical neurovascular structures at the skull base makes planning for these procedures highly complex. Furthermore, additional surgical portals are often used to improve visualization and instrument access, which adds to the complexity of pre-operative planning. Surgical approach planning is currently limited and typically involves review of 2D axial, coronal, and sagittal CT and MRI images. In addition, skull base surgeons manually change the visualization effect to review all possible approaches to the target lesion and achieve an optimal surgical plan. This cumbersome process relies heavily on surgeon experience and it does not allow for 3D visualization. In this paper, we describe a rapid pre-operative planning system for skull base surgery using the following two novel concepts: importance-based highlight and mobile portal. With this innovation, critical areas in the 3D CT model are highlighted based on segmentation results. Mobile portals allow surgeons to review multiple potential entry portals in real-time with improved visualization of critical structures located inside the pathway. To achieve this we used the following methods: (1) novel bone-only atlases were manually generated, (2) orbits and the center of the skull serve as features to quickly pre-align the patient's scan with the atlas, (3) deformable registration technique was used for fine alignment, (4) surgical importance was assigned to each voxel according to a surgical dictionary, and (5) pre-defined transfer function was applied to the processed data to highlight important structures. The proposed idea was fully implemented as independent planning software and additional data are used for verification and validation. The experimental results show: (1) the proposed methods provided greatly improved planning efficiency while optimal surgical plans were successfully achieved, (2) the proposed methods successfully highlighted important structures and facilitated planning, (3) the proposed methods require shorter processing time than classical segmentation algorithms, and (4) these methods can be used to improve surgical safety for surgical robots.

Re-engineering the Federal planning process: A total Federal planning strategy, integrating NEPA with modern management tools

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

Eccleston, C.H.

1997-09-05

The National Environmental Policy Act (NEPA) of 1969 was established by Congress more than a quarter of a century ago, yet there is a surprising lack of specific tools, techniques, and methodologies for effectively implementing these regulatory requirements. Lack of professionally accepted techniques is a principal factor responsible for many inefficiencies. Often, decision makers do not fully appreciate or capitalize on the true potential which NEPA provides as a platform for planning future actions. New approaches and modem management tools must be adopted to fully achieve NEPA`s mandate. A new strategy, referred to as Total Federal Planning, is proposed formore » unifying large-scale federal planning efforts under a single, systematic, structured, and holistic process. Under this approach, the NEPA planning process provides a unifying framework for integrating all early environmental and nonenvironmental decision-making factors into a single comprehensive planning process. To promote effectiveness and efficiency, modem tools and principles from the disciplines of Value Engineering, Systems Engineering, and Total Quality Management are incorporated. Properly integrated and implemented, these planning tools provide the rigorous, structured, and disciplined framework essential in achieving effective planning. Ultimately, the goal of a Total Federal Planning strategy is to construct a unified and interdisciplinary framework that substantially improves decision-making, while reducing the time, cost, redundancy, and effort necessary to comply with environmental and other planning requirements. At a time when Congress is striving to re-engineer the governmental framework, apparatus, and process, a Total Federal Planning philosophy offers a systematic approach for uniting the disjointed and often convoluted planning process currently used by most federal agencies. Potentially this approach has widespread implications in the way federal planning is approached.« less

The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care.

PubMed

Steinfeld, Bradley; Scott, Jennifer; Vilander, Gavin; Marx, Larry; Quirk, Michael; Lindberg, Julie; Koerner, Kelly

2015-10-01

To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.

Accelerating quality improvement within your organization: Applying the Model for Improvement.

PubMed

Crowl, Ashley; Sharma, Anita; Sorge, Lindsay; Sorensen, Todd

2015-01-01

To discuss the fundamentals of the Model for Improvement and how the model can be applied to quality improvement activities associated with medication use, including understanding the three essential questions that guide quality improvement, applying a process for actively testing change within an organization, and measuring the success of these changes on care delivery. PubMed from 1990 through April 2014 using the search terms quality improvement, process improvement, hospitals, and primary care. At the authors' discretion, studies were selected based on their relevance in demonstrating the quality improvement process and tests of change within an organization. Organizations are continuously seeking to enhance quality in patient care services, and much of this work focuses on improving care delivery processes. Yet change in these systems is often slow, which can lead to frustration or apathy among frontline practitioners. Adopting and applying the Model for Improvement as a core strategy for quality improvement efforts can accelerate the process. While the model is frequently well known in hospitals and primary care settings, it is not always familiar to pharmacists. In addition, while some organizations may be familiar with the "plan, do, study, act" (PDSA) cycles-one element of the Model for Improvement-many do not apply it effectively. The goal of the model is to combine a continuous process of small tests of change (PDSA cycles) within an overarching aim with a longitudinal measurement process. This process differs from other forms of improvement work that plan and implement large-scale change over an extended period, followed by months of data collection. In this scenario it may take months or years to determine whether an intervention will have a positive impact. By following the Model for Improvement, frontline practitioners and their organizational leaders quickly identify strategies that make a positive difference and result in a greater degree of success.

Region Three Aerial Measurement System Flight Planning Tool - 12006

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

Messick, Chuck; Pham, Minh; Smith, Ron

The Region 3 Aerial Measurement System Flight Planning Tool is used by the National Nuclear Security Agency (NNSA), United States Department of Energy, Radiological Assistance Program, Region 3, to respond to emergency radiological situations. The tool automates the flight planning package process while decreasing Aerial Measuring System response times and decreases the potential for human error. Deployment of the Region Three Aerial Measurement System Flight Planning Tool has resulted in an immediate improvement to the flight planning process in that time required for mission planning has been reduced from 1.5 hours to 15 minutes. Anecdotally, the RAP team reports thatmore » the rate of usable data acquired during surveys has improved from 40-60 percent to over 90 percent since they began using the tool. Though the primary product of the flight planning tool is a pdf format document for use by the aircraft flight crew, the RAP team has begun carrying their laptop computer on the aircraft during missions. By connecting a Global Positioning System (GPS) device to the laptop and using ESRI ArcMap's GPS tool bar to overlay the aircraft position directly on the flight plan in real time, the RAP team can evaluate and correct the aircraft position as the mission is executed. (authors)« less

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

Action Plan on Communication Practices: Roles of Tutors at EMU Distance Education Institute to Overcome Social Barriers in Constructing Knowledge

ERIC Educational Resources Information Center

Aksal, Fahriye A.

2009-01-01

The research involved an action plan for the improvement of the quality of the Distance Education Institute of Eastern Mediterranean University and based on EUA norms. This research is part of a work based learning process to enhance the contribution of online pedagogy and teaching process for online tutors. The research aimed to stress the…

Using the Whole School, Whole Community, Whole Child Model: Implications for Practice

PubMed Central

Rooney, Laura E; Videto, Donna M; Birch, David A

2015-01-01

BACKGROUND Schools, school districts, and communities seeking to implement the Whole School, Whole Community, Whole Child (WSCC) model should carefully and deliberately select planning, implementation, and evaluation strategies. METHODS In this article, we identify strategies, steps, and resources within each phase that can be integrated into existing processes that help improve health outcomes and academic achievement. Implementation practices may vary across districts depending upon available resources and time commitments. RESULTS Obtaining and maintaining administrative support at the beginning of the planning phase is imperative for identifying and implementing strategies and sustaining efforts to improve student health and academic outcomes. Strategy selection hinges on priority needs, community assets, and resources identified through the planning process. Determining the results of implementing the WSCC is based upon a comprehensive evaluation that begins during the planning phase. Evaluation guides success in attaining goals and objectives, assesses strengths and weaknesses, provides direction for program adjustment, revision, and future planning, and informs stakeholders of the effect of WSCC, including the effect on academic indicators. CONCLUSIONS With careful planning, implementation, and evaluation efforts, use of the WSCC model has the potential of focusing family, community, and school education and health resources to increase the likelihood of better health and academic success for students and improve school and community life in the present and in the future. PMID:26440824

VirSSPA- a virtual reality tool for surgical planning workflow.

PubMed

Suárez, C; Acha, B; Serrano, C; Parra, C; Gómez, T

2009-03-01

A virtual reality tool, called VirSSPA, was developed to optimize the planning of surgical processes. Segmentation algorithms for Computed Tomography (CT) images: a region growing procedure was used for soft tissues and a thresholding algorithm was implemented to segment bones. The algorithms operate semiautomati- cally since they only need seed selection with the mouse on each tissue segmented by the user. The novelty of the paper is the adaptation of an enhancement method based on histogram thresholding applied to CT images for surgical planning, which simplifies subsequent segmentation. A substantial improvement of the virtual reality tool VirSSPA was obtained with these algorithms. VirSSPA was used to optimize surgical planning, to decrease the time spent on surgical planning and to improve operative results. The success rate increases due to surgeons being able to see the exact extent of the patient's ailment. This tool can decrease operating room time, thus resulting in reduced costs. Virtual simulation was effective for optimizing surgical planning, which could, consequently, result in improved outcomes with reduced costs.

The TAME Project: Towards improvement-oriented software environments

NASA Technical Reports Server (NTRS)

Basili, Victor R.; Rombach, H. Dieter

1988-01-01

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

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

Barbee, D; McCarthy, A; Galavis, P

Purpose: Errors found during initial physics plan checks frequently require replanning and reprinting, resulting decreased departmental efficiency. Additionally, errors may be missed during physics checks, resulting in potential treatment errors or interruption. This work presents a process control created using the Eclipse Scripting API (ESAPI) enabling dosimetrists and physicists to detect potential errors in the Eclipse treatment planning system prior to performing any plan approvals or printing. Methods: Potential failure modes for five categories were generated based on available ESAPI (v11) patient object properties: Images, Contours, Plans, Beams, and Dose. An Eclipse script plugin (PlanCheck) was written in C# tomore » check errors most frequently observed clinically in each of the categories. The PlanCheck algorithms were devised to check technical aspects of plans, such as deliverability (e.g. minimum EDW MUs), in addition to ensuring that policy and procedures relating to planning were being followed. The effect on clinical workflow efficiency was measured by tracking the plan document error rate and plan revision/retirement rates in the Aria database over monthly intervals. Results: The number of potential failure modes the PlanCheck script is currently capable of checking for in the following categories: Images (6), Contours (7), Plans (8), Beams (17), and Dose (4). Prior to implementation of the PlanCheck plugin, the observed error rates in errored plan documents and revised/retired plans in the Aria database was 20% and 22%, respectively. Error rates were seen to decrease gradually over time as adoption of the script improved. Conclusion: A process control created using the Eclipse scripting API enabled plan checks to occur within the planning system, resulting in reduction in error rates and improved efficiency. Future work includes: initiating full FMEA for planning workflow, extending categories to include additional checks outside of ESAPI via Aria database queries, and eventual automated plan checks.« less

Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran.

PubMed

Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E

2014-04-01

We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

A Model to Translate Evidence-Based Interventions Into Community Practice

PubMed Central

Christiansen, Ann L.; Peterson, Donna J.; Guse, Clare E.; Maurana, Cheryl A.; Brandenburg, Terry

2012-01-01

There is a tension between 2 alternative approaches to implementing community-based interventions. The evidence-based public health movement emphasizes the scientific basis of prevention by disseminating rigorously evaluated interventions from academic and governmental agencies to local communities. Models used by local health departments to incorporate community input into their planning, such as the community health improvement process (CHIP), emphasize community leadership in identifying health problems and developing and implementing health improvement strategies. Each approach has limitations. Modifying CHIP to formally include consideration of evidence-based interventions in both the planning and evaluation phases leads to an evidence-driven community health improvement process that can serve as a useful framework for uniting the different approaches while emphasizing community ownership, priorities, and wisdom. PMID:22397341

25 CFR 170.501 - What happens when the review process identifies areas for improvement?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What happens when the review process identifies areas for improvement? 170.501 Section 170.501 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Planning, Design, and Construction of Indian Reservation Roads...

Improving the Students' Spiritual Intelligence in English Writing through Whole Brain Learning

ERIC Educational Resources Information Center

Santoso, Didik

2016-01-01

The objective of this research was to improve the students' spiritual intelligence in English writing through Whole Brain Learning strategy. Therefore, this study was conducted as a classroom action research. The research pocedure followed the cyclonic process of planning, action, observation, and reflection. This process was preceeded by…

Defense Acquisition Workforce: Actions Needed to Guide Planning Efforts and Improve Workforce Capability

DTIC Science & Technology

2015-12-01

positions. However, 6 of the 13 acquisition career fields, including 3 priority career fields—contracting, business and engineering—did not meet growth...the competency assessment process and challenges. The leaders we interviewed were from the business ; program management; contracting; engineering...Complete Assessments to Improve Future Civilian Strategic Workforce Plans, GAO-12- 1014 (Washington, D.C.: September 27, 2012). 5GAO, High-Risk Series: An

NASA Performance Plan

NASA Technical Reports Server (NTRS)

1999-01-01

The Government Performance and Results Act (GPRA) passed by Congress and signed by the President in 1993 provides a new tool to improve the efficiency of all Federal agencies. The goals of GPRA are to: Improve citizen confidence in Government performance; Improve Federal program management, effectiveness, and public accountability; and Improve congressional decisionmaking on where to commit the Nation's financial and human resources. The Act directs Executive Branch agencies to develop a customer-focused strategic plan that aligns activities with concrete missions and goals. The first plans were submitted in September 1998 as part of the Fiscal Year 1999 (FY99) budget process. These budget submissions were expected to support the goals expressed in the agency strategic plans. The Act also directs agencies to manage and measure results to justify congressional appropriations and authorizations. Six months after the completion of the fiscal year, agencies will report on the degree of success in achieving the goals and evaluation measures defined in the strategic and performance plans. The plans required by GPRA have been submitted to the Office of Management and Budget (OMB) and to Congress. Copies of NASA plans are available from the Office of Policy and Plans at NASA Headquarters and can be accessed on the i nterinet web sites identified in the Appendix.

Health sector operational planning and budgeting processes in Kenya—“never the twain shall meet”

PubMed Central

Molyneux, Sassy; Goodman, Catherine

2015-01-01

Summary Operational planning is considered an important tool for translating government policies and strategic objectives into day‐to‐day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top‐down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local‐level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. PMID:25783862

Demystifying process mapping: a key step in neurosurgical quality improvement initiatives.

PubMed

McLaughlin, Nancy; Rodstein, Jennifer; Burke, Michael A; Martin, Neil A

2014-08-01

Reliable delivery of optimal care can be challenging for care providers. Health care leaders have integrated various business tools to assist them and their teams in ensuring consistent delivery of safe and top-quality care. The cornerstone to all quality improvement strategies is the detailed understanding of the current state of a process, captured by process mapping. Process mapping empowers caregivers to audit how they are currently delivering care to subsequently strategically plan improvement initiatives. As a community, neurosurgery has clearly shown dedication to enhancing patient safety and delivering quality care. A care redesign strategy named NERVS (Neurosurgery Enhanced Recovery after surgery, Value, and Safety) is currently being developed and piloted within our department. Through this initiative, a multidisciplinary team led by a clinician neurosurgeon has process mapped the way care is currently being delivered throughout the entire episode of care. Neurosurgeons are becoming leaders in quality programs, and their education on the quality improvement strategies and tools is essential. The authors present a comprehensive review of process mapping, demystifying its planning, its building, and its analysis. The particularities of using process maps, initially a business tool, in the health care arena are discussed, and their specific use in an academic neurosurgical department is presented.

Lean methodology for performance improvement in the trauma discharge process.

PubMed

O'Mara, Michael Shaymus; Ramaniuk, Aliaksandr; Graymire, Vickie; Rozzell, Monica; Martin, Stacey

2014-07-01

High-volume, complex services such as trauma and acute care surgery are at risk for inefficiency. Lean process improvement can reduce health care waste. Lean allows a structured look at processes not easily amenable to analysis. We applied lean methodology to the current state of communication and discharge planning on an urban trauma service, citing areas for improvement. A lean process mapping event was held. The process map was used to identify areas for immediate analysis and intervention-defining metrics for the stakeholders. After intervention, new performance was assessed by direct data evaluation. The process was completed with an analysis of effect and plans made for addressing future focus areas. The primary area of concern identified was interservice communication. Changes centering on a standardized morning report structure reduced the number of consult questions unanswered from 67% to 34% (p = 0.0021). Physical therapy rework was reduced from 35% to 19% (p = 0.016). Patients admitted to units not designated to the trauma service had 1.6 times longer stays (p < 0.0001). The lean process lasted 8 months, and three areas for new improvement were identified: (1) the off-unit patients; (2) patients with length of stay more than 15 days contribute disproportionately to length of stay; and (3) miscommunication exists around patient education at discharge. Lean process improvement is a viable means of health care analysis. When applied to a trauma service with 4,000 admissions annually, lean identifies areas ripe for improvement. Our inefficiencies surrounded communication and patient localization. Strategies arising from the input of all stakeholders led to real solutions for communication through a face-to-face morning report and identified areas for ongoing improvement. This focuses resource use and identifies areas for improvement of throughput in care delivery.

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.

MORS Workshop on Improving Defense Analysis through Better Data Practices, held in Alexandria, Virginia on March 25, 26 and 27, 2003

DTIC Science & Technology

2004-12-03

other process improvements could also enhance DoD data practices. These include the incorporation of library science techniques as well as processes to...coalition communities as well as adapting the approaches and lessons of the library science community. Second, there is a need to generate a plan of...Best Practices (2 of 2) - Processes - Incorporate library science techniques in repository design - Improve visibility and accessibility of DoD data

Automated geospatial Web Services composition based on geodata quality requirements

NASA Astrophysics Data System (ADS)

Cruz, Sérgio A. B.; Monteiro, Antonio M. V.; Santos, Rafael

2012-10-01

Service-Oriented Architecture and Web Services technologies improve the performance of activities involved in geospatial analysis with a distributed computing architecture. However, the design of the geospatial analysis process on this platform, by combining component Web Services, presents some open issues. The automated construction of these compositions represents an important research topic. Some approaches to solving this problem are based on AI planning methods coupled with semantic service descriptions. This work presents a new approach using AI planning methods to improve the robustness of the produced geospatial Web Services composition. For this purpose, we use semantic descriptions of geospatial data quality requirements in a rule-based form. These rules allow the semantic annotation of geospatial data and, coupled with the conditional planning method, this approach represents more precisely the situations of nonconformities with geodata quality that may occur during the execution of the Web Service composition. The service compositions produced by this method are more robust, thus improving process reliability when working with a composition of chained geospatial Web Services.

Guidelines for inclusion: Ensuring Indigenous peoples' involvement in water planning processes across South Eastern Australia

NASA Astrophysics Data System (ADS)

Saenz Quitian, Alejandra; Rodríguez, Gloria Amparo

2016-11-01

Indigenous peoples within the Murray-Darling Basin have traditionally struggled for the recognition of their cultural, social, environmental, spiritual, commercial and economic connection to the waters that they have traditionally used, as well as their right to engage in all stages of water planning processes. Despite Australian national and federal frameworks providing for the inclusion of Indigenous Australians' objectives in planning frameworks, water plans have rarely addressed these objectives in water, or the strategies to achieve them. Indeed, insufficient resources, a lack of institutional capacity in both Indigenous communities and agencies and an inadequate understanding of Indigenous people's objectives in water management have limited the extent to which Indigenous objectives are addressed in water plans within the Murray-Darling Basin. In this context, the adoption of specific guidelines to meet Indigenous requirements in relation to basin water resources is crucial to support Indigenous engagement in water planning processes. Using insights from participatory planning methods and human rights frameworks, this article outlines a set of alternative and collaborative guidelines to improve Indigenous involvement in water planning and to promote sustainable and just water allocations.

Java RMI Software Technology for the Payload Planning System of the International Space Station

NASA Technical Reports Server (NTRS)

Bryant, Barrett R.

1999-01-01

The Payload Planning System is for experiment planning on the International Space Station. The planning process has a number of different aspects which need to be stored in a database which is then used to generate reports on the planning process in a variety of formats. This process is currently structured as a 3-tier client/server software architecture comprised of a Java applet at the front end, a Java server in the middle, and an Oracle database in the third tier. This system presently uses CGI, the Common Gateway Interface, to communicate between the user-interface and server tiers and Active Data Objects (ADO) to communicate between the server and database tiers. This project investigated other methods and tools for performing the communications between the three tiers of the current system so that both the system performance and software development time could be improved. We specifically found that for the hardware and software platforms that PPS is required to run on, the best solution is to use Java Remote Method Invocation (RMI) for communication between the client and server and SQLJ (Structured Query Language for Java) for server interaction with the database. Prototype implementations showed that RMI combined with SQLJ significantly improved performance and also greatly facilitated construction of the communication software.

SU-F-T-65: AutomaticTreatment Planning for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

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

Zhou, Y; Tan, J; Jiang, S

Purpose: High dose rate (HDR) brachytherapy treatment planning is conventionally performed in a manual fashion. Yet it is highly desirable to perform computerized automated planning to improve treatment planning efficiency, eliminate human errors, and reduce plan quality variation. The goal of this research is to develop an automatic treatment planning tool for HDR brachytherapy with a cylinder applicator for vaginal cancer. Methods: After inserting the cylinder applicator into the patient, a CT scan was acquired and was loaded to an in-house developed treatment planning software. The cylinder applicator was automatically segmented using image-processing techniques. CTV was generated based on user-specifiedmore » treatment depth and length. Locations of relevant points (apex point, prescription point, and vaginal surface point), central applicator channel coordinates, and dwell positions were determined according to their geometric relations with the applicator. Dwell time was computed through an inverse optimization process. The planning information was written into DICOM-RT plan and structure files to transfer the automatically generated plan to a commercial treatment planning system for plan verification and delivery. Results: We have tested the system retrospectively in nine patients treated with vaginal cylinder applicator. These cases were selected with different treatment prescriptions, lengths, depths, and cylinder diameters to represent a large patient population. Our system was able to generate treatment plans for these cases with clinically acceptable quality. Computation time varied from 3–6 min. Conclusion: We have developed a system to perform automated treatment planning for HDR brachytherapy with a cylinder applicator. Such a novel system has greatly improved treatment planning efficiency and reduced plan quality variation. It also served as a testbed to demonstrate the feasibility of automatic HDR treatment planning for more complicated cases.« less

Space Station Mission Planning System (MPS) development study. Volume 2

NASA Technical Reports Server (NTRS)

Klus, W. J.

1987-01-01

The process and existing software used for Spacelab payload mission planning were studied. A complete baseline definition of the Spacelab payload mission planning process was established, along with a definition of existing software capabilities for potential extrapolation to the Space Station. This information was used as a basis for defining system requirements to support Space Station mission planning. The Space Station mission planning concept was reviewed for the purpose of identifying areas where artificial intelligence concepts might offer substantially improved capability. Three specific artificial intelligence concepts were to be investigated for applicability: natural language interfaces; expert systems; and automatic programming. The advantages and disadvantages of interfacing an artificial intelligence language with existing FORTRAN programs or of converting totally to a new programming language were identified.

Manpower and project planning

NASA Technical Reports Server (NTRS)

Johnson, David W.

1991-01-01

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

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

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.

Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project

PubMed Central

O’Suilleabhain, Padraig E.; Sanghera, Manjit; Patel, Neepa; Khemani, Pravin; Lacritz, Laura H.; Chitnis, Shilpa; Whitworth, Louis A.; Dewey, Richard B.

2016-01-01

Objective To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. Methods We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. Results The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Conclusions Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring. PMID:27711133

Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project.

PubMed

Dewey, Richard B; O'Suilleabhain, Padraig E; Sanghera, Manjit; Patel, Neepa; Khemani, Pravin; Lacritz, Laura H; Chitnis, Shilpa; Whitworth, Louis A; Dewey, Richard B

2016-01-01

To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring.

Artificial Neural Network Based Mission Planning Mechanism for Spacecraft

NASA Astrophysics Data System (ADS)

Li, Zhaoyu; Xu, Rui; Cui, Pingyuan; Zhu, Shengying

2018-04-01

The ability to plan and react fast in dynamic space environments is central to intelligent behavior of spacecraft. For space and robotic applications, many planners have been used. But it is difficult to encode the domain knowledge and directly use existing techniques such as heuristic to improve the performance of the application systems. Therefore, regarding planning as an advanced control problem, this paper first proposes an autonomous mission planning and action selection mechanism through a multiple layer perceptron neural network approach to select actions in planning process and improve efficiency. To prove the availability and effectiveness, we use autonomous mission planning problems of the spacecraft, which is a sophisticated system with complex subsystems and constraints as an example. Simulation results have shown that artificial neural networks (ANNs) are usable for planning problems. Compared with the existing planning method in EUROPA, the mechanism using ANNs is more efficient and can guarantee stable performance. Therefore, the mechanism proposed in this paper is more suitable for planning problems of spacecraft that require real time and stability.

Health sector operational planning and budgeting processes in Kenya-"never the twain shall meet".

PubMed

Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

2016-07-01

Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top-down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local-level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

23 CFR 450.306 - Scope of the metropolitan transportation planning process.

Code of Federal Regulations, 2010 CFR

2010-04-01

...: (1) Support the economic vitality of the metropolitan area, especially by enabling global... transportation improvements and State and local planned growth and economic development patterns; (6) Enhance the... transportation system development, land use, employment, economic development, human and natural environment, and...

American Historical Association Faculty Development Program: Planning and Implementation.

ERIC Educational Resources Information Center

Hoffmann, Charles

The planning and implementation processes of the Long Island Faculty Development Program are described. Originally sponsored by the American Historical Association's Faculty Development Program to improve history instruction, this project includes faculty representatives from four Long Island universities, colleges, and junior colleges. The…

Multi-objective optimization in spatial planning: Improving the effectiveness of multi-objective evolutionary algorithms (non-dominated sorting genetic algorithm II)

NASA Astrophysics Data System (ADS)

Karakostas, Spiros

2015-05-01

The multi-objective nature of most spatial planning initiatives and the numerous constraints that are introduced in the planning process by decision makers, stakeholders, etc., synthesize a complex spatial planning context in which the concept of solid and meaningful optimization is a unique challenge. This article investigates new approaches to enhance the effectiveness of multi-objective evolutionary algorithms (MOEAs) via the adoption of a well-known metaheuristic: the non-dominated sorting genetic algorithm II (NSGA-II). In particular, the contribution of a sophisticated crossover operator coupled with an enhanced initialization heuristic is evaluated against a series of metrics measuring the effectiveness of MOEAs. Encouraging results emerge for both the convergence rate of the evolutionary optimization process and the occupation of valuable regions of the objective space by non-dominated solutions, facilitating the work of spatial planners and decision makers. Based on the promising behaviour of both heuristics, topics for further research are proposed to improve their effectiveness.

Advancing mission in the marketplace. Integrated strategic planning and budgeting helps a system remain accountable.

PubMed

Smessaert, A H

1992-10-01

In the late 1980s Holy Cross Health System (HCHS), South Bend, IN, began to implement a revised strategic planning and budgeting process to effectively link the system's mission with its day-to-day operations. Leaders wanted a process that would help system employees internalize and act on the four major elements articulated in the HCHS mission statement: fidelity, excellence, empowerment, and stewardship. Representatives from mission, strategic planning, and finance from the corporate office and subsidiaries examined planning and budgeting methods. From the beginning, HCHS leaders decided that the process should be implemented gradually, with each step focusing on refining methodology and improving mission integration. As the process evolved. HCHS developed a sequence in which planning preceded budgeting. The system also developed a variety of educational and collaborative initiatives to help system employees adapt to the organization's change of direction. One critical aspect of HCHS's ongoing education is an ethical reflection process that helps participants balance ethical considerations by viewing an issue from three perspectives: social vision, multiple responsibility, and self-interest.

Evaluation of participatory planning: Lessons from Hungarian Natura 2000 management planning processes.

PubMed

Kovács, Eszter; Kelemen, Eszter; Kiss, Gabriella; Kalóczkai, Ágnes; Fabók, Veronika; Mihók, Barbara; Megyesi, Boldizsár; Pataki, György; Bodorkós, Barbara; Balázs, Bálint; Bela, Györgyi; Margóczi, Katalin; Roboz, Ágnes; Molnár, Dániel

2017-12-15

Stakeholder participation in nature conservation policies and especially in the management of protected areas has gained importance in the last decades. These changes are underlined by democratic principles and the perceived contribution of stakeholder involvement to the effectiveness of conservation management. Evaluating participatory processes is essential to learn about the past and thus increase the quality of future processes. The evaluation can be useful for the organisations responsible for planning and management, stakeholders and policy makers as well. The present paper shows the results of a systematic evaluation of 25 participatory processes related to the development of management plans for Natura 2000 sites in Hungary between 2007 and 2015. A conceptual framework was developed to evaluate the process and outcome of participatory management planning processes. Criteria were based on the scientific literature on public participation and tailored to conservation-related management planning and stakeholder involvement. Evaluated processes were grouped in three cases based on their time range and financial sources. Overall, the analysed processes scored at a medium level, showing better performance in the process criteria than in the outcome criteria. The best case scored significantly higher in four criteria compared to the other cases: representativeness, resource availability for facilitation, new, creative ideas and impact on the plan. The main factors behind the success were (1) embeddedness of the planning process in a larger project, where the plan was a tool for conservation, (2) carrying out only one process at a time, (3) previous experience of facilitators and planners with participatory planning and (4) the opportunity and capacity to propose a payment scheme as an incentive. But even this case received low scores in some criteria: conflict resolution, early involvement and well defined goals. Based on the results we suggest that more data is needed to evaluate the implementation of the plans and, in many cases, the impact of the process on the plan. Performance can be improved with the assistance of policy makers by further developing guidelines, harmonising payment schemes with the conservation measures of the plans and providing training on conflict resolution. The evaluation framework proved to be suitable for the assessment of a large set of conservation related management planning processes, but it also had some limitations, e.g. concerning the incorporation of stakeholders' views in the evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Continuous Energy Improvement in Motor Driven Systems - A Guidebook for Industry

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

Gilbert A. McCoy and John G. Douglass

2014-02-01

This guidebook provides a step-by-step approach to developing a motor system energy-improvement action plan. An action plan includes which motors should be repaired or replaced with higher efficiency models, recommendations on maintaining a spares inventory, and discussion of improvements in maintenance practices. The guidebook is the successor to DOE’s 1997 Energy Management for Motor Driven Systems. It builds on its predecessor publication by including topics such as power transmission systems and matching driven equipment to process requirements in addition to motors.

Applying a Continuous Quality Improvement Model To Assess Institutional Effectiveness.

ERIC Educational Resources Information Center

Roberts, Keith

This handbook outlines techniques and processes for improving institutional effectiveness and ensuring continuous quality improvement, based on strategic planning activities at Wisconsin's Milwaukee Area Technical College (MATC). First, institutional effectiveness is defined and 17 core indicators of effectiveness developed by the Wisconsin…

Developing a Quality Improvement Process to Optimize Faculty Success

ERIC Educational Resources Information Center

Merillat, Linda; Scheibmeir, Monica

2016-01-01

As part of a major shift to embed quality improvement processes within a School of Nursing at a medium-sized Midwestern university, a faculty enrichment program using a Plan-Do-Act-Study design was implemented. A central focus for the program was the development and maintenance of an online faculty resource center identified as "My Faculty…

TU-F-CAMPUS-J-04: Evaluation of Metal Artifact Reduction Technique for the Radiation Therapy Planning

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

Jeong, K; Kuo, H; Ritter, J

Purpose: To evaluate the feasibility of using a metal artifact reduction technique in depleting metal artifact and its application in improving dose calculation in External Radiation Therapy Planning. Methods: CIRS electron density phantom was scanned with and without steel drill bits placed in some plug holes. Meta artifact reduction software with Metal Deletion Technique (MDT) was used to remove metal artifacts for scanned image with metal. Hounsfield units of electron density plugs from artifact free reference image and MDT processed images were compared. To test the dose calculation improvement after the MDT processed images, clinically approved head and neck planmore » with manual dental artifact correction was tested. Patient images were exported and processed with MDT and plan was recalculated with new MDT image without manual correction. Dose profiles near the metal artifacts were compared. Results: The MDT used in this study effectively reduced the metal artifact caused by beam hardening and scatter. The windmill around the metal drill was greatly improved with smooth rounded view. Difference of the mean HU in each density plug between reference and MDT images were less than 10 HU in most of the plugs. Dose difference between original plan and MDT images were minimal. Conclusion: Most metal artifact reduction methods were developed for diagnostic improvement purpose. Hence Hounsfield unit accuracy was not rigorously tested before. In our test, MDT effectively eliminated metal artifacts with good HU reproduciblity. However, it can introduce new mild artifacts so the MDT images should be checked with original images.« less

Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

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

Purdie, Thomas G., E-mail: Tom.Purdie@rmp.uhn.on.ca; Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Techna Institute, University Health Network, Toronto, Ontario

Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to definemore » and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented improvements in care for breast cancer patients, using technologies that are widely available and already in clinical use.« less

Automation and intensity modulated radiation therapy for individualized high-quality tangent breast treatment plans.

PubMed

Purdie, Thomas G; Dinniwell, Robert E; Fyles, Anthony; Sharpe, Michael B

2014-11-01

To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented improvements in care for breast cancer patients, using technologies that are widely available and already in clinical use. Copyright © 2014 Elsevier Inc. All rights reserved.

Process improvement for the safe delivery of multidisciplinary-executed treatments-A case in Y-90 microspheres therapy.

PubMed

Cai, Bin; Altman, Michael B; Garcia-Ramirez, Jose; LaBrash, Jason; Goddu, S Murty; Mutic, Sasa; Parikh, Parag J; Olsen, Jeffrey R; Saad, Nael; Zoberi, Jacqueline E

To develop a safe and robust workflow for yttrium-90 (Y-90) radioembolization procedures in a multidisciplinary team environment. A generalized Define-Measure-Analyze-Improve-Control (DMAIC)-based approach to process improvement was applied to a Y-90 radioembolization workflow. In the first DMAIC cycle, events with the Y-90 workflow were defined and analyzed. To improve the workflow, a web-based interactive electronic white board (EWB) system was adopted as the central communication platform and information processing hub. The EWB-based Y-90 workflow then underwent a second DMAIC cycle. Out of 245 treatments, three misses that went undetected until treatment initiation were recorded over a period of 21 months, and root-cause-analysis was performed to determine causes of each incident and opportunities for improvement. The EWB-based Y-90 process was further improved via new rules to define reliable sources of information as inputs into the planning process, as well as new check points to ensure this information was communicated correctly throughout the process flow. After implementation of the revised EWB-based Y-90 workflow, after two DMAIC-like cycles, there were zero misses out of 153 patient treatments in 1 year. The DMAIC-based approach adopted here allowed the iterative development of a robust workflow to achieve an adaptable, event-minimizing planning process despite a complex setting which requires the participation of multiple teams for Y-90 microspheres therapy. Implementation of such a workflow using the EWB or similar platform with a DMAIC-based process improvement approach could be expanded to other treatment procedures, especially those requiring multidisciplinary management. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Current practice and future prospects for social data in coastal and ocean planning.

PubMed

Le Cornu, Elodie; Kittinger, John N; Koehn, J Zachary; Finkbeiner, Elena M; Crowder, Larry B

2014-08-01

Coastal and ocean planning comprises a broad field of practice. The goals, political processes, and approaches applied to planning initiatives may vary widely. However, all planning processes ultimately require adequate information on both the biophysical and social attributes of a planning region. In coastal and ocean planning practice, there are well-established methods to assess biophysical attributes; however, less is understood about the role and assessment of social data. We conducted the first global assessment of the incorporation of social data in coastal and ocean planning. We drew on a comprehensive review of planning initiatives and a survey of coastal and ocean practitioners. There was significantly more incorporation of social data in multiuse versus conservation-oriented planning. Practitioners engaged a wide range of social data, including governance, economic, and cultural attributes of planning regions and human impacts data. Less attention was given to ecosystem services and social-ecological linkages, both of which could improve coastal and ocean planning practice. Although practitioners recognize the value of social data, little funding is devoted to its collection and incorporation in plans. Increased capacity and sophistication in acquiring critical social and ecological data for planning is necessary to develop plans for more resilient coastal and ocean ecosystems and communities. We suggest that improving social data monitoring, and in particular spatial social data, to complement biophysical data, is necessary for providing holistic information for decision-support tools and other methods. Moving beyond people as impacts to people as beneficiaries, through ecosystem services assessments, holds much potential to better incorporate the tenets of ecosystem-based management into coastal and ocean planning by providing targets for linked biodiversity conservation and human welfare outcomes. © 2014 Society for Conservation Biology.

Collaboration as a process and an outcome: Consumer experiences of collaborating with nurses in care planning in an acute inpatient mental health unit.

PubMed

Reid, Rebecca; Escott, Phil; Isobel, Sophie

2018-04-14

This qualitative study explores inpatient mental health consumer perceptions of how collaborative care planning with mental health nurses impacts personal recovery. Semi-structured interviews were conducted with consumers close to discharge from one unit in Sydney, Australia. The unit had been undertaking a collaborative care planning project which encouraged nurses to use care plan documentation to promote person-centred and goal-focussed interactions and the development of meaningful strategies to aid consumer recovery. The interviews explored consumer understandings of the collaborative care planning process, perceptions of the utility of the care plan document and the process of collaborating with the nurses, and their perception of the impact of collaboration on their recovery. Findings are presented under four organizing themes: the process of collaborating, the purpose of collaborating, the nurse as collaborator and the role of collaboration in wider care and recovery. Consumers highlighted the importance of the process of developing their care plan with a nurse as being as helpful for recovery as the goals and strategies themselves. The findings provide insights into consumers' experiences of care planning in an acute inpatient unit, the components of care that support recovery and highlight specific areas for mental health nursing practice improvement in collaboration. © 2018 Australian College of Mental Health Nurses Inc.

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis

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

Zheng, Yuanshui, E-mail: yuanshui.zheng@okc.procure.com; Johnson, Randall; Larson, Gary

Purpose: Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. Methods: The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authorsmore » estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. Results: In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. Conclusions: The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.« less

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis.

PubMed

Zheng, Yuanshui; Johnson, Randall; Larson, Gary

2016-06-01

Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authors estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.

33 CFR 385.9 - Implementation principles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Responsibilities § 385.9 Implementation principles. The Corps of Engineers and the South Florida Water Management...) Endorsement of the Plan as a restoration framework is not intended as a constraint on innovation during implementation through the adaptive management process. Continuous improvement of the Plan shall be sought to...

School Climate Improvement Action Guide for Working with Students. School Climate Improvement Resource Package

ERIC Educational Resources Information Center

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines key action steps to engage students in the school climate improvement process. Key action steps are provided for the following strategies: (1) Participate in planning for school climate improvements; (2) Engage stakeholders in…

Methods and approaches to support Indigenous water planning: An example from the Tiwi Islands, Northern Territory, Australia

NASA Astrophysics Data System (ADS)

Hoverman, Suzanne; Ayre, Margaret

2012-12-01

SummaryIndigenous land owners of the Tiwi Islands, Northern Territory Australia have begun the first formal freshwater allocation planning process in Australia entirely within Indigenous lands and waterways. The process is managed by the Northern Territory government agency responsible for water planning, the Department of Natural Resources, Environment, The Arts and Sport, in partnership with the Tiwi Land Council, the principal representative body for Tiwi Islanders on matters of land and water management and governance. Participatory planning methods ('tools') were developed to facilitate community participation in Tiwi water planning. The tools, selected for their potential to generate involvement in the planning process needed both to incorporate Indigenous knowledge of water use and management and raise awareness in the Indigenous community of Western science and water resources management. In consultation with the water planner and Tiwi Land Council officers, the researchers selected four main tools to develop, trial and evaluate. Results demonstrate that the tools provided mechanisms which acknowledge traditional management systems, improve community engagement, and build confidence in the water planning process. The researchers found that participatory planning approaches supported Tiwi natural resource management institutions both in determining appropriate institutional arrangements and clarifying roles and responsibilities in the Islands' Water Management Strategy.

What Were They Thinking? Reducing Sunk-Cost Bias in a Life-Span Sample

PubMed Central

Strough, JoNell; Bruine de Bruin, Wändi; Parker, Andrew M.; Karns, Tara; Lemaster, Philip; Pichayayothin, Nipat; Delaney, Rebecca; Stoiko, Rachel

2016-01-01

We tested interventions to reduce “sunk-cost bias,” the tendency to continue investing in failing plans even when those plans have soured and are no longer rewarding. We showed members of a national U.S. life-span panel a hypothetical scenario about a failing plan that was halfway complete. Participants were randomly assigned to an intervention to focus on how to improve the situation, an intervention to focus on thoughts and feelings, or a no-intervention control group. First, we found that the thoughts and feelings intervention reduced sunk-cost bias in decisions about project completion, as compared to the improvement intervention and the no-intervention control. Second, older age was associated with greater willingness to cancel the failing plan across all three groups. Third, we found that introspection processes helped to explain the effectiveness of the interventions. Specifically, the larger reduction in sunk-cost bias as observed in the thoughts and feelings intervention (vs. the improvement intervention) was associated with suppression of future-oriented thoughts of eventual success, and with suppression of augmentations of the scenario that could make it seem reasonable to continue the plan. Fourth, we found that introspection processes were related to age differences in decisions. Older people were less likely to mention future-oriented thoughts of eventual success associated with greater willingness to continue the failing plan. We discuss factors to consider when designing interventions for reducing sunk-cost bias. PMID:27831712

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".

Strategic Management of Resource Markets: An Exploratory Study of Department of Defense Contractors.

DTIC Science & Technology

1982-04-01

prime contractors focusing on (1) the operation and functional content of strategic management systems and their approaches to identifying, prioritizing...Introduction Strategic Planning for Procurement Approaches to Strategic Planning Relationship with the Procurement Process Organizational Demands Studies...planning/management with the same skill, content and commitment, what suggested improvements can come from a study of the approaches used by the more

Use of risk assessment panels during revision of the Tongass Land and Resource Management Plan.

Treesearch

Charles G. Shaw

1999-01-01

This paper describes the process used to conduct the 16 risk assessment panels and a subsistence working group held during revision of the Tongass land management plan. It provides an overview of how results from the panels were used by forest managers in plan-related decisionmaking, discusses some reactions to the effort, and identifies some opportunities to improve...

Planning for Life: Program Guidebook. Career Planning: Definitions, Improvement Ideas and Self-Review Process, Application Guidelines.

ERIC Educational Resources Information Center

National Consortium of State Career Guidance Supervisors, Columbus, OH.

Career and life planning are central to education and provide a unifying focus for school guidance efforts. There is growing evidence that individuals who have goals and dreams often attain them, while those who set no objectives in life frequently fall short of their potential. This guidebook was prepared for schools and institutions to use to…

Building a vision for the future: strategic planning in a shared governance nursing organization.

PubMed

Baker, C; Beglinger, J E; Bowles, K; Brandt, C; Brennan, K M; Engelbaugh, S; Hallock, T; LaHam, M

2000-06-01

Today's health care delivery environment is marked by extreme turbulence and ever-increasing complexity. Now, more than ever, an organization's strategic plan must do more than outline a business plan. Rather, the strategic plan is a fundamental tool for building and sustaining an organizational vision for the future. The strong, dynamic strategic plan (1) represents a long-range vision for improving organizational performance, (2) provides a model for planning and implementing structures and processes for the management of outcomes, (3) reflects and shapes the organizational culture and customer focus, (4) provides decision support for difficult operational choices made day to day, and (5) integrates and aligns the work of the organization. This article describes the development, implementation, and evaluation of a methodology for strategic planning within a shared governance nursing organization. Built upon the strategic plan of the hospital, the process undertaken by the nursing organization reflects the following commitments: (1) to develop a strategic plan that is meaningful and part of daily work life at all levels of the nursing organization, (2) to make the plan practical and realistic through incremental building, (3) to locate and articulate accountability for each step, and (4) to build in a process for checking progress toward goal achievement and readjusting the plan as necessary.

Advance Care Planning in palliative care: a qualitative investigation into the perspective of Paediatric Intensive Care Unit staff.

PubMed

Mitchell, Sarah; Dale, Jeremy

2015-04-01

The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. To explore the experiences of senior medical and nursing staff regarding the challenges associated with Advance Care Planning in relation to children and young people with life-limiting illnesses in the Paediatric Intensive Care Unit environment and opportunities for improvement. Qualitative one-to-one, semi-structured interviews were conducted with Paediatric Intensive Care Unit consultants and senior nurses, to gain rich, contextual data. Thematic content analysis was carried out. UK tertiary referral centre Paediatric Intensive Care Unit. Eight Paediatric Intensive Care Unit consultants and six senior nurses participated. Four main themes emerged: recognition of an illness as 'life-limiting'; Advance Care Planning as a multi-disciplinary, structured process; the value of Advance Care Planning and adverse consequences of inadequate Advance Care Planning. Potential benefits of Advance Care Planning include providing the opportunity to make decisions regarding end-of-life care in a timely fashion and in partnership with patients, where possible, and their families. Barriers to the process include the recognition of the life-limiting nature of an illness and gaining consensus of medical opinion. Organisational improvements towards earlier recognition of life-limiting illness and subsequent Advance Care Planning were recommended, including education and training, as well as the need for wider societal debate. Advance Care Planning for children and young people with life-limiting conditions has the potential to improve care for patients and their families, providing the opportunity to make decisions based on clear information at an appropriate time, and avoid potentially harmful intensive clinical interventions at the end of life. © The Author(s) 2015.

Stakeholder Participation in Marine Spatial Plan Making Process in Lampung Province

NASA Astrophysics Data System (ADS)

Asirin; Asbi, A. M.; Pakpahan, V. H.

2018-05-01

Lampung Province has coastal areas, seas and small islands facing conflicts of interest between tourism, conservation areas for defense, environmental conservation, and the threat of unsustainable marine resource utilization. Indonesia (including Lampung Province) has committed itself to achieving the objectives of conservation and sustainable use of oceans, seas and marine resources in view of sustainable development. One of the instruments used to achieve this goal is by using marine spatial planning (MSP). The purpose of this research was to analyse the marine spatial plan making process in Lampung Province. This research also evaluated the participation process and participation level based on plan-making process criteria and the stakeholder participation ladder. This research can be useful as a recommendation in the evaluation step to improve the plan-making process in order to address conflicts of interest between various related interest groups, so that planning can be accomplished with the involvement of all relevant parties to reach consensus on how to achieve a sustainable marine environment. This research used a qualitative research method as well as a case study approach. The scope of this study was limited by the conceptual framework of marine spatial planning and the stakeholder participation ladder. The authors recommend study of the preparation of marine spatial planning in addition to a technocratic approach considering the results of the study aspects of spatial allocation and physical aspects of marine resources, while prioritizing building consensus among various interest groups related to the utilization of marine resources. Thus, it is necessary to develop technical steps to build consensus in the marine spatial plan-making process.

Scenario analysis and strategic planning: practical applications for radiology practices.

PubMed

Lexa, Frank James; Chan, Stephen

2010-05-01

Modern business science has many tools that can be of great value to radiologists and their practices. One of the most important and underused is long-term planning. Part of the problem has been the pace of change. Making a 5-year plan makes sense only if your develop robust scenarios of possible future conditions you will face. Scenario analysis is one of many highly regarded tools that can improve your predictive capability. However, as with many tools, it pays to have some training and to get practical tips on how to improve their value. It also helps to learn from other people's mistakes rather than your own. The authors discuss both theoretical and practical issues in using scenario analysis to improve your planning process. They discuss actionable ways this set of tools can be applied in a group meeting or retreat. Copyright (c) 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Improving Therapeutic Relationships: Joint Crisis Planning for Individuals With Psychotic Disorders.

PubMed

Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R Claire; Szmukler, George; Thornicroft, Graham

2015-12-01

Outcomes for individuals with psychosis remain far from acceptable. Recently, prominent psychiatrists have called for an improved understanding of the impact of social contexts, and how social contexts might influence the development and maintenance of mental health problems. A key social context for individuals with psychosis is the therapeutic relationship. As part of a trial of joint crisis planning in England, this qualitative study aimed to determine the mechanism through which joint crisis planning might affect the therapeutic relationship. Results suggest that routine processes in mental health care are affected by policy and organizational requirements for risk mitigation-aspects that undermine person-centered approaches. In contrast, strong therapeutic relationships are characterized by individualized care and reliable and respectful treatment. The Joint Crisis Plan intervention partially succeeded in reducing contextual influences on routine role enactments, facilitating the demonstration of respect and improving the therapeutic relationship. © The Author(s) 2015.

Design and Implementation of Total Quality Management in a Civil Engineering Squadron

DTIC Science & Technology

1989-09-01

instruct employees and seek new ways to integrate quality into all functions, such as planning, marketing , and controlling. The second strategy is for...implement a TQM plan that contributes to the overall DOD TQM process. 7 2. Managers at all levels will provide leadership and integrate TQM principles... integral part of our daily activities. 8 3. Quality improvement is the key to productivity improvement and must be pursued with the necessary resources to

Mono-stereo-autostereo: the evolution of 3-dimensional neurosurgical planning.

PubMed

Stadie, Axel T; Kockro, Ralf A

2013-01-01

In the past decade, surgery planning has changed significantly. The main reason is the improvements in computer graphical rendering power and display technology, which turned the plain graphics of the mid-1990s into interactive stereoscopic objects. To report our experiences with 2 virtual reality systems used for planning neurosurgical operations. A series of 208 operations were planned with the Dextroscope (Bracco AMT, Singapore) requiring the use of liquid crystal display shutter glasses. The participating neurosurgeons answered a questionnaire after the planning procedure and postoperatively. In a second prospective series of 33 patients, we used an autostereoscopic monitor system (MD20-3-D; Setred SA, Sweden) to plan intracranial operations. A questionnaire regarding the value of surgery planning was answered preoperatively and postoperatively. The Dextroscope could be integrated into daily surgical routine. Surgeons regarded their understanding of the pathoanatomical situation as improved, leading to enhanced intraoperative orientation and confidence compared with conventional planning. The autostereoscopic Setred system was regarded as helpful in establishing the surgical strategy and analyzing the pathoanatomical situation compared with conventional planning. Both systems were perceived as a backup in case of failure of the standard navigation system. Improvement of display and interaction techniques adds to the realism of the planning process and enables precise structural understanding preoperatively. This minimizes intraoperative guesswork and exploratory dissection. Autostereoscopic display techniques will further increase the value and acceptance of 3-dimensional planning and intraoperative navigation.

Using the Big6[TM] To Plan Instruction and Services.

ERIC Educational Resources Information Center

Kearns, Jodi L.

2000-01-01

Explains how the relationship between school library collection development, curriculum development, and information problem solving can be improved by applying the Big6 Skills process to the selection of materials and teacher collaboration. Includes charts for cooperative planning that follow the Big6 Skills. (Contains 3 references.) (LRW)

Revenue Forecasting to Integrate CCC Planning and Resource Allocation for Transformative Leadership

ERIC Educational Resources Information Center

Hovey, Ann

2012-01-01

In recent years the majority of California community colleges evaluated for re-accreditation received sanctions requiring documented improvement in the integration of college planning and budgeting processes. This study explores the challenges colleges face and the best practices utilized by successful colleges in implementing integrated…

Long-Term Technology Planning: Laying the Foundation To Improve Illinois Schools.

ERIC Educational Resources Information Center

Barker, Bruce O.; Hall, Robert F.

This report provides guidelines for establishing a long-term technology plan for education, applicable to schools in all states. Advanced and emerging telecommunications and computer technologies have resulted in an ever increasing need for teachers and students to develop information processing and lifelong learning skills for gathering and…

Choice-Making in Vocational Activities Planning: Recommendations from Job Coaches

ERIC Educational Resources Information Center

Cobigo, Virginie; Lachapelle, Yves; Morin, Diane

2010-01-01

Choice in the job seeking process may lead to increased satisfaction with the chosen job, and improve attention, performance, and motivation. Consequently, providing opportunities to express choices and interests while planning vocational activities is a key factor in achieving employment outcomes. Despite their commitment to promoting…

Integrating Strategic Planning Concepts into the Negotiating Process.

ERIC Educational Resources Information Center

Winer, Toby R.; Winer, Russell S.

1987-01-01

The purchase of a new telecommunications system at Vanderbilt University is described. By understanding conditions in which buyers generally obtain leverage over sellers in industries, it was possible to improve negotiating power. Strategic-planning concepts developed by Michael Porter in his book "Competitive Strategy" were used as a…

Strategic Leadership in Schools

ERIC Educational Resources Information Center

Williams, Henry S.; Johnson, Teryl L.

2013-01-01

Strategic leadership is built upon traits and actions that encompass the successful execution of all leadership styles. In a world that is rapidly changing, strategic leadership in schools guides school leader through assuring constant improvement process by anticipating future trends and planning for them and noting that plans must be flexible to…

Lawrence Berkeley Laboratory, Institutional Plan FY 1994--1999

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

Not Available

1993-09-01

The Institutional Plan provides an overview of the Lawrence Berkeley Laboratory mission, strategic plan, scientific initiatives, research programs, environment and safety program plans, educational and technology transfer efforts, human resources, and facilities needs. For FY 1994-1999 the Institutional Plan reflects significant revisions based on the Laboratory`s strategic planning process. The Strategic Plan section identifies long-range conditions that will influence the Laboratory, as well as potential research trends and management implications. The Initiatives section identifies potential new research programs that represent major long-term opportunities for the Laboratory, and the resources required for their implementation. The Scientific and Technical Programs section summarizesmore » current programs and potential changes in research program activity. The Environment, Safety, and Health section describes the management systems and programs underway at the Laboratory to protect the environment, the public, and the employees. The Technology Transfer and Education programs section describes current and planned programs to enhance the nation`s scientific literacy and human infrastructure and to improve economic competitiveness. The Human Resources section identifies LBL staff diversity and development program. The section on Site and Facilities discusses resources required to sustain and improve the physical plant and its equipment. The new section on Information Resources reflects the importance of computing and communication resources to the Laboratory. The Resource Projections are estimates of required budgetary authority for the Laboratory`s ongoing research programs. The Institutional Plan is a management report for integration with the Department of Energy`s strategic planning activities, developed through an annual planning process.« less

Measuring and improving quality of care in an academic medical center.

PubMed

Blayney, Douglas W

2013-05-01

The Donabedian definition of quality—structure, process, and outcome—provides a useful framework. A relentless focus on measuring process adherence and outcome is critical. Systemic improvements usually require teams to plan and to implement them. The lean or Toyota production system for process improvement is one useful method of organizing work, although different approaches are often necessary at the physician, practice unit, and statewide level. Challenges include scalability of the change (ie, rolling them out across the institution or system), tailoring the information technology tools, and building systems for sustainability.

Thrust and parry of the SIOP (single integrated operational plan) and sdi (strategic defense initiative). Research report

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

Zank, G.D.

1989-05-01

The relationship between strategic offensive capabilities (reflected in the SIOP) and emerging strategic defensive capabilities (reflected by SDI) is not being adequately addressed. A summary of the existing nuclear war planning process is provided, and an analagous defensive process is postulated. Parallels and differences between the two processes are discussed. Potential areas for information exchange and cooperation are identified to enhance deterrence and improve war fighting potential. Operational, technical and political issues requiring resolution are raised and recommendations to resolve these issues are made.

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

Research on Taxiway Path Optimization Based on Conflict Detection

PubMed Central

Zhou, Hang; Jiang, Xinxin

2015-01-01

Taxiway path planning is one of the effective measures to make full use of the airport resources, and the optimized paths can ensure the safety of the aircraft during the sliding process. In this paper, the taxiway path planning based on conflict detection is considered. Specific steps are shown as follows: firstly, make an improvement on A * algorithm, the conflict detection strategy is added to search for the shortest and safe path in the static taxiway network. Then, according to the sliding speed of aircraft, a time table for each node is determined and the safety interval is treated as the constraint to judge whether there is a conflict or not. The intelligent initial path planning model is established based on the results. Finally, make an example in an airport simulation environment, detect and relieve the conflict to ensure the safety. The results indicate that the model established in this paper is effective and feasible. Meanwhile, make comparison with the improved A*algorithm and other intelligent algorithms, conclude that the improved A*algorithm has great advantages. It could not only optimize taxiway path, but also ensure the safety of the sliding process and improve the operational efficiency. PMID:26226485

Research on Taxiway Path Optimization Based on Conflict Detection.

PubMed

Zhou, Hang; Jiang, Xinxin

2015-01-01

Taxiway path planning is one of the effective measures to make full use of the airport resources, and the optimized paths can ensure the safety of the aircraft during the sliding process. In this paper, the taxiway path planning based on conflict detection is considered. Specific steps are shown as follows: firstly, make an improvement on A * algorithm, the conflict detection strategy is added to search for the shortest and safe path in the static taxiway network. Then, according to the sliding speed of aircraft, a time table for each node is determined and the safety interval is treated as the constraint to judge whether there is a conflict or not. The intelligent initial path planning model is established based on the results. Finally, make an example in an airport simulation environment, detect and relieve the conflict to ensure the safety. The results indicate that the model established in this paper is effective and feasible. Meanwhile, make comparison with the improved A*algorithm and other intelligent algorithms, conclude that the improved A*algorithm has great advantages. It could not only optimize taxiway path, but also ensure the safety of the sliding process and improve the operational efficiency.

Implementation of advanced LCNG fueling infrastructure in Texas along the I-35/NAFTA Clean Corridor Project. Final report

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

Taylor, Stan; Hightower, Jared; Knight, Koby

This report documents the process of planning, siting, and permitting recent LCNG station projects; identifying existing constraints in these processes, and recommendations for improvements; LCNG operating history.

A School-Based Quality Improvement Program.

ERIC Educational Resources Information Center

Rappaport, Lewis A.

1993-01-01

As one Brooklyn high school discovered, quality improvement begins with administrator commitment and participants' immersion in the literature. Other key elements include ongoing training of personnel involved in the quality-improvement process, tools such as the Deming Cycle (plan-do-check-act), voluntary and goal-oriented teamwork, and a worthy…

Improvement of research report distribution and access and promotion of more effective use of Technical Report Documentation Page, USDOT Form 1700.7.

DOT National Transportation Integrated Search

2014-09-30

This report covers two studies: (Part A) Improvement of research report distribution and access process improvement of State Planning and Research (SPR) funded reports; and (Part B) Promotion of more effective use of the Technical Report Documentatio...

Development of an autonomous treatment planning strategy for radiation therapy with effective use of population-based prior data.

PubMed

Wang, Huan; Dong, Peng; Liu, Hongcheng; Xing, Lei

2017-02-01

Current treatment planning remains a costly and labor intensive procedure and requires multiple trial-and-error adjustments of system parameters such as the weighting factors and prescriptions. The purpose of this work is to develop an autonomous treatment planning strategy with effective use of prior knowledge and in a clinically realistic treatment planning platform to facilitate radiation therapy workflow. Our technique consists of three major components: (i) a clinical treatment planning system (TPS); (ii) a formulation of decision-function constructed using an assemble of prior treatment plans; (iii) a plan evaluator or decision-function and an outer-loop optimization independent of the clinical TPS to assess the TPS-generated plan and to drive the search toward a solution optimizing the decision-function. Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines for querying and interacting with the TPS. These subroutines are called back in the outer-loop optimization program to navigate the plan selection process through the solution space iteratively. The utility of the approach is demonstrated by using clinical prostate and head-and-neck cases. An autonomous treatment planning technique with effective use of an assemble of prior treatment plans is developed to automatically maneuver the clinical treatment planning process in the platform of a commercial TPS. The process mimics the decision-making process of a human planner and provides a clinically sensible treatment plan automatically, thus reducing/eliminating the tedious manual trial-and-errors of treatment planning. It is found that the prostate and head-and-neck treatment plans generated using the approach compare favorably with that used for the patients' actual treatments. Clinical inverse treatment planning process can be automated effectively with the guidance of an assemble of prior treatment plans. The approach has the potential to significantly improve the radiation therapy workflow. © 2016 American Association of Physicists in Medicine.

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.

Defining robustness protocols: a method to include and evaluate robustness in clinical plans

NASA Astrophysics Data System (ADS)

McGowan, S. E.; Albertini, F.; Thomas, S. J.; Lomax, A. J.

2015-04-01

We aim to define a site-specific robustness protocol to be used during the clinical plan evaluation process. Plan robustness of 16 skull base IMPT plans to systematic range and random set-up errors have been retrospectively and systematically analysed. This was determined by calculating the error-bar dose distribution (ebDD) for all the plans and by defining some metrics used to define protocols aiding the plan assessment. Additionally, an example of how to clinically use the defined robustness database is given whereby a plan with sub-optimal brainstem robustness was identified. The advantage of using different beam arrangements to improve the plan robustness was analysed. Using the ebDD it was found range errors had a smaller effect on dose distribution than the corresponding set-up error in a single fraction, and that organs at risk were most robust to the range errors, whereas the target was more robust to set-up errors. A database was created to aid planners in terms of plan robustness aims in these volumes. This resulted in the definition of site-specific robustness protocols. The use of robustness constraints allowed for the identification of a specific patient that may have benefited from a treatment of greater individuality. A new beam arrangement showed to be preferential when balancing conformality and robustness for this case. The ebDD and error-bar volume histogram proved effective in analysing plan robustness. The process of retrospective analysis could be used to establish site-specific robustness planning protocols in proton therapy. These protocols allow the planner to determine plans that, although delivering a dosimetrically adequate dose distribution, have resulted in sub-optimal robustness to these uncertainties. For these cases the use of different beam start conditions may improve the plan robustness to set-up and range uncertainties.

Focused process improvement events: sustainability of impact on process and performance in an academic radiology department.

PubMed

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P

2015-01-01

To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Uncertainty in Population Estimates for Endangered Animals and Improving the Recovery Process.

PubMed

Haines, Aaron M; Zak, Matthew; Hammond, Katie; Scott, J Michael; Goble, Dale D; Rachlow, Janet L

2013-08-13

United States recovery plans contain biological information for a species listed under the Endangered Species Act and specify recovery criteria to provide basis for species recovery. The objective of our study was to evaluate whether recovery plans provide uncertainty (e.g., variance) with estimates of population size. We reviewed all finalized recovery plans for listed terrestrial vertebrate species to record the following data: (1) if a current population size was given, (2) if a measure of uncertainty or variance was associated with current estimates of population size and (3) if population size was stipulated for recovery. We found that 59% of completed recovery plans specified a current population size, 14.5% specified a variance for the current population size estimate and 43% specified population size as a recovery criterion. More recent recovery plans reported more estimates of current population size, uncertainty and population size as a recovery criterion. Also, bird and mammal recovery plans reported more estimates of population size and uncertainty compared to reptiles and amphibians. We suggest the use of calculating minimum detectable differences to improve confidence when delisting endangered animals and we identified incentives for individuals to get involved in recovery planning to improve access to quantitative data.

Decreasing Psychiatric Admission Wait Time in the Emergency Department by Facilitating Psychiatric Discharges.

PubMed

Stover, Pamela R; Harpin, Scott

2015-12-01

Limited capacity in a psychiatric unit contributes to long emergency department (ED) admission wait times. Regulatory and accrediting agencies urge hospitals nationally to improve patient flow for better access to care for all types of patients. The purpose of the current study was to decrease psychiatric admission wait time from 10.5 to 8 hours and increase the proportion of patients discharged by 11 a.m. from 20% to 50%. The current study compared pre- and post-intervention data. Plan-Do-Study-Act cycles aimed to improve discharge processes and timeliness through initiation of new practices. Admission wait time improved to an average of 5.1 hours (t = 3.87, p = 0.006). The proportion of discharges occurring by 11 a.m. increased to 46% (odds ratio = 3.42, p < 0.0001). Improving discharge planning processes and timeliness in a psychiatric unit significantly decreased admission wait time from the ED, improving access to psychiatric care. Copyright 2015, SLACK Incorporated.

Quality assessment for VMAT prostate radiotherapy planning based on data envelopment analysis

NASA Astrophysics Data System (ADS)

Lin, Kuan-Min; Simpson, John; Sasso, Giuseppe; Raith, Andrea; Ehrgott, Matthias

2013-08-01

The majority of commercial radiotherapy treatment planning systems requires planners to iteratively adjust the plan parameters in order to find a satisfactory plan. This iterative trial-and-error nature of radiotherapy treatment planning results in an inefficient planning process and in order to reduce such inefficiency, plans can be accepted without achieving the best attainable quality. We propose a quality assessment method based on data envelopment analysis (DEA) to address this inefficiency. This method compares a plan of interest to a set of past delivered plans and searches for evidence of potential further improvement. With the assistance of DEA, planners will be able to make informed decisions on whether further planning is required and ensure that a plan is only accepted when the plan quality is close to the best attainable one. We apply the DEA method to 37 prostate plans using two assessment parameters: rectal generalized equivalent uniform dose (gEUD) as the input and D95 (the minimum dose that is received by 95% volume of a structure) of the planning target volume (PTV) as the output. The percentage volume of rectum overlapping PTV is used to account for anatomical variations between patients and is included in the model as a non-discretionary output variable. Five plans that are considered of lesser quality by DEA are re-optimized with the goal to further improve rectal sparing. After re-optimization, all five plans improve in rectal gEUD without clinically considerable deterioration of the PTV D95 value. For the five re-optimized plans, the rectal gEUD is reduced by an average of 1.84 Gray (Gy) with only an average reduction of 0.07 Gy in PTV D95. The results demonstrate that DEA can correctly identify plans with potential improvements in terms of the chosen input and outputs.

Using continuous process improvement methodology to standardize nursing handoff communication.

PubMed

Klee, Kristi; Latta, Linda; Davis-Kirsch, Sallie; Pecchia, Maria

2012-04-01

The purpose of this article was to describe the use of continuous performance improvement (CPI) methodology to standardize nurse shift-to-shift handoff communication. The goals of the process were to standardize the content and process of shift handoff, improve patient safety, increase patient and family involvement in the handoff process, and decrease end-of-shift overtime. This article will describe process changes made over a 4-year period as result of application of the plan-do-check-act procedure, which is an integral part of the CPI methodology, and discuss further work needed to continue to refine this critical nursing care process. Copyright © 2012 Elsevier Inc. All rights reserved.

Automated planning of tangential breast intensity-modulated radiotherapy using heuristic optimization.

PubMed

Purdie, Thomas G; Dinniwell, Robert E; Letourneau, Daniel; Hill, Christine; Sharpe, Michael B

2011-10-01

To present an automated technique for two-field tangential breast intensity-modulated radiotherapy (IMRT) treatment planning. A total of 158 planned patients with Stage 0, I, and II breast cancer treated using whole-breast IMRT were retrospectively replanned using automated treatment planning tools. The tools developed are integrated into the existing clinical treatment planning system (Pinnacle(3)) and are designed to perform the manual volume delineation, beam placement, and IMRT treatment planning steps carried out by the treatment planning radiation therapist. The automated algorithm, using only the radio-opaque markers placed at CT simulation as inputs, optimizes the tangential beam parameters to geometrically minimize the amount of lung and heart treated while covering the whole-breast volume. The IMRT parameters are optimized according to the automatically delineated whole-breast volume. The mean time to generate a complete treatment plan was 6 min, 50 s ± 1 min 12 s. For the automated plans, 157 of 158 plans (99%) were deemed clinically acceptable, and 138 of 158 plans (87%) were deemed clinically improved or equal to the corresponding clinical plan when reviewed in a randomized, double-blinded study by one experienced breast radiation oncologist. In addition, overall the automated plans were dosimetrically equivalent to the clinical plans when scored for target coverage and lung and heart doses. We have developed robust and efficient automated tools for fully inversed planned tangential breast IMRT planning that can be readily integrated into clinical practice. The tools produce clinically acceptable plans using only the common anatomic landmarks from the CT simulation process as an input. We anticipate the tools will improve patient access to high-quality IMRT treatment by simplifying the planning process and will reduce the effort and cost of incorporating more advanced planning into clinical practice. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

Langley Research Center's Unitary Plan Wind Tunnel: Testing Capabilities and Recent Modernization Activities

NASA Technical Reports Server (NTRS)

Micol, John R.

2001-01-01

Description, capabilities, initiatives, and utilization of the NASA Langley Research Center's Unitary Plan Wind Tunnel are presented. A brief overview of the facility's operational capabilities and testing techniques is provided. A recent Construction of Facilities (CoF) project to improve facility productivity and efficiency through facility automation has been completed and is discussed. Several new and maturing thrusts are underway that include systematic efforts to provide credible assessment for data quality, modifications to the new automation control system for increased compatibility with the Modern Design Of Experiments (MDOE) testing methodology, and process improvements for better test coordination, planning, and execution.

Langley Research Center's Unitary Plan Wind Tunnel: Testing Capabilities and Recent Modernization Activities

NASA Technical Reports Server (NTRS)

Micol, John R.

2001-01-01

Description, capabilities, initiatives, and utilization of the NASA Langley Research Center's Unitary Plan Wind Tunnel are presented. A brief overview of the facility's operational capabilities and testing techniques is provided. A recent Construction of Facilities (Car) project to improve facility productivity and efficiency through facility automation has been completed and is discussed. Several new and maturing thrusts are underway that include systematic efforts to provide credible assessment for data quality, modifications to the new automation control system for increased compatibility with the Modern Design of Experiments (MDOE) testing methodology, and process improvements for better test coordination, planning, and execution.

Long-Range Planning Can Improve the Efficiency of Agricultural Research and Development.

DTIC Science & Technology

1981-07-24

planning is not done » Conclusions Recommendat ion Agency comments ADVISORY BODIES HAVE HAD MIXED SUCCESS IN AFFECTING LONG-RANGE PLANNING... kfc r Their efforts have more impact on determining priorities for the short-range budgeting cycle rather than influencing development of long...cultural products, (2) developing an efficient marketing and processing system, (3) conserving natural resources, and (4) im- proving the well-being of

Individual Differences in Planning Processes.

DTIC Science & Technology

1980-06-01

prescriptive guidelines for improving planning. The research focuses on the analysis of thinking-aloud proto- cols produced by five subjects as they performed a...planning. ICURITV CLAI, PICA’IOw of il PAogemben Do&l abwr . --- ...... - iii - PREFACE This Note describes an analysis of "think-aloud" protocols gen...a conceptual framework for the analysis . The model specifies a Dumber of decision categories that could be matched to sub- jects’ descriptions of

CINRG: Infrastructure for Clinical Trials in Duchenne Dystrophy

DTIC Science & Technology

2013-09-01

research centers sharing a common goal of improving the quality of life of neuromuscular disease patients by cooperative planning , implementation, analysis...discrepancies were noted surrounding the regulatory binder, consent process and data records. The site personnel have a scheduled plan with the CINRG CC...missing long term follow-up visits). The project manager also reviewed the study records to date while onsite. A high priority plan was developed with the

Apply creative thinking of decision support in electrical nursing record.

PubMed

Hao, Angelica Te-Hui; Hsu, Chien-Yeh; Li-Fang, Huang; Jian, Wen-Shan; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Chang, Her-Kung

2006-01-01

The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with.

Integrating MRP (materiel requirements planning) into modern business.

PubMed

Lunn, T

1994-05-01

Time is the commodity of the '90s. Therefore, we all must learn how to use our manufacturing systems to shorten lead time and increase customer satisfaction. The objective of this article is to discuss practical ways people integrate the techniques of materiel requirements planning (MRP) systems with just-in-time (JIT) execution systems to increase customer satisfaction. Included are examples of new ways people use MRP systems to exemplify the process of continuous improvement--multiple items on work orders, consolidated routings, flexing capacity, and other new developments. Ways that successful companies use MRP II for planning and JIT for execution are discussed. There are many examples of how to apply theory to real life situations and a discussion of techniques that work to keep companies in the mode of continuous improvement. Also included is a look at hands-on, practical methods people use to achieve lead time reduction and simplify bills of material. Total quality management concepts can be applied to the MRP process itself. This in turn helps people improve schedule adherence, which leads to customer satisfaction.

Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer

NASA Astrophysics Data System (ADS)

Winkel, D.; Bol, G. H.; van Asselen, B.; Hes, J.; Scholten, V.; Kerkmeijer, L. G. W.; Raaymakers, B. W.

2016-12-01

To develop an automated radiotherapy treatment planning and optimization workflow to efficiently create patient specifically optimized clinical grade treatment plans for prostate cancer and to implement it in clinical practice. A two-phased planning and optimization workflow was developed to automatically generate 77Gy 5-field simultaneously integrated boost intensity modulated radiation therapy (SIB-IMRT) plans for prostate cancer treatment. A retrospective planning study (n  =  100) was performed in which automatically and manually generated treatment plans were compared. A clinical pilot (n  =  21) was performed to investigate the usability of our method. Operator time for the planning process was reduced to  <5 min. The retrospective planning study showed that 98 plans met all clinical constraints. Significant improvements were made in the volume receiving 72Gy (V72Gy) for the bladder and rectum and the mean dose of the bladder and the body. A reduced plan variance was observed. During the clinical pilot 20 automatically generated plans met all constraints and 17 plans were selected for treatment. The automated radiotherapy treatment planning and optimization workflow is capable of efficiently generating patient specifically optimized and improved clinical grade plans. It has now been adopted as the current standard workflow in our clinic to generate treatment plans for prostate cancer.

Implementation of science process skills using ICT-based approach to facilitate student life skills

NASA Astrophysics Data System (ADS)

Rahayu, Y. S.; Yuliani; Wijaya, B. R.

2018-01-01

The purpose of this study is to describe the results of the implementation of a teaching-learning package in Plant Physiology courses to improve the student’s life skills using the science process skills-based approach ICT. This research used 15 students of Biology Education of Undergraduate International Class who are in the Plant Physiology course. This study consists of two phases items, namely the development phase and implementation phase by using a one-shot case study design. Research parameters were the feasibility of lesson plans, student achievement, Including academic skills, thinking skills, and social skills. Data were descriptively Analyzed According to the characteristics of the existing data. The result shows that the feasibility of a lesson plan is very satisfied and can be improvements in student’s life skills, especially with regards to student’s thinking skills and scientific thinking skills. The results indicate that the science process skills using ICT-based approach can be effective methods to improve student’s life skills.

Strategic management system in a healthcare setting--moving from strategy to results.

PubMed

Devitt, Rob; Klassen, Wolf; Martalog, Julian

2005-01-01

One of the historical challenges in the healthcare system has been the identification and collection of meaningful data to measure an organization's progress towards the achievement of its strategic goals and the concurrent alignment of internal operating practices with this strategy. Over the last 18 months the Toronto East General Hospital (TEGH) has adopted a strategic management system and organizing framework that has led to a metric-based strategic plan. It has allowed for formal and measurable linkages across a full range of internal business processes, from the annual operating plan to resource allocation decisions, to the balanced scorecard and individual performance evaluations. The Strategic Management System (SMS) aligns organizational planning and performance measurement, facilitates an appropriate balance between organizational priorities and resolving "local" problems, and encourages behaviours that are consistent with the values upon which the organization is built. The TEGH Accountability Framework serves as the foundation for the entire system. A key tool of the system is the rolling three-year strategic plan for the organization that sets out specific annual improvement targets on a number of key strategic measures. Individual program/department plans with corresponding measures ensure that the entire organization is moving forward strategically. Each year, all plans are reviewed, with course adjustments made to reflect changes in the hospital's environment and with re-calibration of performance targets for the next three years to ensure continued improvement and organizational progress. This system has been used through one annual business cycle. Results from the past year show measurable success. The hospital has improved on 12 of the 15 strategic plan metrics, including achieving the targeted 1% operating surplus while operating in an environment of tremendous change and uncertainty. This article describes the strategic management system used at TEGH and demonstrates the formal integration of the plan into its operating and decision making processes. It also provides examples of the metrics, their use in decision-making and the variance reporting and improvement mechanisms. The article also demonstrates that a measurement-oriented approach to the planning and delivery of community hospital service is both achievable and valuable in terms of accountability and organizational responsiveness.

Strategic planning for organizational effectiveness during dynamic change.

PubMed

Carlson, Susan L; Harris, Melodee; McLeskey, Nanci

2013-01-01

The leadership of a professional association is charged with developing a strategic plan to operationalize the organization's goals, tactics, and progress. Within the context of its values and goals, a strategic plan steers the organization toward its mission. While there are a variety of models and approaches used in strategic planning, the National Gerontological Nursing Association (NGNA) has historically used goal-based methodology. This method is congruent with the organization's leadership preferences, consistent with the mission-driven culture of the organization, and collaborative in its approach. In 2009 the NGNA Board of Directors initiated a plan for the organization's transformation to a more dynamic and member-driven association through a deliberate process. This article addresses the process used to arrive at the 2010–2011 NGNA strategic initiatives, including a discussion of pertinent data revealed in the 2011 needs assessment survey and NGNA's future initiatives focused on networking, communication, and membership benefits. This process is relevant for all organizations and groups seeking improvement in serving their constituents.

75 FR 18095 - America's Marine Highway Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... domestic water transportation services as an alternative means of moving containerized and wheeled freight... marine highway into the transportation planning process; and research improvements in efficiencies and... conducting research related to marine highway development. The program should improve system capacity and...

Strategic facility planning improves capital decision making.

PubMed

Reeve, J R

2001-03-01

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

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

NASA Technical Reports Server (NTRS)

Vairo, Daniel M.

1998-01-01

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

Coupling the Biophysical and Social Dimensions of Wildfire Risk to Improve Wildfire Mitigation Planning.

PubMed

Ager, Alan A; Kline, Jeffrey D; Fischer, A Paige

2015-08-01

We describe recent advances in biophysical and social aspects of risk and their potential combined contribution to improve mitigation planning on fire-prone landscapes. The methods and tools provide an improved method for defining the spatial extent of wildfire risk to communities compared to current planning processes. They also propose an expanded role for social science to improve understanding of community-wide risk perceptions and to predict property owners' capacities and willingness to mitigate risk by treating hazardous fuels and reducing the susceptibility of dwellings. In particular, we identify spatial scale mismatches in wildfire mitigation planning and their potential adverse impact on risk mitigation goals. Studies in other fire-prone regions suggest that these scale mismatches are widespread and contribute to continued wildfire dwelling losses. We discuss how risk perceptions and behavior contribute to scale mismatches and how they can be minimized through integrated analyses of landscape wildfire transmission and social factors that describe the potential for collaboration among landowners and land management agencies. These concepts are then used to outline an integrated socioecological planning framework to identify optimal strategies for local community risk mitigation and improve landscape-scale prioritization of fuel management investments by government entities. © 2015 Society for Risk Analysis.

Working in partnership: the application of shared decision-making to health visitor practice.

PubMed

Astbury, Ruth; Shepherd, Ashley; Cheyne, Helen

2017-01-01

To explore the processes that support shared decision-making when health visitors and parents are creating plans to improve the well-being of babies and children. Worldwide, there is a focus on promoting children's well-being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of 'shared decision-making' frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision-making with health visitor practice. A qualitative, descriptive study. The study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor-parent decision-making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants' experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care. Evidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision-making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals. Despite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision-making was unable to take place due to the absence of supportive processes. Health visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision-making framework to structure planning, as application of a framework identified the processes that support a collaborative approach in practice. © 2016 John Wiley & Sons Ltd.

A model for improving endangered species recovery programs

NASA Astrophysics Data System (ADS)

Miller, Brian; Reading, Richard; Conway, Courtney; Jackson, Jerome A.; Hutchins, Michael; Snyder, Noel; Forrest, Steve; Frazier, Jack; Derrickson, Scott

1994-09-01

This paper discusses common organizational problems that cause inadequate planning and implementation processes of endangered species recovery across biologically dissimilar species. If these problems occur, even proven biological conservation techniques are jeopardized. We propose a solution that requires accountability in all phases of the restoration process and is based on cooperative input among government agencies, nongovernmental conservation organizations, and the academic community. The first step is formation of a task-oriented recovery team that integrates the best expertise into the planning process. This interdisciplinary team should be composed of people whose skills directly address issues critical for recovery. Once goals and procedures are established, the responsible agency (for example, in the United States, the US Fish and Wildlife Service) could divest some or all of its obligation for implementing the plan, yet still maintain oversight by holding implementing entities contractually accountable. Regular, periodic outside review and public documentation of the recovery team, lead agency, and the accomplishments of implementing bodies would permit evaluation necessary to improve performance. Increased cooperation among agency and nongovernmental organizations provided by this model promises a more efficient use of limited resources toward the conservation of biodiversity.

76 FR 34713 - Proposed Establishment of a Federally Funded Research and Development Center-Third Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... (FFRDC) to facilitate the modernization of business processes and supporting systems and their operations... processes and supporting systems and their operations. Some of the broad task areas that will be utilized..., organizational planning, research and development, continuous process improvement, Independent Verification and...

Leveraging Successful Collaborative Processes to Improve Performance Outcomes in Large-Scale Event Planning: Super Bowl, A Planned Homeland Security Event

DTIC Science & Technology

2010-03-01

are turning out to be counterproductive because they are culturally anathema (Wollman, 2009). A consideration of psychological tenets by Sigmund ... Freud suggests a principle aspect of dysfunction in collaboration. He reasoned that An Ego governed by social convention and a Superego governed by

Multi-Informant Assessment of Transition-Related Skills and Skill Importance in Adolescents with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hume, Kara; Dykstra Steinbrenner, Jessica; Sideris, John; Smith, Leann; Kucharczyk, Suzanne; Szidon, Kate

2018-01-01

Adolescents with autism spectrum disorder have limited participation in the transition planning process, despite the link between active participation and an improvement in postsecondary education and employment outcomes. The Secondary School Success Checklist was designed to support transition planning for adolescents with autism spectrum…

Educational Planning Methodology for the Integrated Development of Rural Areas. Reports Studies... S.83.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

A summary of educational planning methodologies tested in Argentina, Guatemala, Brazil, Ecuador, and Bolivia, the document offers opinions and proposals about integrated rural development. Integrated rural development is seen as a social, economic, political, and cultural process in rural areas, designed to improve living conditions. Chapters…

Strategic Plan for Information Resources Management, FY 1993-97: Improving Education through Automation.

ERIC Educational Resources Information Center

Texas Education Agency, Austin.

In support of educational excellence and equity, the Texas Education Agency views all state public education information resources and technology as strategic assets of the education enterprise. This plan is presented in support of the goals of enhancing instruction through technology, restructuring the data processing environment for…

Research Utilizing Problem Solving (RUPS) - Classroom Version. Description of Teacher Inservice Education Materials.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Project on Utilization of Inservice Education R & D Outcomes.

The workshop instructional materials described here are designed to try out a systematic problem solving process as a way of working toward improvements in the school setting. Topics include diagnosis using force field technique, small group dynamics, planning for action, and planning a RUPS (Research Using Problem Solving) project. This…

Results-Based Monitoring and Evaluation at the Commonwealth of Learning: A Handbook

ERIC Educational Resources Information Center

Farrell, Glen M.

2009-01-01

Results-based management (RBM) is an approach to programme planning and management that integrates strategy, people, resources, processes and measurements to improve decision-making, transparency and accountability. The Commonwealth of Learning (COL) began the adoption of a RBM model with its 2003-2006 Three-Year Plan. This led to a significantly…

Technology Teacher Trainees' Lesson Planning Approach in South Africa: Room for Improvement

ERIC Educational Resources Information Center

Kola, Malose Isaac

2017-01-01

Technology education in South Africa provides learners with the opportunity to, inter alia, solve problems by applying creative skills using authentic contexts that are embedded in real-life situations. Effective lesson planning is rather imperative in exploiting this opportunity. The design process is considered to be the backbone of teaching…

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

Focus on motivation in the work rehabilitation planning process: a qualitative study from the employer's perspective.

PubMed

Gard, Gunvor; Larsson, Agneta

2003-09-01

Since the working environment act was passed in 1991, employers in Sweden are to plan and control the working environment conditions in workplaces. They are responsible for organized rehabilitation at the workplace including the development of rehabilitation plans and a plan for interventions in order for a sick-listed client to be able to return to work. The aim of this study was to describe employers' experiences of how motivation can be improved in a work rehabilitation process. Qualitative interviews were performed with 10 employers who had employees that had taken part in a period of vocational rehabilitation at a rehabilitation center in the north of Sweden, over a 2-year period. The result showed that increased focus on motivation for change is needed in work rehabilitation. The clients' motivation for change could be improved by a focus on motivational conversations at the workplace aiming at motivation for change in their working and living conditions. The employers' power of initiative, competence, economic resources, and motivation are needed for creative solutions at the workplace.

End-State Comfort Across the Lifespan: A Cross-Sectional Investigation of How Movement Context Influences Motor Planning in an Overturned Glass Task.

PubMed

Scharoun, Sara M; Gonzalez, David A; Roy, Eric A; Bryden, Pamela J

2018-04-01

Young adults plan actions in advance to minimize the cost of movement. This is exemplified by the end-state comfort (ESC) effect. A pattern of improvement in ESC in children is linked to the development of cognitive control processes, and decline in older adults is attributed to cognitive decline. This study used a cross-sectional design to examine how movement context (pantomime, demonstration with image/glass as a guide, actual grasping) influences between-hand differences in ESC planning. Children (5- to 12-year-olds), young adults, and two groups of older adults (aged 60-70, and aged 71 and older) were assessed. Findings provide evidence for adult-like patterns of ESC in 8-year-olds. Results are attributed to improvements in proprioceptive acuity and proficiency in generating and implementing internal representations of action. For older adults early in the aging process, sensitivity to ESC did not differ from young adults. However, with increasing age, differences reflect challenges in motor planning with increases in cognitive demand, similar to previous work. Findings have implications for understanding lifespan motor behavior.

An integrated decision model for the application of airborne sensors for improved response to accidental and terrorist chemical vapor releases

NASA Astrophysics Data System (ADS)

Kapitan, Loginn

This research created a new model which provides an integrated approach to planning the effective selection and employment of airborne sensor systems in response to accidental or intentional chemical vapor releases. The approach taken was to use systems engineering and decision analysis methods to construct a model architecture which produced a modular structure for integrating both new and existing components into a logical procedure to assess the application of airborne sensor systems to address chemical vapor hazards. The resulting integrated process model includes an internal aggregation model which allowed differentiation among alternative airborne sensor systems. Both models were developed and validated by experts and demonstrated using appropriate hazardous chemical release scenarios. The resultant prototype integrated process model or system fills a current gap in capability allowing improved planning, training and exercise for HAZMAT teams and first responders when considering the selection and employment of airborne sensor systems. Through the research process, insights into the current response structure and how current airborne capability may be most effectively used were generated. Furthermore, the resultant prototype system is tailorable for local, state, and federal application, and can potentially be modified to help evaluate investments in new airborne sensor technology and systems. Better planning, training and preparedness exercising holds the prospect for the effective application of airborne assets for improved response to large scale chemical release incidents. Improved response will result in fewer casualties and lives lost, reduced economic impact, and increased protection of critical infrastructure when faced with accidental and intentional terrorist release of hazardous industrial chemicals. With the prospect of more airborne sensor systems becoming available, this prototype system integrates existing and new tools into an effective process for the selection and employment of airborne sensors to better plan, train and exercise ahead of potential chemical release events.

Review, reaction, and projection: the role of the CFO in planning.

PubMed

Nauert, R C

1985-08-01

In recent years, CFOs have become an integral part of the healthcare organization's strategic planning process. Although not the leader in the process, CFOs should assume a role of review, reaction, and projection. Furthermore, they should oppose any venture that would weaken the financial strength of the institution--whether or not they support the venture on social grounds. The CFO's responsibility in planning is to improve the financial strength of the organization, using support documentation, thorough preparation, and logic. The CEO's concern for community needs and desire to pursue a new business should be tempered by the CFO's financial and economic judgment.

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.

Lean-driven improvements slash wait times, drive up patient satisfaction scores.

PubMed

2012-07-01

Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

School Improvement: A Resource and Planning Guide. Bulletin No. 8448.

ERIC Educational Resources Information Center

Gomoll, Robert; Burke, Peter J.

This guide describes a design for building-level school improvement in the state of Wisconsin. Summarized is effective-schools research that is designed to encourage schools and districts to become familiar with and engage in the improvement process. The first section describes what a school district needs to consider when beginning the school…

Employability Planning Process. STIP II (Skill Training Improvement Programs Round II).

ERIC Educational Resources Information Center

Los Angeles Community Coll. District, CA.

Four reports are presented detailing procedures for improving the employability of students enrolled in the Los Angeles Community College District's Skill Training Improvement Programs (STIP II). Each report was submitted by one of the four STIP II programs: Los Angeles Southwest College's program for computer programming; the programs for…

Population management, systems-based practice, and planned chronic illness care: integrating disease management competencies into primary care to improve composite diabetes quality measures.

PubMed

Kimura, Joe; DaSilva, Karen; Marshall, Richard

2008-02-01

The increasing prevalence of chronic illnesses in the United States requires a fundamental redesign of the primary care delivery system's structure and processes in order to meet the changing needs and expectations of patients. Population management, systems-based practice, and planned chronic illness care are 3 potential processes that can be integrated into primary care and are compatible with the Chronic Care Model. In 2003, Harvard Vanguard Medical Associates, a multispecialty ambulatory physician group practice based in Boston, Massachusetts, began implementing all 3 processes across its primary care practices. From 2004 to 2006, the overall diabetes composite quality measures improved from 51% to 58% for screening (HgA1c x 2, low-density lipoprotein, blood pressure in 12 months) and from 13% to 17% for intermediate outcomes (HgA1c

36 CFR 222.10 - Range betterment fund.

Code of Federal Regulations, 2010 CFR

2010-07-01

... within the 16 contiguous western States, the Chief, Forest Service, shall implement range improvement... allocated for range rehabilitation, protection and improvements on National Forest lands within the Forest Service Regions where they were derived. During the planning process there will be consultation with...

7 CFR 4280.102 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Improvements Program § 4280.102 General. (a) Sections 4280.103 through 4280.106 discuss definitions, exception... evaluation process, and post-grant Federal requirements for both the simplified and full application processes. Sections 4280.115 through 4280.117 address project planning, development, and completion as...

Plotting performance improvement progress through the development of a trauma dashboard.

PubMed

Hochstuhl, Diane C; Elwell, Sean

2014-01-01

Performance improvement processes are the core of a pediatric trauma program. The ability to identify, resolve, and trend specific indicators related to patient care and to show effective loop closure can be especially challenging. Using the hospital's overall quality process as a template, the trauma program built its own electronic dashboard. Our maturing trauma PI program now guides the overall trauma care. All departments own at least one performance indicator and must provide action plans for improvement. Utilization of an electronic dashboard for trauma performance improvement has provided a highly visible scorecard, which highlights successes and tracks areas needing improvement.

Limiting the risk of cardiac toxicity with esophageal-sparing intensity modulated radiotherapy for locally advanced lung cancers.

PubMed

Woodford, Katrina; Panettieri, Vanessa; Ruben, Jeremy D; Senthi, Sashendra

2016-05-01

Intensity modulated radiotherapy (IMRT) is routinely utilized in the treatment of locally advanced non-small cell lung cancer (NSCLC). RTOG 0617 found that overall survival was impacted by increased low (5 Gy) and intermediate (30 Gy) cardiac doses. We evaluated the impact of esophageal-sparing IMRT on cardiac doses with and without the heart considered in the planning process and predicted toxicity compared to 3D-conventional radiotherapy (3DCRT). Ten consecutive patients with N2 Stage III NSCLC treated to 60 Gy in 30 fractions, between February 2012 and September 2014, were evaluated. For each patient, 3DCRT and esophageal-sparing IMRT plans were generated. IMRT plans were then created with and without the heart considered in the optimization process. To compare plans, the dose delivered to 95% and 99% of the target (D95% and D99%), and doses to the esophagus, lung and heart were compared by determining the volume receiving X dose (VXGy) and the normal tissue complication probability (NTCP) calculated. IMRT reduced maximum esophagus dose to below 60 Gy in all patients and produced significant reductions to V50Gy, V40Gy and esophageal NTCP. The cost of this reduction was a non-statistically, non-clinically significant increase in low dose (5 Gy) lung exposure that did not worsen lung NTCP. IMRT plans produced significant cardiac sparing, with the amount of improvement correlating to the amount of heart overlapping with the target. When included in plan optimization, for selected patients further sparing of the heart and improvement in heart NTCP was possible. Esophageal-sparing IMRT can significantly spare the heart even if it is not considered in the optimization process. Further sparing can be achieved if plan optimization constrains low and intermediate heart doses, without compromising lung doses.

Resource Allocation Planning Helper (RALPH): Lessons learned

NASA Technical Reports Server (NTRS)

Durham, Ralph; Reilly, Norman B.; Springer, Joe B.

1990-01-01

The current task of Resource Allocation Process includes the planning and apportionment of JPL's Ground Data System composed of the Deep Space Network and Mission Control and Computing Center facilities. The addition of the data driven, rule based planning system, RALPH, has expanded the planning horizon from 8 weeks to 10 years and has resulted in large labor savings. Use of the system has also resulted in important improvements in science return through enhanced resource utilization. In addition, RALPH has been instrumental in supporting rapid turn around for an increased volume of special what if studies. The status of RALPH is briefly reviewed and important lessons learned from the creation of an highly functional design team are focused on through an evolutionary design and implementation period in which an AI shell was selected, prototyped, and ultimately abandoned, and through the fundamental changes to the very process that spawned the tool kit. Principal topics include proper integration of software tools within the planning environment, transition from prototype to delivered to delivered software, changes in the planning methodology as a result of evolving software capabilities and creation of the ability to develop and process generic requirements to allow planning flexibility.

Remediation plans in family medicine residency

PubMed Central

Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

2015-01-01

Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

Evaluation of an artificial intelligence guided inverse planning system: clinical case study.

PubMed

Yan, Hui; Yin, Fang-Fang; Willett, Christopher

2007-04-01

An artificial intelligence (AI) guided method for parameter adjustment of inverse planning was implemented on a commercial inverse treatment planning system. For evaluation purpose, four typical clinical cases were tested and the results from both plans achieved by automated and manual methods were compared. The procedure of parameter adjustment mainly consists of three major loops. Each loop is in charge of modifying parameters of one category, which is carried out by a specially customized fuzzy inference system. A physician prescribed multiple constraints for a selected volume were adopted to account for the tradeoff between prescription dose to the PTV and dose-volume constraints for critical organs. The searching process for an optimal parameter combination began with the first constraint, and proceeds to the next until a plan with acceptable dose was achieved. The initial setup of the plan parameters was the same for each case and was adjusted independently by both manual and automated methods. After the parameters of one category were updated, the intensity maps of all fields were re-optimized and the plan dose was subsequently re-calculated. When final plan arrived, the dose statistics were calculated from both plans and compared. For planned target volume (PTV), the dose for 95% volume is up to 10% higher in plans using the automated method than those using the manual method. For critical organs, an average decrease of the plan dose was achieved. However, the automated method cannot improve the plan dose for some critical organs due to limitations of the inference rules currently employed. For normal tissue, there was no significant difference between plan doses achieved by either automated or manual method. With the application of AI-guided method, the basic parameter adjustment task can be accomplished automatically and a comparable plan dose was achieved in comparison with that achieved by the manual method. Future improvements to incorporate case-specific inference rules are essential to fully automate the inverse planning process.

Implementing a cardiac resynchronization therapy program in a county hospital.

PubMed

Merchant, Karen; Laborde, Ann

2005-09-01

Clinical trials and research literature show the benefits of cardiac resynchronization therapy and implantable cardioverter defibrillator devices in improving the quality of life for selected patients with heart failure. While translating these positive research results into clinical practice is a major effort requiring a strategic planning process, implementing these practices in-house may result in cost savings and possible increased revenue. The authors describe the planning and implementation process used to introduce these therapies in a cardiac catheterization laboratory at a county teaching hospital.

Improving processes through evolutionary optimization.

PubMed

Clancy, Thomas R

2011-09-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies on complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 18th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, I discuss methods to optimize complex healthcare processes through learning, adaptation, and evolutionary planning.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

Improving Quality and Efficiency of Postpartum Hospital Education

PubMed Central

Buchko, Barbara L.; Gutshall, Connie H.; Jordan, Elizabeth T.

2012-01-01

The purpose of this study was to investigate the implementation of an evidence-based, streamlined, education process (comprehensive education booklet, individualized education plan, and integration of education into the clinical pathway) and nurse education to improve the quality and efficiency of postpartum education during hospitalization. A one-group pretest–posttest design was used to measure the quality of discharge teaching for new mothers and efficiency of the education process for registered nurses before and after implementation of an intervention. Results indicated that a comprehensive educational booklet and enhanced documentation can improve efficiency in the patient education process for nurses. PMID:23997552

Operational Plan Ontology Model for Interconnection and Interoperability

NASA Astrophysics Data System (ADS)

Long, F.; Sun, Y. K.; Shi, H. Q.

2017-03-01

Aiming at the assistant decision-making system’s bottleneck of processing the operational plan data and information, this paper starts from the analysis of the problem of traditional expression and the technical advantage of ontology, and then it defines the elements of the operational plan ontology model and determines the basis of construction. Later, it builds up a semi-knowledge-level operational plan ontology model. Finally, it probes into the operational plan expression based on the operational plan ontology model and the usage of the application software. Thus, this paper has the theoretical significance and application value in the improvement of interconnection and interoperability of the operational plan among assistant decision-making systems.

Application of 3-Dimensional Printing in a Case of Osteogenesis Imperfecta for Patient Education, Anatomic Understanding, Preoperative Planning, and Intraoperative Evaluation.

PubMed

Eisenmenger, Laura B; Wiggins, Richard H; Fults, Daniel W; Huo, Eugene J

2017-11-01

The techniques and applications of 3-dimensional (3D) printing have progressed at a fast pace. In the last 10 years, there has been significant progress in applying this technology to medical applications. We present a case of osteogenesis imperfecta in which treatment was aided by prospectively using patient-specific, anatomically accurate 3D prints of the calvaria. The patient-specific, anatomically accurate 3D prints were used in the clinic and in the operating room to augment patient education, improve surgical decision making, and enhance preoperative planning. A 41-year-old woman with osteogenesis imperfecta and an extensive neurosurgical history presented for cranioplasty revision. Computed tomography (CT) data obtained as part of routine preoperative imaging were processed into a 3D model. The 3D patient-specific models were used in the clinic for patient education and in the operating room for preoperative visualization, planning, and intraoperative evaluation of anatomy. The patient reported the 3D models improved her understanding and comfort with the planned surgery when compared with discussing the procedure with the neurosurgeon or viewing the CT images with a neuroradiologist. The neurosurgeon reported an improved understanding of the patient's anatomy and potential cause of patient symptoms as well as improved preoperative planning compared with viewing the CT imaging alone. The neurosurgeon also reported an improvement in the planned surgical approach with a better intraoperative visualization and confirmation of the regions of planned calvarial resection. The use of patient-specific, anatomically accurate 3D prints may improve patient education, surgeon understanding and visualization, preoperative decision making, and intraoperative management. Copyright © 2017 Elsevier Inc. All rights reserved.

Progress towards CSR RL06 GRACE gravity solutions

NASA Astrophysics Data System (ADS)

Save, Himanshu

2017-04-01

The GRACE project plans to re-processes the GRACE mission data in order to be consistent with the first gravity products released by the GRACE-FO project. The next generation Release-06 (RL06) gravity products from GRACE will include the improvements in GRACE Level-1 data products, background gravity models and the processing methodology. This paper will outline the planned improvements for CSR - RL06 and discuss the preliminary results. This paper will discuss the evolution of the quality of the GRACE solutions, especially over the past few years. We will also discuss the possible challenges we may face in connecting/extending the measurements of mass fluxes from the GRACE era to the GRACE-FO era due quality of the GRACE solutions from recent years.

Training Psychotherapists in Hierarchical Treatment Planning

PubMed Central

MAKOVER, RICHARD B.

1992-01-01

Treatment planning is a central and persistent challenge in psychotherapy. This paper outlines a four-level planning hierarchy that encourages the therapist to conceptualize a desired overall outcome (the "aim") that can be realized through subsidiary objectives (the "goals"). The "strategies" by which goals are pursued and the "tactics" that carry out those strategies are subordinate and instrumental elements of the treatment process. Greater emphasis on this type of treatment planning in the training and supervision of psychotherapists should make therapy more effective, improve treatment outcomes, and allow more efficient use of therapy resources. PMID:22700115

The Impact of Computing in Education in Korea.

ERIC Educational Resources Information Center

Huh, Unna

1993-01-01

Discusses educational computing in Korea to be used for improving the teaching-learning process, improving science education, and preparing for an information society. Highlights include government, higher education, and private company support; basic objectives and long-term planning for educational computing; software applications; and future…

Care plans and care planning in long-term conditions: a conceptual model.

PubMed

Burt, Jenni; Rick, Jo; Blakeman, Thomas; Protheroe, Joanne; Roland, Martin; Bower, Pete

2014-10-01

The prevalence and impact of long-term conditions continues to rise. Care planning for people with long-term conditions has been a policy priority for chronic disease management in a number of health-care systems. However, patients and providers appear unclear about the formulation and implementation of care planning. Further work in this area is therefore required to inform the development, implementation and evaluation of future care planning initiatives. We distinguish between 'care planning' (the process by which health-care professionals and patients discuss, agree and review an action plan to achieve the goals or behaviour change of most relevance and concern to the patient) and a 'care plan' (a written document recording the outcome of a care planning process). We propose a typology of care planning and care plans with three core dimensions: perspective (patient or professional), scope (a focus on goals or on behaviours) and networks (confined to the professional-patient dyad or extending to the entire care network). In addition, we draw on psychological models of mediation and moderation to outline potential mechanisms through which care planning and care plans may lead to improved outcomes for both patients and the wider health-care system. The proposed typology of care planning and care plans offered here, along with the model of the process by which care planning may influence outcomes, provide a useful framework for future policy developments and evaluations. Empirical work is required to explore the degree to which current care planning approaches and care plans can be described according to these dimensions, and the factors that determine which types of patients and professionals use which type of care plans.

23 CFR 924.9 - Planning.

Code of Federal Regulations, 2014 CFR

2014-04-01

... evaluation process to analyze and assess results achieved by the HSIP and uses this information, where... program of projects, technologies, or strategies to reduce or eliminate highway safety hazards; (G) Adopts... elements to develop highway safety improvement projects. (5) A process for establishing priorities for...

23 CFR 924.9 - Planning.

Code of Federal Regulations, 2012 CFR

2012-04-01

... evaluation process to analyze and assess results achieved by the HSIP and uses this information, where... program of projects, technologies, or strategies to reduce or eliminate highway safety hazards; (G) Adopts... elements to develop highway safety improvement projects. (5) A process for establishing priorities for...

23 CFR 924.9 - Planning.

Code of Federal Regulations, 2013 CFR

2013-04-01

... evaluation process to analyze and assess results achieved by the HSIP and uses this information, where... program of projects, technologies, or strategies to reduce or eliminate highway safety hazards; (G) Adopts... elements to develop highway safety improvement projects. (5) A process for establishing priorities for...

Developing the Image and Public Reputation of Universities: The Managerial Process.

ERIC Educational Resources Information Center

Davies, John L.; Melchiori, Gerlinda S.

1982-01-01

Managerial processes used in developing programs to improve an institution's public image are outlined, drawing on both theory and experience in college administration and public relations. Eight case studies provide illustrations. A five-stage managerial plan is presented. (MSE)

Improving productivity and profitability of a bioanalytical business through sales and operation planning.

PubMed

Islam, Rafiqul

2013-07-01

Today's bioanalytical CROs face increasing global competition, highly variable demand, high fixed costs, pricing pressure, and increasing demand for quality and speed. Most bioanalytical laboratories have responded to these challenges by implementing automation and by implementing process improvement methodologies (e.g., Six Sigma). These solutions have not resulted in a significant improvement in productivity and profitability since none of them are able to predict the upturn or downturn in demand. High volatility of demand causes long lead times and high costs during peak demand and poor productivity during trough demand. Most bioanalytical laboratories lack the tools to align supply efficiently to meet changing demand. In this paper, sales and operation planning (S&OP) has been investigated as a tool to balance supply and demand. The S&OP process, when executed effectively, can be the single greatest determinant of profitability for a bioanalytical business.

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.

Redefining and expanding quality assurance.

PubMed

Robins, J L

1992-12-01

To meet the current standards of excellence necessary for blood establishments, we have learned from industry that a movement toward organization-wide quality assurance/total quality management must be made. Everyone in the organization must accept responsibility for participating in providing the highest quality products and services. Quality must be built into processes and design systems to support these quality processes. Quality assurance has been redefined to include a quality planning function described as the most effective way of designing quality into processes. A formalized quality planning process must be part of quality assurance. Continuous quality improvement has been identified as the strategy every blood establishment must support while striving for error-free processing as the long-term objective. The auditing process has been realigned to support and facilitate this same objective. Implementing organization-wide quality assurance/total quality management is one proven plan for guaranteeing the quality of the 20 million products that are transfused into 4 million patients each year and for moving toward the new order.

Quality initiatives: lean approach to improving performance and efficiency in a radiology department.

PubMed

Kruskal, Jonathan B; Reedy, Allen; Pascal, Laurie; Rosen, Max P; Boiselle, Phillip M

2012-01-01

Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development. © RSNA, 2012.

Constraint-based Attribute and Interval Planning

NASA Technical Reports Server (NTRS)

Jonsson, Ari; Frank, Jeremy

2013-01-01

In this paper we describe Constraint-based Attribute and Interval Planning (CAIP), a paradigm for representing and reasoning about plans. The paradigm enables the description of planning domains with time, resources, concurrent activities, mutual exclusions among sets of activities, disjunctive preconditions and conditional effects. We provide a theoretical foundation for the paradigm, based on temporal intervals and attributes. We then show how the plans are naturally expressed by networks of constraints, and show that the process of planning maps directly to dynamic constraint reasoning. In addition, we de ne compatibilities, a compact mechanism for describing planning domains. We describe how this framework can incorporate the use of constraint reasoning technology to improve planning. Finally, we describe EUROPA, an implementation of the CAIP framework.

Inspection planning development: An evolutionary approach using reliability engineering as a tool

NASA Technical Reports Server (NTRS)

Graf, David A.; Huang, Zhaofeng

1994-01-01

This paper proposes an evolutionary approach for inspection planning which introduces various reliability engineering tools into the process and assess system trade-offs among reliability, engineering requirement, manufacturing capability and inspection cost to establish an optimal inspection plan. The examples presented in the paper illustrate some advantages and benefits of the new approach. Through the analysis, reliability and engineering impacts due to manufacturing process capability and inspection uncertainty are clearly understood; the most cost effective and efficient inspection plan can be established and associated risks are well controlled; some inspection reductions and relaxations are well justified; and design feedbacks and changes may be initiated from the analysis conclusion to further enhance reliability and reduce cost. The approach is particularly promising as global competitions and customer quality improvement expectations are rapidly increasing.

Production layout improvement by using line balancing and Systematic Layout Planning (SLP) at PT. XYZ

NASA Astrophysics Data System (ADS)

Buchari; Tarigan, U.; Ambarita, M. B.

2018-02-01

PT. XYZ is a wood processing company which produce semi-finished wood with production system is make to order. In the production process, it can be seen that the production line is not balanced. The imbalance of the production line is caused by the difference in cycle time between work stations. In addition, there are other issues, namely the existence of material flow pattern is irregular so it resulted in the backtracking and displacement distance away. This study aimed to obtain the allocation of work elements to specific work stations and propose an improvement of the production layout based on the result of improvements in the line balancing. The method used in the balancing is Ranked Positional Weight (RPW) or also known as Helgeson Birnie method. While the methods used in the improvement of the layout is the method of Systematic Layout Planning (SLP). By using Ranked Positional Weight (RPW) obtained increase in line efficiency becomes 84,86% and decreased balance delay becomes 15,14%. Repairing the layout using the method of Systematic Layout Planning (SLP) also give good results with a reduction in path length becomes 133,82 meters from 213,09 meters previously or a decrease of 37.2%.

A Process for Self-Directed Professional Growth or "I Could Do My Job Better if Only...".

ERIC Educational Resources Information Center

Hofstrand, Richard K.

1979-01-01

PAPA: Plans, Action and Progress Assessment, a process whereby the professional educator can effectively organize professional growth and development efforts, is presented. The process can also aid teachers, counselors, professors, or administrators in improving job performance. The three parts of the program are described. (CT)

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…

Embedding Assessment to Improve Learning

ERIC Educational Resources Information Center

Whitehouse, Mary

2013-01-01

The traditional plan of teaching science content and then deciding at the end what to ask in an examination is challenged in this presentation, which starts the planning at the other end of the process. The intention is to consider the topic, decide what children should know and be able to do by the end, then structure the teaching, with…

7 CFR Exhibit A to Subpart B of... - Grant Agreement-Growth Management and Housing Planning for Approved Designated Energy Impacted Areas

Code of Federal Regulations, 2011 CFR

2011-01-01

... met; (iii) Problems, delays, or adverse conditions which will materially affect attainment of planned... process which will improve local conditions and alleviate problems associated with increased coal or... Grantee programs, projects, related activities, and problems. (b) The Grantee shall inform the Grantor as...

Health Care Transition Planning among Adolescents with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Walsh, Casey; Jones, Barbara; Schonwald, Alison

2017-01-01

Improving the health care transition process for youth with autism spectrum disorder (ASD) is critically important. This study was designed to examine the overall national transition core outcome among youth with ASD and each of the component measures of health care transition planning. Fewer than 10% of youth with ASD meet the national transition…

75 FR 32920 - Publication of State Plan Pursuant to the Help America Vote Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

...)(11)(A) and 255(b) of the Help America Vote Act (HAVA), Public Law 107-252, the U.S. Election... improving the voting process in America. Dated: May 26, 2010. Thomas R. Wilkey, Executive Director, U.S... ELECTION ASSISTANCE COMMISSION Publication of State Plan Pursuant to the Help America Vote Act...

CQI: using the Hoshin planning system to design an orientation process.

PubMed

Platt, D; Laird, C

1995-01-01

The Hoshin planning system, developed in Japan after World War II, includes management tools intended specifically for planning new processes. There are seven tools, which can be used individually or in any combination: affinity diagrams, interrelationship digraphs, systematic diagrams, matrix diagrams, process decision program charts, arrow diagrams and prioritization matrices. The radiology department at Carson-Tahoe Hospital formed a CQI team to improve the training of front office clerks. The team quickly discovered that a new orientation program was needed and decided to use Hoshin tools to create one. Using the tools, the team identified and prioritized all relevant factors, described specific tasks needed to complete the planning process and how long each would take, anticipated problems, and assigned areas of responsibility to members of the team. Each time the team grew weary or discouraged, the clarity and organization afforded by the tools helped them feel productive and in control of the process. The team was amazed at the creative ideas they generated through this 3-month-long process. Not only did they develop and implement a new orientation program, they also cultivated a stronger sense of pride and confidence in their work and each other.

[Quality planning of Family Health Units using Quality Function Deployment (QFD)].

PubMed

Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

2010-08-01

Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

DRMS (Defense Reutilization and Marketing Service) Total Quality Management (TQM) Implementation Plan

DTIC Science & Technology

1989-07-01

FUNDING NUMBERS DRMS Total Quality Management (TQM) Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...OF PAGES TOM (Total Quality Management ), Continuous Process Improvement. ’f’ - Management 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...7540-01-280-5500 Standard Form 298 (Rev. 2-89) Pr"cried by ANi SWt 139-i 296-101 DRMS TOTAL QUALITY MANAGEMENT (TQM) IMPLEMENTATION PLAN PURPOSE The

Bidding-based autonomous process planning and scheduling

NASA Astrophysics Data System (ADS)

Gu, Peihua; Balasubramanian, Sivaram; Norrie, Douglas H.

1995-08-01

Improving productivity through computer integrated manufacturing systems (CIMS) and concurrent engineering requires that the islands of automation in an enterprise be completely integrated. The first step in this direction is to integrate design, process planning, and scheduling. This can be achieved through a bidding-based process planning approach. The product is represented in a STEP model with detailed design and administrative information including design specifications, batch size, and due dates. Upon arrival at the manufacturing facility, the product registered in the shop floor manager which is essentially a coordinating agent. The shop floor manager broadcasts the product's requirements to the machines. The shop contains autonomous machines that have knowledge about their functionality, capabilities, tooling, and schedule. Each machine has its own process planner and responds to the product's request in a different way that is consistent with its capabilities and capacities. When more than one machine offers certain process(es) for the same requirements, they enter into negotiation. Based on processing time, due date, and cost, one of the machines wins the contract. The successful machine updates its schedule and advises the product to request raw material for processing. The concept was implemented using a multi-agent system with the task decomposition and planning achieved through contract nets. The examples are included to illustrate the approach.

Medicare+Choice: what lies ahead?

PubMed

Layne, R Jeffrey

2002-03-01

Health plans have continued to exit the Medicare+Choice program in recent years, despite efforts of Congress and the Centers for Medicare and Medicaid Services (CMS) to reform the program. Congress and CMS therefore stand poised to make additional, substantial reforms to the program. CMS has proposed to consolidate its oversight of the program, extend the due date for Medicare+Choice plans to file their adjusted community rate proposals, revise risk-adjustment processes, streamline the marketing review process, enhance quality-improvement requirements, institute results based performance assessment audits, coordinate policy changes to coincide with contracting cycles, expand its fall advertising campaign for the program, provide better employer-based Medicare options for beneficiaries, and take steps to minimize beneficiary costs. Congressional leaders have proposed various legislative remedies to improve the program, including creation of an entirely new pricing structure for the program based on a competitive bidding process.

Juggling Act: Re-Planning and Building on Observatory...Simultaneously!

NASA Technical Reports Server (NTRS)

Zavala, Eddie; Daws, Patricia

2011-01-01

SOFIA (Stratospheric Observatory for Infrared Astronomy) is a major SMD program that has been required to meet several requirements and implement major planning and business initiatives overthe past 1 1/2 years, in the midst of system development and flight test phases. The program was required to implementing JCL and EVM simultaneously, as well as undergo a major replan and Standing Review Board - and all without impacting technical schedule progress. The team developed innovative processes that met all the requirements, and improved Program Management process toolsets. The SOFIA team, being subject to all the typical budget constraints, found ways to leverage existing roles in new ways to meet the requirements without creating unmanageable overhead. The team developed strategies and value added processes - such as improved risk identification, structured reserves management, cost/risk integration - so that the effort expended resulted in a positive return to the program.

Integrating ecosystem services analysis into scenario planning practice: accounting for street tree benefits with i-Tree valuation in Central Texas.

PubMed

Hilde, Thomas; Paterson, Robert

2014-12-15

Scenario planning continues to gain momentum in the United States as an effective process for building consensus on long-range community plans and creating regional visions for the future. However, efforts to integrate more sophisticated information into the analytical framework to help identify important ecosystem services have lagged in practice. This is problematic because understanding the tradeoffs of land consumption patterns on ecological integrity is central to mitigating the environmental degradation caused by land use change and new development. In this paper we describe how an ecosystem services valuation model, i-Tree, was integrated into a mainstream scenario planning software tool, Envision Tomorrow, to assess the benefits of public street trees for alternative future development scenarios. The tool is then applied to development scenarios from the City of Hutto, TX, a Central Texas Sustainable Places Project demonstration community. The integrated tool represents a methodological improvement for scenario planning practice, offers a way to incorporate ecosystem services analysis into mainstream planning processes, and serves as an example of how open source software tools can expand the range of issues available for community and regional planning consideration, even in cases where community resources are limited. The tool also offers room for future improvements; feasible options include canopy analysis of various future land use typologies, as well as a generalized street tree model for broader U.S. application. Copyright © 2014 Elsevier Ltd. All rights reserved.

Strategic Planning Process Resource Manual.

ERIC Educational Resources Information Center

Mohammadi, John

Capital Community-Technical College (CCTC) (Connecticut) has developed a comprehensive institutional effectiveness model that will guide the college toward the year 2002. Its primary purposes are to improve the quality of decision making, to enhance the quality of its students' outcomes, and to improve the effectiveness of the institution in…

Care plans and care planning in long term conditions: a conceptual model

PubMed Central

Burt, J; Rick, J; Blakeman, T; Protheroe, J; Roland, M; Bower, P

2013-01-01

The prevalence and impact of long term conditions continues to rise. Care planning for people with long term conditions has been a policy priority for chronic disease management in a number of health care systems. However, patients and providers appear unclear about the formulation and implementation of care planning. Further work in this area is therefore required to inform the development, implementation and evaluation of future care planning initiatives. We distinguish between ‘care planning’ (the process by which health care professionals and patients discuss, agree and review an action plan to achieve the goals or behaviour change of most relevance and concern to the patient) and a ‘care plan’ (a written document recording the outcome of a care planning process). We propose a typology of care planning and care plans with three core dimensions: perspective (patient or professional), scope (a focus on goals or on behaviours) and networks (confined to the professional-patient dyad or extending to the entire care network). In addition, we draw on psychological models of mediation and moderation to outline potential mechanisms through which care planning and care plans may lead to improved outcomes for both patients and the wider health care system. The proposed typology of care planning and care plans offered here, along with the model of the process by which care planning may influence outcomes, provide a useful framework for future policy developments and evaluations. Empirical work is required to explore the degree to which current care planning approaches and care plans can be described according to these dimensions, and the factors that determine which types of patients and professionals use which type of care plans. PMID:23883621

Integration of Treatment Innovation Planning and Implementation: Strategic Process Models and Organizational Challenges

PubMed Central

Lehman, Wayne E. K.; Simpson, D. Dwayne; Knight, Danica K.; Flynn, Patrick M.

2015-01-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A 2-phase procedural approach is therefore presented based on the integration of TCU models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. PMID:21443294

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.

A study of a nursing department performance measurement system: using the Balanced Scorecard and the Analytic Hierarchy Process.

PubMed

Chu, Hsuan-Lien; Wang, Chen-Chin; Dai, Yu-Tzu

2009-01-01

The health care industry is under pressure from government and private entities as well as from market conditions to contain costs. In an effort to respond to these pressures, the case hospital in this study implemented a Balanced Scorecard (BSC) in January 2003 and integrated it with the hospital's formal incentive plan for non-physicians in January 2005. The nursing department's performance improved in the 2 years following the introduction of the plan. This study contributes to the literature by demonstrating the performance improvement that results from integrating the BSC with an incentive plan in the nursing field. The results provide insight into the current BSC performance metrics applied by the case nursing department, and could be used as guidelines by other health care organizations that wish to implement BSC-based incentive plans.

Program Risk Planning with Risk as a Resource

NASA Technical Reports Server (NTRS)

Ray, Paul S.

1998-01-01

The current focus of NASA on cost effective ways of achieving mission objectives has created a demand for a change in the risk management process of a program. At present, there is no guidelines as to when risk taking is justified due to high cost for a marginal improvement in risk. As a remedial step, Dr. Greenfield of NASA, developed a concept of risk management with risk as a resource. In the report, the following topics are addressed: (1) the risk management approach; (2) planning risk and program life cycle; (3) key components of a typical program; (4) the risk trading methodology; (5) review and decision process; (6) merits of the proposed risk planning approach; and (7) recommendations.

Healthy Eating and Activity Across the Lifespan (HEAL): A call to action to integrate research, clinical practice, policy, and community resources to address weight-related health disparities.

PubMed

Berge, Jerica M; Adamek, Margaret; Caspi, Caitlin; Loth, Katie A; Shanafelt, Amy; Stovitz, Steven D; Trofholz, Amanda; Grannon, Katherine Y; Nanney, Marilyn S

2017-08-01

Despite intense nationwide efforts to improve healthy eating and physical activity across the lifespan, progress has plateaued. Moreover, health inequities remain. Frameworks that integrate research, clinical practice, policy, and community resources to address weight-related behaviors are needed. Implementation and evaluation of integration efforts also remain a challenge. The purpose of this paper is to: (1) Describe the planning and development process of an integrator entity, HEAL (Healthy Eating and Activity across the Lifespan); (2) present outcomes of the HEAL development process including the HEAL vision, mission, and values statements; (3) define the planned integrator functions of HEAL; and (4) describe the ongoing evaluation of the integration process. HEAL team members used a theoretically-driven, evidence-based, systemic, twelve-month planning process to guide the development of HEAL and to lay the foundation for short- and long-term integration initiatives. Key development activities included a review of the literature and case studies, identifying guiding principles and infrastructure needs, conducting stakeholder/key informant interviews, and continuous capacity building among team members. Outcomes/deliverables of the first year of HEAL included a mission, vision, and values statements; definitions of integration and integrator functions and roles; a set of long-range plans; and an integration evaluation plan. Application of the HEAL integration model is currently underway through community solicited initiatives. Overall, HEAL aims to lead real world integrative work that coalesce across research, clinical practice, and policy with community resources to inspire a culture of health equity aimed at improving healthy eating and physical activity across the lifespan. Copyright © 2017 Elsevier Inc. All rights reserved.

Building an outpatient imaging center: A case study at genesis healthcare system, part 2.

PubMed

Yanci, Jim

2006-01-01

In the second of 2 parts, this article will focus on process improvement projects utilizing a case study at Genesis HealthCare System located in Zanesville, OH. Operational efficiency is a key step in developing a freestanding diagnostic imaging center. The process improvement projects began with an Expert Improvement Session (EIS) on the scheduling process. An EIS session is a facilitated meeting that can last anywhere from 3 hours to 2 days. Its intention is to take a group of people involved with the problem or operational process and work to understand current failures or breakdowns in the process. Recommendations are jointly developed to overcome any current deficiencies, and a work plan is structured to create ownership over the changes. A total of 11 EIS sessions occurred over the course of this project, covering 5 sections: Scheduling/telephone call process, Pre-registration, Verification/pre-certification, MRI throughput, CT throughput. Following is a single example of a project focused on the process improvement efforts. All of the process improvement projects utilized a quasi methodology of "DMAIC" (Define, Measure, Analyze, Improve, and Control).

CNES Strategic Plan 2001-2005

NASA Astrophysics Data System (ADS)

Janichewski, S.; Ben Aı̈m, H.

2004-04-01

CNES's latest strategic plan defines the French space agency's strategic focus and charts its course for the 2001-2005 timeframe. Based on a vision of how the space sector will evolve over the period up to 2010, the Strategic Plan sets out the agency's ambition for 2005: " CNES—space technology serving society". This ambition is structured around four challenges: Focusing actions on society's needs in three areas where space technology can make a major difference—environment, science and the information society and mobility. Building the foundation for success by ensuring competitive access to space and boosting basic research and technological innovation. Strengthening national and European synergies to ensure complementarity between: the ESA European framework, which is well adapted for major projects and the development of a European Space Strategy (ESS); and the national framework to support activities of national responsibility such as defence, science and technology development, and to improve competitiveness through direct international cooperation with other space agencies. Forging effective partnerships with its research and industry partners in Europe and France to enhance performance by: developing a service culture; building partnerships; concentrating on core competencies where it can most add value; improving skills and responsiveness in line with its strategic position; ensuring transparent and rigorous management of public funds. This Strategic Plan will be implemented in the 2001-2005 timeframe at all management levels. Implementation will be eased by the fact that the plan has been drawn up through a specific process designed to make internal management aware of the analysis underlying it. This will ensure that all stakeholders understand and appropriate the plan's orientations and thus play an active role in CNES' development. This process involved five successive steps: shared assessment of the space sector's evolution, providing a common baseline from which to build on CNES's vision; shared ambition, defining the agency's objectives and strategic focus; applying lines of action at each of the agency's four space centres through specifically targeted action plans at centre and process level; setting up of a monitoring and oversight structure; definition of a communication strategy to support management of change, designed to keep all CNES personnel informed about the plan and the process behind it.

Development and Validation of a Questionnaire to Detect Behavior Change in Multiple Advance Care Planning Behaviors

PubMed Central

Sudore, Rebecca L.; Stewart, Anita L.; Knight, Sara J.; McMahan, Ryan D.; Feuz, Mariko; Miao, Yinghui; Barnes, Deborah E.

2013-01-01

Introduction Advance directives have traditionally been considered the gold standard for advance care planning. However, recent evidence suggests that advance care planning involves a series of multiple discrete behaviors for which people are in varying stages of behavior change. The goal of our study was to develop and validate a survey to measure the full advance care planning process. Methods The Advance Care Planning Engagement Survey assesses “Process Measures” of factors known from Behavior Change Theory to affect behavior (knowledge, contemplation, self-efficacy, and readiness, using 5-point Likert scales) and “Action Measures” (yes/no) of multiple behaviors related to surrogate decision makers, values and quality of life, flexibility for surrogate decision making, and informed decision making. We administered surveys at baseline and 1 week later to 50 diverse, older adults from San Francisco hospitals. Internal consistency reliability of Process Measures was assessed using Cronbach's alpha (only continuous variables) and test-retest reliability of Process and Action Measures was examined using intraclass correlations. For discriminant validity, we compared Process and Action Measure scores between this cohort and 20 healthy college students (mean age 23.2 years, SD 2.7). Results Mean age was 69.3 (SD 10.5) and 42% were non-White. The survey took a mean of 21.4 minutes (±6.2) to administer. The survey had good internal consistency (Process Measures Cronbach's alpha, 0.94) and test-retest reliability (Process Measures intraclass correlation, 0.70; Action Measures, 0.87). Both Process and Action Measure scores were higher in the older than younger group, p<.001. Conclusion A new Advance Care Planning Engagement Survey that measures behavior change (knowledge, contemplation, self-efficacy, and readiness) and multiple advance care planning actions demonstrates good reliability and validity. Further research is needed to assess whether survey scores improve in response to advance care planning interventions and whether scores are associated with receipt of care consistent with one's wishes. PMID:24039772

Measuring ward round quality in urology.

PubMed

Darbyshire, Daniel; Barrett, Charlotte; Ross, David; Shackley, David

2015-01-01

Ward rounds are the traditional process by which clinical information is interpreted and management plans made in the inpatient setting and the only time during which patient-doctor interaction can reliably occur. Efforts to improve quality and safety have started looking at the ward round but this has mainly been in the acute medical setting. To begin the quality improvement process for Urological ward rounds. Twenty indicators thought to relate to quality were recorded for every weekday ward round by the Urology team for one month. Twenty ward rounds, 93 patient encounters, were reviewed. A consultant was present for 37% of the patient encounters. 84% of observation charts were reviewed; drug charts 28% and antibiotics 70%. Plans were communicated to the doctors, patient and nursing staff. All notes were typed directly onto the electronic system, 20% of notes were checked by the lead clinician. Mean time per patient was 6 minutes. By starting a discussion about ward rounds we aim to align the process with the broader values of the organisation. Ward rounds can be the cornerstone of delivering safe, clean and personal care and measuring this process is vital to understanding efforts to improve them.

A whole school approach: collaborative development of school health policies, processes, and practices.

PubMed

Hunt, Pete; Barrios, Lisa; Telljohann, Susan K; Mazyck, Donna

2015-11-01

The Whole School, Whole Community, Whole Child (WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved. © 2015 The Authors. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

Intensity modulated neutron radiotherapy optimization by photon proxy

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

Snyder, Michael; Hammoud, Ahmad; Bossenberger, Todd

2012-08-15

Purpose: Introducing intensity modulation into neutron radiotherapy (IMNRT) planning has the potential to mitigate some normal tissue complications seen in past neutron trials. While the hardware to deliver IMNRT plans has been in use for several years, until recently the IMNRT planning process has been cumbersome and of lower fidelity than conventional photon plans. Our in-house planning system used to calculate neutron therapy plans allows beam weight optimization of forward planned segments, but does not provide inverse optimization capabilities. Commercial treatment planning systems provide inverse optimization capabilities, but currently cannot model our neutron beam. Methods: We have developed a methodologymore » and software suite to make use of the robust optimization in our commercial planning system while still using our in-house planning system to calculate final neutron dose distributions. Optimized multileaf collimator (MLC) leaf positions for segments designed in the commercial system using a 4 MV photon proxy beam are translated into static neutron ports that can be represented within our in-house treatment planning system. The true neutron dose distribution is calculated in the in-house system and then exported back through the MATLAB software into the commercial treatment planning system for evaluation. Results: The planning process produces optimized IMNRT plans that reduce dose to normal tissue structures as compared to 3D conformal plans using static MLC apertures. The process involves standard planning techniques using a commercially available treatment planning system, and is not significantly more complex than conventional IMRT planning. Using a photon proxy in a commercial optimization algorithm produces IMNRT plans that are more conformal than those previously designed at our center and take much less time to create. Conclusions: The planning process presented here allows for the optimization of IMNRT plans by a commercial treatment planning optimization algorithm, potentially allowing IMNRT to achieve similar conformality in treatment as photon IMRT. The only remaining requirements for the delivery of very highly modulated neutron treatments are incremental improvements upon already implemented hardware systems that should be readily achievable.« less

The Joint Action on Health Workforce Planning and Forecasting: Results of a European programme to improve health workforce policies.

PubMed

Kroezen, Marieke; Van Hoegaerden, Michel; Batenburg, Ronald

2018-02-01

Health workforce (HWF) planning and forecasting is faced with a number of challenges, most notably a lack of consistent terminology, a lack of data, limited model-, demand-based- and future-based planning, and limited inter-country collaboration. The Joint Action on Health Workforce Planning and Forecasting (JAHWF, 2013-2016) aimed to move forward on the HWF planning process and support countries in tackling the key challenges facing the HWF and HWF planning. This paper synthesizes and discusses the results of the JAHWF. It is shown that the JAHWF has provided important steps towards improved HWF planning and forecasting across Europe, among others through the creation of a minimum data set for HWF planning and the 'Handbook on Health Workforce Planning Methodologies across EU countries'. At the same time, the context-sensitivity of HWF planning was repeatedly noticeable in the application of the tools through pilot- and feasibility studies. Further investments should be made by all actors involved to support and stimulate countries in their HWF efforts, among others by implementing the tools developed by the JAHWF in diverse national and regional contexts. Simultaneously, investments should be made in evaluation to build a more robust evidence base for HWF planning methods. Copyright © 2017 Elsevier B.V. All rights reserved.

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

Hardin, M; Harrison, A; Lockamy, V

Purpose: Desire to improve efficiency and throughput inspired a review of our physics chart check procedures. Departmental policy mandates plan checks pre-treatment, after first treatment and weekly every 3–5 days. This study examined the effectiveness of the “after first” check with respect to improving patient safety and clinical efficiency. Type and frequency of variations discovered during this redundant secondary review was examined over seven months. Methods: A community spreadsheet was created to record variations in care discovered during chart review following the first fraction of treatment and before the second fraction (each plan reviewed prior to treatment). Entries were recordedmore » from August 2014 through February 2015, amounting to 43 recorded variations out of 906 reviewed charts. The variations were divided into categories and frequencies were assessed month-to-month. Results: Analysis of recorded variations indicates an overall variation rate of 4.7%. The initial rate was 13.5%; months 2–7 average 3.7%. The majority of variations related to discrepancies in documentation at 46.5%, followed by prescription, plan deficiency, and dose tracking related variations at 25.5%, 12.8%, and 12.8%, respectively. Minor variations (negligible consequence on patient treatment) outweighed major variations 3 to 1. Conclusion: This work indicates that this redundant secondary check is effective. The first month spike in rates could be due to the Hawthorne/observer effect, but the consistent 4% variation rate suggests the need for periodical re-training on variations noted as frequent to improve awareness and quality of the initial chart review process, which may lead to improved treatment quality, patient safety and increased clinical efficiency. Utilizing these results, a continuous quality improvement process following Deming’s Plan-Do-Study-Act (PDSA) methodology was generated. The first iteration of this PDSA was adding a specific dose tracking checklist item in the pre-treatment plan check assessment; the ramification of which will be assessed in future data.« less

Improved resource use decisions and actions through remote sensing

NASA Technical Reports Server (NTRS)

Hill-Rowley, R.; Boylan, M.; Enslin, W.; Vlasin, R. D.

1975-01-01

Operational uses of remote sensing for improving management decisions and actions concerning resource uses are considered in terms of first generation, or direct-action; and second generation or indirect, delayed-action applications. From among applications completed during 1974-75, seven case studies are offered in illustration of the many contrasts which can be drawn between first and second generation application studies. These include: (1) multi-agency river basin planning; (2) corridor assessment and route location for highway location together with improvement of county-level planning decisions; (3) improving timber management practices; (4) enforcement of new state statutes; (5) county-wide open space preservation; (6) land value reappraisal relative to property tax equalization; and (7) optimizing agri-business processing plant locations.

SU-F-P-03: Management of Time to Treatment Inititation: Case for An Electronic Whiteboard

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

Adnani, N

2016-06-15

Purpose: To determine if data mining of an electronic whiteboard improves the management of the Time to Treatment Initiation (TTI) in radiation oncology. Methods: An electronic whiteboard designed to help in managing the planning workflow and improves communication regarding patient planning progress was used to record the dates at which each phase of the planning process began or completed. These are CT Sim date, Plan Start, Physician Review, Physicist Review, Approval for Treatment Delivery, Setup or Verification of Simulation. Results: During clinical implementation, the electronic whiteboard was able to fulfill its primary objective of providing a transparent account of themore » planning progress of each patient. Peer pressure also meant that individual tasks, such as contouring, were easily brought to the attention of the responsible party and prioritized accordingly. Data mining to analyze the electronic whiteboard per patient (figure 1), per diagnosis (figure 2), per treatment modality (figure 3), per physician (figure 4), per planner (figure 5), etc., added another sophisticated tool in the management of Time to Treatment Initiation without compromising quality of the plans being generated. A longer than necessary time between CT Sim and Plan Start can be discussed among the members of the treatment team as an indication of inadequate/outdated CT Simulator, Contouring Tools, Image Fusion Tools, Other Imaging Studies (MRI, PET/CT) performed, etc. The same for the Plan Start to Physician Review where an extended time than expected may be due unrealistic planning goals, limited planning system features, etc. Conclusion: An Electronic Whiteboard in radiation oncology is not only helping with organizing planning workflow, it is also a potent tool that can be used to reduce the Time to Treatment Initiation by providing the clinic with hard data about the duration of each phase treatment planning as a function of different variable affecting the planning process. The work is supported by the Global Medical Physics Institute.« less

Physiotherapists' Perceptions of and Experiences with the Discharge Planning Process in Acute-Care General Internal Medicine Units in Ontario

PubMed Central

Uyeno, Jennifer; Heck, Carol S.

2014-01-01

ABSTRACT Purpose: To examine discharge planning of patients in general internal medicine units in Ontario acute-care hospitals from the perspective of physiotherapists. Methods: A cross-sectional study using an online questionnaire was sent to participants in November 2011. Respondents' demographic characteristics and ranking of factors were analyzed using descriptive statistics; t-tests were performed to determine between-group differences (based on demographic characteristics). Responses to open-ended questions were coded to identify themes. Results: Mobility status was identified as the key factor in determining discharge readiness; other factors included the availability of social support and community resources. While inter-professional communication was identified as important, processes were often informal. Discharge policies, timely availability of other discharge options, and pressure for early discharge were identified as affecting discharge planning. Respondents also noted a lack of training in discharge planning; accounts of ethical dilemmas experienced by respondents supported these themes. Conclusions: Physiotherapists consider many factors beyond the patient's physical function during the discharge planning process. The improvement of team communication and resource allocation should be considered to deal with the realities of discharge planning. PMID:25125778

Stakeholders’ participation in planning and priority setting in the context of a decentralised health care system: the case of prevention of mother to child transmission of HIV programme in Tanzania

PubMed Central

2013-01-01

Background In Tanzania, decentralisation processes and reforms in the health sector aimed at improving planning and accountability in the sector. As a result, districts were given authority to undertake local planning and set priorities as well as allocate resources fairly to promote the health of a population with varied needs. Nevertheless, priority setting in the health care service has remained a challenge. The study assessed the priority setting processes in the planning of the prevention of mother to child transmission of HIV (PMTCT) programme at the district level in Tanzania. Methods This qualitative study was conducted in Mbarali district, south-western Tanzania. The study applied in-depth interviews and focus group discussions in the data collection. Informants included members of the Council Health Management Team, regional PMTCT managers and health facility providers. Results Two plans were reported where PMTCT activities could be accommodated; the Comprehensive Council Health Plan and the Regional PMTCT Plan that was donor funded. As donors had their own globally defined priorities, it proved difficult for district and regional managers to accommodate locally defined PMTCT priorities in these plans. As a result few of these were funded. Guidelines and main priority areas of the Ministry of Health and Social Welfare (MoHSW) also impacted on the ability of the districts and regions to act, undermining the effectiveness of the decentralisation policy in the health sector. Conclusion The challenges in the priority setting processes revealed within the PMTCT initiative indicate substantial weaknesses in implementing the Tanzania decentralisation policy. There is an urgent need to revive the strategies and aims of the decentralisation policy at all levels of the health care system with a view to improving health service delivery. PMID:23849730

Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs.

PubMed

Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Graves, Yan Jiang; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

2013-12-21

Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using our in-house optimization engine.

Home health nurse decision-making regarding visit intensity planning for newly admitted patients: a qualitative descriptive study.

PubMed

Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H

2018-04-13

Despite patients referred to home health having diverse and complex needs, it is unknown how nurses develop personalized visit plans. In this qualitative descriptive study, we interviewed 26 nurses from three agencies about their decision-making process to determine visit intensity and analyzed data using directed content analysis. Following a multifactorial assessment of the patient, nurses relied on their experience and their agency's protocols to develop the personalized visit plan. They revised the plan based on changes in the patient's clinical condition, engagement, and caregiver availability. Findings suggest strategies to improve visit planning and positively influence outcomes of home health patients.

Integrated Data & Analysis in Support of Informed and Transparent Decision Making

NASA Astrophysics Data System (ADS)

Guivetchi, K.

2012-12-01

The California Water Plan includes a framework for improving water reliability, environmental stewardship, and economic stability through two initiatives - integrated regional water management to make better use of local water sources by integrating multiple aspects of managing water and related resources; and maintaining and improving statewide water management systems. The Water Plan promotes ways to develop a common approach for data standards and for understanding, evaluating, and improving regional and statewide water management systems, and for common ways to evaluate and select from alternative management strategies and projects. The California Water Plan acknowledges that planning for the future is uncertain and that change will continue to occur. It is not possible to know for certain how population growth, land use decisions, water demand patterns, environmental conditions, the climate, and many other factors that affect water use and supply may change by 2050. To anticipate change, our approach to water management and planning for the future needs to consider and quantify uncertainty, risk, and sustainability. There is a critical need for information sharing and information management to support over-arching and long-term water policy decisions that cross-cut multiple programs across many organizations and provide a common and transparent understanding of water problems and solutions. Achieving integrated water management with multiple benefits requires a transparent description of dynamic linkages between water supply, flood management, water quality, land use, environmental water, and many other factors. Water Plan Update 2013 will include an analytical roadmap for improving data, analytical tools, and decision-support to advance integrated water management at statewide and regional scales. It will include recommendations for linking collaborative processes with technical enhancements, providing effective analytical tools, and improving and sharing data and information. Specifically, this includes achieving better integration and consistency with other planning activities; obtaining consensus on quantitative deliverables; building a common conceptual understanding of the water management system; developing common schematics of the water management system; establishing modeling protocols and standards; and improving transparency and exchange of Water Plan information.

Improving IMRT delivery efficiency with reweighted L1-minimization for inverse planning

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

Kim, Hojin; Becker, Stephen; Lee, Rena

2013-07-15

Purpose: This study presents an improved technique to further simplify the fluence-map in intensity modulated radiation therapy (IMRT) inverse planning, thereby reducing plan complexity and improving delivery efficiency, while maintaining the plan quality.Methods: First-order total-variation (TV) minimization (min.) based on L1-norm has been proposed to reduce the complexity of fluence-map in IMRT by generating sparse fluence-map variations. However, with stronger dose sparing to the critical structures, the inevitable increase in the fluence-map complexity can lead to inefficient dose delivery. Theoretically, L0-min. is the ideal solution for the sparse signal recovery problem, yet practically intractable due to its nonconvexity of themore » objective function. As an alternative, the authors use the iteratively reweighted L1-min. technique to incorporate the benefits of the L0-norm into the tractability of L1-min. The weight multiplied to each element is inversely related to the magnitude of the corresponding element, which is iteratively updated by the reweighting process. The proposed penalizing process combined with TV min. further improves sparsity in the fluence-map variations, hence ultimately enhancing the delivery efficiency. To validate the proposed method, this work compares three treatment plans obtained from quadratic min. (generally used in clinic IMRT), conventional TV min., and our proposed reweighted TV min. techniques, implemented by a large-scale L1-solver (template for first-order conic solver), for five patient clinical data. Criteria such as conformation number (CN), modulation index (MI), and estimated treatment time are employed to assess the relationship between the plan quality and delivery efficiency.Results: The proposed method yields simpler fluence-maps than the quadratic and conventional TV based techniques. To attain a given CN and dose sparing to the critical organs for 5 clinical cases, the proposed method reduces the number of segments by 10-15 and 30-35, relative to TV min. and quadratic min. based plans, while MIs decreases by about 20%-30% and 40%-60% over the plans by two existing techniques, respectively. With such conditions, the total treatment time of the plans obtained from our proposed method can be reduced by 12-30 s and 30-80 s mainly due to greatly shorter multileaf collimator (MLC) traveling time in IMRT step-and-shoot delivery.Conclusions: The reweighted L1-minimization technique provides a promising solution to simplify the fluence-map variations in IMRT inverse planning. It improves the delivery efficiency by reducing the entire segments and treatment time, while maintaining the plan quality in terms of target conformity and critical structure sparing.« less

Encoding and choice in the task span paradigm.

PubMed

Reiman, Kaitlin M; Weaver, Starla M; Arrington, Catherine M

2015-03-01

Cognitive control during sequences of planned behaviors requires both plan-level processes such as generating, maintaining, and monitoring the plan, as well as task-level processes such as selecting, establishing and implementing specific task sets. The task span paradigm (Logan in J Exp Psychol Gen 133:218-236, 2004) combines two common cognitive control paradigms, task switching and working memory span, to investigate the integration of plan-level and task-level processes during control of sequential behavior. The current study expands past task span research to include measures of encoding processes and choice behavior with volitional sequence generation, using the standard task span as well as a novel voluntary task span paradigm. In two experiments, we consider how sequence complexity, defined separately for plan-level and task-level complexity, influences sequence encoding (Experiment 1), sequence choice (Experiment 2), sequence memory, and task performance of planned sequences of action. Results indicate that participants were sensitive to sequence complexity, but that different aspects of behavior are most strongly influenced by different types of complexity. Hierarchical complexity at the plan level best predicts voluntary sequence generation and memory; while switch frequency at the task level best predicts encoding of externally defined sequences and task performance. Furthermore, performance RTs were similar for externally and internally defined plans, whereas memory was improved for internally defined sequences. Finally, participants demonstrated a significant sequence choice bias in the voluntary task span. Consistent with past research on choice behavior, volitional selection of plans was markedly influenced by both the ease of memory and performance.

Interdisciplinary research on the application of ERTS-1 data to the regional land use planning process

NASA Technical Reports Server (NTRS)

Clapp, J. L. (Principal Investigator); Kiefer, R. W.; Mccarthy, M. M.; Niemann, B. J., Jr.

1972-01-01

The author has identified the following significant results. Although the degree to which ERTS-1 imagery can satisfy regional land use planning data needs is not yet known, it appears to offer means by which the data acquisition process can be immeasurably improved. The initial experiences of an interdisciplinary group attempting to formulate ways of analyzing the effectiveness of ERTS-1 imagery as a base for environmental monitoring and the resolution of regional land allocation problems are documented. Application of imagery to the regional planning process consists of utilizing representative geographical regions within the state of Wisconsin. Because of the need to describe and depict regional resource complexity in an interrelatable state, certain resources within the geographical regions have been inventoried and stored in a two-dimensional computer-based map form. Computer oriented processes were developed to provide for the economical storage, analysis, and spatial display of natural and cultural data for regional land use planning purposes. The authors are optimistic that the imagery will provide revelant data for land use decision making at regional levels.

Behavioral and Managerial Models That Can Help Improve AIDS Campaign Planning.

ERIC Educational Resources Information Center

Simmons, Robert E.; And Others

This paper focuses on the challenge raised by the acquired immunodeficiency syndrome (AIDS) epidemic regarding the need to improve the effectiveness of health communication or education campaigns. The paper discusses the behaviors underlying health information processing and particularly what is called the "knowledge but not behavior-change…

76 FR 42590 - Retrospective Review Under E.O. 13563; Improving Common Acreage Reporting Processes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... solutions to preserve and strengthen the economic stability of America's agricultural producers. RMA..., commodity, credit, conservation, disaster, and emergency assistance programs that help improve the stability... management system. To implement ACRSI in an economical manner, we plan to the extent possible to utilize CIMS...

Instructional Improvement in Maryland: Impact on Educators and Students.

ERIC Educational Resources Information Center

Roberts, Jane M. E.; Kenney, Jane L.

The impact of the School Improvement Through Instructional Process (SITIP) program in Maryland schools was evaluated. The program encourages application of research on planned change to implement one or more of four instructional models: (1) Active Teaching--emphasis on direct instruction, review and discussion of homework, individually supervised…

Program Costing in a Community College

ERIC Educational Resources Information Center

Balinsky, Warren; Burns, John

1975-01-01

This paper discusses improving the budget control process for a community college by use of program cost accounting. The authors suggest that adoption of such a program will improve resource allocation and program evaluation, aid planning, and better inform the public about the purposes, costs, and results of school programs. (JG)

From Planning to Action: Government Initiatives for Improving School-Level Practice.

ERIC Educational Resources Information Center

Chapman, David W., Ed.; Mahlck, Lars O., Ed.; Smulders, Anna E. M., Ed.

This work examines ways central and regional education ministries can influence practices at the school level. Chapter 1, "Changing What Happens in Schools: Central-Level Initiatives to Improve School Practice," reviews common themes, concerns, problems, and emphases. Chapter 2, "Knowledge Utilization and the Process of Policy…

Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

PubMed

Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

2015-09-01

To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PubMed Central

Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

2016-01-01

Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124

Global planning of several plants

NASA Technical Reports Server (NTRS)

Bescos, Sylvie

1992-01-01

This paper discusses an attempt to solve the problem of planning several pharmaceutical plants at a global level. The interest in planning at this level is to increase the global control over the production process, to improve its overall efficiency, and to reduce the need for interaction between production plants. In order to reduce the complexity of this problem and to make it tractable, some abstractions were made. Based on these abstractions, a prototype is being developed within the framework of the EUREKA project PROTOS, using Constraint Logic Programming techniques.

Productivity enhancement planning using participative management concepts

NASA Technical Reports Server (NTRS)

White, M. E.; Kukla, J. C.

1985-01-01

A productivity enhancement project which used participative management for both planning and implementation is described. The process and results associated with using participative management to plan and implement a computer terminal upgrade project where the computer terminals are used by research and development (R&D) personnel are reported. The upgrade improved the productivity of R&D personnel substantially, and their commitment of the implementation is high. Successful utilization of participative management for this project has laid a foundation for continued style shift toward participation within the organization.

PLANNED CHANGE AND ORGANIZATIONAL HEALTH--FIGURE AND GROUND. CHAPTER 2, CHANGE PROCESSES IN THE PUBLIC SCHOOLS.

ERIC Educational Resources Information Center

MILES, MATTHEW B.

PLANNED CHANGE, CONDITIONED BY THE STATE OF THE SYSTEM IN WHICH IT OCCURS, MUST TAKE THE IMPROVEMENT OF ORGANIZATIONAL HEALTH AS A PRIMARY TARGET. THE HEALTHY SCHOOL SYSTEM IS ABLE TO FUNCTION EFFECTIVELY AND TO DEVELOP INTO A MORE FULLY FUNCTIONING SYSTEM. OF TEN ORGANIZATIONAL HEALTH DIMENSIONS APPLICABLE TO SCHOOLS, THREE ARE TASK CENTERED…

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

PubMed

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

2015-01-01

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

The Defense Industrial Base: Prescription for a Psychosomatic Ailment

DTIC Science & Technology

1983-08-01

The Decision- Making Process ------------------------- 65 Notes ---------------------------------------- FIGURE 4-1. The Decision [laking Process...the strategy and tactics process to make certain that we can attain out national security objectives. (IFP is also known as mobilization planning or...decision- making model that could improve the capacity and capability-of the military-industrial complex, thereby increasing the probability of success

Manufacturing engineering: Principles for optimization

NASA Astrophysics Data System (ADS)

Koenig, Daniel T.

Various subjects in the area of manufacturing engineering are addressed. The topics considered include: manufacturing engineering organization concepts and management techniques, factory capacity and loading techniques, capital equipment programs, machine tool and equipment selection and implementation, producibility engineering, methods, planning and work management, and process control engineering in job shops. Also discussed are: maintenance engineering, numerical control of machine tools, fundamentals of computer-aided design/computer-aided manufacture, computer-aided process planning and data collection, group technology basis for plant layout, environmental control and safety, and the Integrated Productivity Improvement Program.

International Space Station Payload Training Overview

NASA Technical Reports Server (NTRS)

Underwood, Deborah B.; Noneman, Steven R.; Sanchez, Julie N.

2001-01-01

This paper describes payload crew training-related activities performed by NASA and the U.S. Payload Developer (PD) community for the International Space Station (ISS) Program. It describes how payloads will be trained and the overall training planning and integration process. The overall concept, definition, and template for payload training are described. The roles and responsibilities of individuals, organizations, and groups involved are discussed. The facilities utilized during payload training and the primary processes and activities performed to plan, develop, implement, and administer payload training for ISS crews are briefly described. Areas of improvement to crew training processes that have been achieved or are currently being worked are identified.

Multisite Assessment of Nursing Continuing Education Learning Needs Using an Electronic Tool.

PubMed

Winslow, Susan; Jackson, Stephanie; Cook, Lesley; Reed, Joanne Williams; Blakeney, Keshia; Zimbro, Kathie; Parker, Cindy

2016-02-01

A continued education needs assessment and associated education plan are required for organizations on the journey for American Nurses Credentialing Center Magnet® designation. Leveraging technology to support the assessment and analysis of continuing education needs was a new venture for a 12-hospital regional health system. The purpose of this performance improvement project was to design and conduct an enhanced process to increase the efficiency and effectiveness of gathering data on nurses' preferences and increase nurse satisfaction with the learner assessment portion of the process. Educators trialed the use of a standardized approach via an electronic survey tool to replace the highly variable processes previously used. Educators were able to view graphical summary of responses by category and setting, which substantially decreased analysis and action planning time for education implementation plans at the system, site, or setting level. Based on these findings, specific continuing education action plans were drafted for each category and classification of nurses. Copyright 2016, SLACK Incorporated.

A New Performance Improvement Model: Adding Benchmarking to the Analysis of Performance Indicator Data.

PubMed

Al-Kuwaiti, Ahmed; Homa, Karen; Maruthamuthu, Thennarasu

2016-01-01

A performance improvement model was developed that focuses on the analysis and interpretation of performance indicator (PI) data using statistical process control and benchmarking. PIs are suitable for comparison with benchmarks only if the data fall within the statistically accepted limit-that is, show only random variation. Specifically, if there is no significant special-cause variation over a period of time, then the data are ready to be benchmarked. The proposed Define, Measure, Control, Internal Threshold, and Benchmark model is adapted from the Define, Measure, Analyze, Improve, Control (DMAIC) model. The model consists of the following five steps: Step 1. Define the process; Step 2. Monitor and measure the variation over the period of time; Step 3. Check the variation of the process; if stable (no significant variation), go to Step 4; otherwise, control variation with the help of an action plan; Step 4. Develop an internal threshold and compare the process with it; Step 5.1. Compare the process with an internal benchmark; and Step 5.2. Compare the process with an external benchmark. The steps are illustrated through the use of health care-associated infection (HAI) data collected for 2013 and 2014 from the Infection Control Unit, King Fahd Hospital, University of Dammam, Saudi Arabia. Monitoring variation is an important strategy in understanding and learning about a process. In the example, HAI was monitored for variation in 2013, and the need to have a more predictable process prompted the need to control variation by an action plan. The action plan was successful, as noted by the shift in the 2014 data, compared to the historical average, and, in addition, the variation was reduced. The model is subject to limitations: For example, it cannot be used without benchmarks, which need to be calculated the same way with similar patient populations, and it focuses only on the "Analyze" part of the DMAIC model.

Reengineering the project design process

NASA Astrophysics Data System (ADS)

Kane Casani, E.; Metzger, Robert M.

1995-01-01

In response to the National Aeronautics and Space Administration's goal of working faster, better, and cheaper, the Jet Propulsion Laboratory (JPL) has developed extensive plans to minimize cost, maximize customer and employee satisfaction, and implement small- and moderate-size missions. These plans include improved management structures and processes, enhanced technical design processes, the incorporation of new technology, and the development of more economical space- and ground-system designs. The Laboratory's new Flight Projects Implementation Development Office has been chartered to oversee these innovations and the reengineering of JPL's project design process, including establishment of the Project Design Center (PDC) and the Flight System Testbed (FST). Reengineering at JPL implies a cultural change whereby the character of the Laboratory's design process will change from sequential to concurrent and from hierarchical to parallel. The Project Design Center will support missions offering high science return, design to cost, demonstrations of new technology, and rapid development. Its computer-supported environment will foster high-fidelity project life-cycle development and more accurate cost estimating. These improvements signal JPL's commitment to meeting the challenges of space exploration in the next century.

A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement.

PubMed

Russell, Cynthia L

2010-01-01

A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.

Strategic Mobility 21: Baseline Joint Experimentation Campaign Plan

DTIC Science & Technology

2008-06-19

including energy. The Value Stream Analysis Future State then designed Kaizens (process optimizations) for an improved Future State to help drive waste...Recommended Improvements and Experimentation Opportunities Initial recommended Kaizens (improvement opportunities) for waste reduction, constraint...Trucking, Service Craft Logistics, BNSF, and Madison Warehouse, Inc. • Kaizen 1 (Figure 17): Full upload electronically of the Dole ANS files • Kaizen

Professional Development in Teacher Digital Competence and Improving School Quality from the Teachers' Perspective: A Case Study

ERIC Educational Resources Information Center

Cervera, Mercè Gisbert; Cantabrana, José L. Lázaro

2015-01-01

Professional development in ICT for teachers, in addition to being necessary given the dynamic nature of technology, also improves the institutional quality of schools. This work, based on action research, provides evidence that the school itself is capable of organising and designing a training plan as part of a broader process to improve quality…

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.

Structure-oriented versus process-oriented approach to enhance efficiency for emergency room operations: what lessons can we learn?

PubMed

Hwang, Taik Gun; Lee, Younsuk; Shin, Hojung

2011-01-01

The efficiency and quality of a healthcare system can be defined as interactions among the system structure, processes, and outcome. This article examines the effect of structural adjustment (change in floor plan or layout) and process improvement (critical pathway implementation) on performance of emergency room (ER) operations for acute cerebral infarction patients. Two large teaching hospitals participated in this study: Korea University (KU) Guro Hospital and KU Anam Hospital. The administration of Guro adopted a structure-oriented approach in improving its ER operations while the administration of Anam employed a process-oriented approach, facilitating critical pathways and protocols. To calibrate improvements, the data for time interval, length of stay, and hospital charges were collected, before and after the planned changes were implemented at each hospital. In particular, time interval is the most essential measure for handling acute stroke patients because patients' survival and recovery are affected by the promptness of diagnosis and treatment. Statistical analyses indicated that both redesign of layout at Guro and implementation of critical pathways at Anam had a positive influence on most of the performance measures. However, reduction in time interval was not consistent at Guro, demonstrating delays in processing time for a few processes. The adoption of critical pathways at Anam appeared more effective in reducing time intervals than the structural rearrangement at Guro, mainly as a result of the extensive employee training required for a critical pathway implementation. Thus, hospital managers should combine structure-oriented and process-oriented strategies to maximize effectiveness of improvement efforts.

CASPER Version 2.0

NASA Technical Reports Server (NTRS)

Chien, Steve; Rabideau, Gregg; Tran, Daniel; Knight, Russell; Chouinard, Caroline; Estlin, Tara; Gaines, Daniel; Clement, Bradley; Barrett, Anthony

2007-01-01

CASPER is designed to perform automated planning of interdependent activities within a system subject to requirements, constraints, and limitations on resources. In contradistinction to the traditional concept of batch planning followed by execution, CASPER implements a concept of continuous planning and replanning in response to unanticipated changes (including failures), integrated with execution. Improvements over other, similar software that have been incorporated into CASPER version 2.0 include an enhanced executable interface to facilitate integration with a wide range of execution software systems and supporting software libraries; features to support execution while reasoning about urgency, importance, and impending deadlines; features that enable accommodation to a wide range of computing environments that include various central processing units and random- access-memory capacities; and improved generic time-server and time-control features.

The people side of MRP (materiel requirements planning).

PubMed

Lunn, T

1994-05-01

A montage of ideas and concepts have been successfully used to train and motivate people to use MRP II systems more effectively. This is important today because many companies are striving to achieve World Class Manufacturing status. Closed loop Materiel Requirements Planning (MRP) systems are an integral part of the process of continuous improvement. Successfully using a formal management planning system, such as MRP II, is a fundamental stepping stone on the path toward World Class Excellence. Included in this article are techniques that companies use to reduce lead time, simplify bills of materiel, and improve schedule adherence. These and other steps all depend on the people who use the system. The focus will be on how companies use the MRP tool more effectively.

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.

Risky Business

NASA Technical Reports Server (NTRS)

Yarbrough, Katherine

2015-01-01

During my internship I worked on two major projects, recommending improvements for the Center's Risk Management Workshop and helping with the strategic planning efforts for Safety and Mission Assurance (S&MA). The risk management improvements is the key project I worked on this semester through my internship, while the strategic planning is the secondary assignment. S&MA Business Office covers both aspects in its delegation, getting both spans some of the work done in the office. A risk is a future event with a negative consequence that has some probability of occurring. Safety and Mission Assurance identifies, analyzes, plans, and tracks risk. The directorate offers the Center a Risk Management Workshop, and part of the ongoing efforts of S&MA is to make continuous improvements to the RM Workshop. By using the Project Management Institute's (PMI) Standard for Risk Management, I performed a gap analysis to make improvements for our materials. I benchmarked the PMI's Risk Management Standard, compared our Risk Management Workshop materials to PMI's standard, and identified any gaps in our material. My major findings were presented to the Business Office of S&MA for a decision on whether or not to incorporate the improvements. These suggestions were made by attending JSC working group meetings, Health, Safety and Environment (HSE) panel reviews and various risk review meetings. The improvements provide better understanding of risk management processes and enhanced risk tracking knowledge and skills. Risk management is an integral part of any engineering discipline, getting exposed to this section of engineering will greatly help shape my career in the future. Johnson Space Center is a world leader in risk management processes; learning risk management here gives me a huge advantage over my peers, as well as understanding decision making in the context of risk management will help me to be a well-rounded engineer. Strategic planning is an area I had not previously studied. Helping with the strategic planning efforts in S&MA has taught me how organizations think and function as a whole. S&MA is adopting a balanced scorecard approach to strategic planning. As part of this planning method strategic themes, objectives, and initiatives are formed. I attended strategic theme team workshops that formed the strategy map for the directorate and gave shape to the plan. Also during these workshops the objectives were discussed and built. Learning the process for strategic planning has helped me better understand how organizations and businesses function, which also helps me to be a more effective employee. Other assignments I had during my internship included completing the Safety and Mission Assurance Technical Excellent Program (STEP) Level 1, as well as doing a two week rotation through the Space Exploration division in S&MA, specifically working with a thermal protection systems (TPS) engineer. While working there, I learned about the Orion capsule and the SpaceX Dragon cargo capsule. I attended meetings to prepare the engineers for the upcoming Critical Design Reviews for both capsules and reviewed test data. Learning risk management, strategic planning, and working in the Space Exploration division has taught me about many aspects of S&MA. My internship at NASA has given me new experiences and taught me numerous subjects that I would have otherwise not learned. This opportunity has expanded my educational horizons and is helping me to become a more useful engineer and employee.

Fast Transformation of Temporal Plans for Efficient Execution

NASA Technical Reports Server (NTRS)

Tsamardinos, Ioannis; Muscettola, Nicola; Morris, Paul

1998-01-01

Temporal plans permit significant flexibility in specifying the occurrence time of events. Plan execution can make good use of that flexibility. However, the advantage of execution flexibility is counterbalanced by the cost during execution of propagating the time of occurrence of events throughout the flexible plan. To minimize execution latency, this propagation needs to be very efficient. Previous work showed that every temporal plan can be reformulated as a dispatchable plan, i.e., one for which propagation to immediate neighbors is sufficient. A simple algorithm was given that finds a dispatchable plan with a minimum number of edges in cubic time and quadratic space. In this paper, we focus on the efficiency of the reformulation process, and improve on that result. A new algorithm is presented that uses linear space and has time complexity equivalent to Johnson s algorithm for all-pairs shortest-path problems. Experimental evidence confirms the practical effectiveness of the new algorithm. For example, on a large commercial application, the performance is improved by at least two orders of magnitude. We further show that the dispatchable plan, already minimal in the total number of edges, can also be made minimal in the maximum number of edges incoming or outgoing at any node.

Framework and components for effective discharge planning system: a delphi methodology

PubMed Central

2012-01-01

Background To reduce avoidable hospital readmissions, effective discharge planning and appropriate post discharge support care are key requirements. This study is a 3-staged process to develop, pretest and pilot a framework for an effective discharge planning system in Hong Kong. This paper reports on the methodology of Delphi approach and findings of the second stage on pre-testing the framework developed so as to validate and attest to its applicability and practicability in which consensus was sought on the key components of discharge planning. Methods Delphi methodology was adopted to engage a group of experienced healthcare professionals to rate and discuss the framework and components of an effective discharge planning. The framework was consisted 36 statements under 5 major themes: initial screening, discharge planning process, coordination of discharge, implementation of discharge, and post discharge follow-up. Each statement was rated independently based on 3 aspects including clarity, validity and applicability on a 5-point Likert-scale. Statement with 75% or above of participants scoring 4–5 on all 3 aspects would be included in the discharge planning framework. For those statements not reaching 75% of consensus in any one of the aspect, it would be revised or discarded following the group discussion, and be re-rated in another round. Results A total of 24 participants participated in the consensus-building process. In round one rating, consensus was achieved in 25 out of 36 statements. Among those 11 statements not reaching consensus, the major concern was related to the “applicability” of the statements. The participants expressed a lack of manpower, skills and time in particular during weekends and long holidays in carrying out assessment and care plans within 24 h after admission. There were also timeliness and availability issue in providing transportation and necessary equipment to the patients. To make the statements more applicable, the wordings of some of the statements were revised to provide greater flexibility. Due to the lack of a statement in clarifying the role of the members of the healthcare professional team, one additional statement on the role and responsibility of the multidisciplinary team members was added. The first theme on “initial screening” was further revised to “initial screening and assessment” to better reflect the first stage of discharge planning process. After two rounds of rating process, all the 36 statements and the newly added statement reached consensus Conclusions A structured, systematic and coordinated system of hospital discharge system is required to facilitate the discharge process to ensure a smooth patient transition from the hospital to the community and improve patient health outcome in both clinical and social aspect. The findings of this paper provide a reference framework helping policymakers and hospital managers to facilitate the development of a coherent and systematized discharge planning process. Adopting a Delphi approach also demonstrates the values of the method as a pre-test (before the clinical run) of the components and requirements of a discharge planning system taking into account of the local context and system constraints, which would lead to improvements to its applicability and practicability. To confirm the applicability and practicability of this consensus framework for discharge planning system, the third stage of process of development of the discharge planning framework is to apply and pilot the framework in a hospital setting to evaluate its feasibility, applicability and impact in hospital including satisfaction from both the perspectives of staff and patients. PMID:23151173

Automated medial axis seeding and guided evolutionary simulated annealing for optimization of gamma knife radiosurgery treatment plans

NASA Astrophysics Data System (ADS)

Zhang, Pengpeng

The Leksell Gamma KnifeRTM (LGK) is a tool for providing accurate stereotactic radiosurgical treatment of brain lesions, especially tumors. Currently, the treatment planning team "forward" plans radiation treatment parameters while viewing a series of 2D MR scans. This primarily manual process is cumbersome and time consuming because the difficulty in visualizing the large search space for the radiation parameters (i.e., shot overlap, number, location, size, and weight). I hypothesize that a computer-aided "inverse" planning procedure that utilizes tumor geometry and treatment goals could significantly improve the planning process and therapeutic outcome of LGK radiosurgery. My basic observation is that the treatment team is best at identification of the location of the lesion and prescribing a lethal, yet safe, radiation dose. The treatment planning computer is best at determining both the 3D tumor geometry and optimal LGK shot parameters necessary to deliver a desirable dose pattern to the tumor while sparing adjacent normal tissue. My treatment planning procedure asks the neurosurgeon to identify the tumor and critical structures in MR images and the oncologist to prescribe a tumoricidal radiation dose. Computer-assistance begins with geometric modeling of the 3D tumor's medial axis properties. This begins with a new algorithm, a Gradient-Phase Plot (G-P Plot) decomposition of the tumor object's medial axis. I have found that medial axis seeding, while insufficient in most cases to produce an acceptable treatment plan, greatly reduces the solution space for Guided Evolutionary Simulated Annealing (GESA) treatment plan optimization by specifying an initial estimate for shot number, size, and location, but not weight. They are used to generate multiple initial plans which become initial seed plans for GESA. The shot location and weight parameters evolve and compete in the GESA procedure. The GESA objective function optimizes tumor irradiation (i.e., as close to the prescribed dose as possible) and minimizes normal tissue and critical structure damage. In tests of five patient data sets (4 acoustic neuromas and 1 meningioma), the G-P Plot/GESA-generated treatment plans improved conformality of the lethal dose to the tumor, required no human interaction, improved dose homogeneity, suggested use of fewer shots, and reduced treatment administration time.

Uncertainty in Population Estimates for Endangered Animals and Improving the Recovery Process

PubMed Central

Haines, Aaron M.; Zak, Matthew; Hammond, Katie; Scott, J. Michael; Goble, Dale D.; Rachlow, Janet L.

2013-01-01

Simple Summary The objective of our study was to evaluate the mention of uncertainty (i.e., variance) associated with population size estimates within U.S. recovery plans for endangered animals. To do this we reviewed all finalized recovery plans for listed terrestrial vertebrate species. We found that more recent recovery plans reported more estimates of population size and uncertainty. Also, bird and mammal recovery plans reported more estimates of population size and uncertainty. We recommend that updated recovery plans combine uncertainty of population size estimates with a minimum detectable difference to aid in successful recovery. Abstract United States recovery plans contain biological information for a species listed under the Endangered Species Act and specify recovery criteria to provide basis for species recovery. The objective of our study was to evaluate whether recovery plans provide uncertainty (e.g., variance) with estimates of population size. We reviewed all finalized recovery plans for listed terrestrial vertebrate species to record the following data: (1) if a current population size was given, (2) if a measure of uncertainty or variance was associated with current estimates of population size and (3) if population size was stipulated for recovery. We found that 59% of completed recovery plans specified a current population size, 14.5% specified a variance for the current population size estimate and 43% specified population size as a recovery criterion. More recent recovery plans reported more estimates of current population size, uncertainty and population size as a recovery criterion. Also, bird and mammal recovery plans reported more estimates of population size and uncertainty compared to reptiles and amphibians. We suggest the use of calculating minimum detectable differences to improve confidence when delisting endangered animals and we identified incentives for individuals to get involved in recovery planning to improve access to quantitative data. PMID:26479531

NASA's Earth Science Enterprise's Water and Energy Cycle Focus Area

NASA Astrophysics Data System (ADS)

Entin, J. K.

2004-05-01

Understanding the Water and Energy cycles is critical towards improving our understanding of climate change, as well as the consequences of climate change. In addition, using results from water and energy cycle research can help improve water resource management, agricultural efficiency, disaster management, and public health. To address this, NASA's Earth Science Enterprise (ESE) has an end-to-end Water and Energy Cycle Focus Area, which along with the ESE's other five focus areas will help NASA answer key Earth Science questions. In an effort to build upon the pre-existing discipline programs, which focus on precipitation, radiation sciences, and terrestrial hydrology, NASA has begun planning efforts to create an implementation plan for integrative research to improve our understanding of the water and energy cycles. The basics of this planning process and the core aspects of the implementation plan will be discussed. Roadmaps will also be used to show the future direction for the entire focus area. Included in the discussion, will be aspects of the end-to-end nature of the Focus Area that encompass current and potential actives to extend research results to operational agencies to enable improved performance of policy and management decision support systems.

GEOTAIL Spacecraft historical data report

NASA Technical Reports Server (NTRS)

Boersig, George R.; Kruse, Lawrence F.

1993-01-01

The purpose of this GEOTAIL Historical Report is to document ground processing operations information gathered on the GEOTAIL mission during processing activities at the Cape Canaveral Air Force Station (CCAFS). It is hoped that this report may aid management analysis, improve integration processing and forecasting of processing trends, and reduce real-time schedule changes. The GEOTAIL payload is the third Delta 2 Expendable Launch Vehicle (ELV) mission to document historical data. Comparisons of planned versus as-run schedule information are displayed. Information will generally fall into the following categories: (1) payload stay times (payload processing facility/hazardous processing facility/launch complex-17A); (2) payload processing times (planned, actual); (3) schedule delays; (4) integrated test times (experiments/launch vehicle); (5) unique customer support requirements; (6) modifications performed at facilities; (7) other appropriate information (Appendices A & B); and (8) lessons learned (reference Appendix C).

Strategic plan modelling by hospital senior administration to integrate diversity management.

PubMed

Newhouse, John J

2010-11-01

Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.

Enhanced human service transportation models : joint demonstration. Phase 1, System planning and design process evaluation : baseline analysis

DOT National Transportation Integrated Search

2007-11-13

This document presents the findings from the baseline phase of the evaluation of the process being used by eight sites to develop a design for a Travel Management Coordination Center (TMCC) for improved coordination of human service transportation wi...

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…

Needs Assessment: Who Needs It?

ERIC Educational Resources Information Center

Hays, Donald G.; Linn, Joan K.

This monograph addresses the issue of needs assessment in the educational process and how it applies to the school counselor's role. The authors provide information on the process of needs assessment, from the initial step of obtaining commitment to the final outcome of improved program planning and development. Using an example common to many…

Admissions: The Higher Education Sector's Plans for Change. Policy Briefing

ERIC Educational Resources Information Center

Universities UK, 2008

2008-01-01

With the increase in student numbers and political concern to ensure fair access to higher education, universities have been reviewing their admissions processes in order to improve their transparency, efficiency and effectiveness. The process contains relatively discrete activities--applications and admissions--in which both the applicants and…

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…

42 CFR 423.564 - Grievance procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Distinguished from the quality improvement organization complaint process. Under section 1154(a)(14) of the Act... of services they have received under the Medicare program. This process is separate and distinct from...) The Part D plan sponsor must notify the enrollee of its decision as expeditiously as the case requires...

Application of science-based restoration planning to a desert river system.

PubMed

Laub, Brian G; Jimenez, Justin; Budy, Phaedra

2015-06-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Application of Science-Based Restoration Planning to a Desert River System

NASA Astrophysics Data System (ADS)

Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

2015-06-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Application of science-based restoration planning to a desert river system

USGS Publications Warehouse

Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

2015-01-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

An optimized workflow for the integration of biological information into radiotherapy planning: experiences with T1w DCE-MRI

NASA Astrophysics Data System (ADS)

Neff, T.; Kiessling, F.; Brix, G.; Baudendistel, K.; Zechmann, C.; Giesel, F. L.; Bendl, R.

2005-09-01

Planning of radiotherapy is often difficult due to restrictions on morphological images. New imaging techniques enable the integration of biological information into treatment planning and help to improve the detection of vital and aggressive tumour areas. This might improve clinical outcome. However, nowadays morphological data sets are still the gold standard in the planning of radiotherapy. In this paper, we introduce an in-house software platform enabling us to combine images from different imaging modalities yielding biological and morphological information in a workflow driven approach. This is demonstrated for the combination of morphological CT, MRI, functional DCE-MRI and PET data. Data of patients with a tumour of the prostate and with a meningioma were examined with DCE-MRI by applying pharmacokinetic two-compartment models for post-processing. The results were compared with the clinical plans for radiation therapy. Generated parameter maps give additional information about tumour spread, which can be incorporated in the definition of safety margins.

Consideration of Environmental Factors in Planning and Development of Urban Areas

NASA Astrophysics Data System (ADS)

Kustysheva, I.

2017-11-01

Environmental factors, in varying degrees, always have a direct influence on the urban environment formation and the provision of favorable and safe conditions for the life of the population. Their role in the planning and development of urban areas remains an integral part of the management of such areas. Management should be aimed at improving the efficiency of use of the territories and ecological environment improvement. Planning must be done with the consideration of identified ecological processes in cities on the basis of the information about their occurrence in the past and present. Currently, cities face a multitude of problems that require urgent and immediate solutions. One of the most important issues is the poor state of the urban environment, so the environmental factors remain one of the most critical problems that should be considered by the authorities while implementing the urban areas’ development plans. The article discusses the role of environmental factors in the management and planning of urban territories by the example of the city of Tobolsk.

The Pilot Land Data System: Report of the Program Planning Workshops

NASA Technical Reports Server (NTRS)

1984-01-01

An advisory report to be used by NASA in developing a program plan for a Pilot Land Data System (PLDS) was developed. The purpose of the PLDS is to improve the ability of NASA and NASA sponsored researchers to conduct land-related research. The goal of the planning workshops was to provide and coordinate planning and concept development between the land related science and computer science disciplines, to discuss the architecture of the PLDs, requirements for information science technology, and system evaluation. The findings and recommendations of the Working Group are presented. The pilot program establishes a limited scale distributed information system to explore scientific, technical, and management approaches to satisfying the needs of the land science community. The PLDS paves the way for a land data system to improve data access, processing, transfer, and analysis, which land sciences information synthesis occurs on a scale not previously permitted because of limits to data assembly and access.

Finite Progressive Planning for the Assembly Process in Footwear

NASA Astrophysics Data System (ADS)

Reyes, John; Aldás, Darwin; Salazar, Edisson; Armendáriz, Evelyn; Álvarez, Kevin; Núñez, José; García, Mario

2017-06-01

The scheduling of the operations of a manufacturing system is recognized for its efficiency in establishing a characteristic rate of production based on the forecasting of the ending date of an order. However, progressive planning focused on the footwear industries has not been studied in detail, since it is limited by the use of machines and supply according to the demand of the production line, whose development is based on just in time. The study proposes a finite progressive planning model in the area of footwear assembly that begins with analysis of the demand and identification of manufacturing constraints in order to establish an optimal ordering sequence. The results show manufacturing requirements through production orders that automatically determine production shifts per order, through experimentation of scenarios, the 25% increase in productivity indicators and a 31% improvement in efficiency are established. This improvement represents higher benefits for the industrial sector when establishing planning in the workplace.

DOD Financial Management: Challenges in Attaining Audit Readiness and Improving Business Processes and Systems

DTIC Science & Technology

2012-04-18

enterprise architecture and transition plan, and improved investment control processes. This statement is primarily based on GAO’s prior work...business system investments , they had not yet performed the key step of validating assessment results. GAO has made prior recommendations to address...be prepared no later than March 1, 1997. See 31 U.S.C. § 3515. 2An agency’s general fund accounts are those accounts in the U.S. Treasury holding

Experience-based quality control of clinical intensity-modulated radiotherapy planning.

PubMed

Moore, Kevin L; Brame, R Scott; Low, Daniel A; Mutic, Sasa

2011-10-01

To incorporate a quality control tool, according to previous planning experience and patient-specific anatomic information, into the intensity-modulated radiotherapy (IMRT) plan generation process and to determine whether the tool improved treatment plan quality. A retrospective study of 42 IMRT plans demonstrated a correlation between the fraction of organs at risk (OARs) overlapping the planning target volume and the mean dose. This yielded a model, predicted dose = prescription dose (0.2 + 0.8 [1 - exp(-3 overlapping planning target volume/volume of OAR)]), that predicted the achievable mean doses according to the planning target volume overlap/volume of OAR and the prescription dose. The model was incorporated into the planning process by way of a user-executable script that reported the predicted dose for any OAR. The script was introduced to clinicians engaged in IMRT planning and deployed thereafter. The script's effect was evaluated by tracking δ = (mean dose-predicted dose)/predicted dose, the fraction by which the mean dose exceeded the model. All OARs under investigation (rectum and bladder in prostate cancer; parotid glands, esophagus, and larynx in head-and-neck cancer) exhibited both smaller δ and reduced variability after script implementation. These effects were substantial for the parotid glands, for which the previous δ = 0.28 ± 0.24 was reduced to δ = 0.13 ± 0.10. The clinical relevance was most evident in the subset of cases in which the parotid glands were potentially salvageable (predicted dose <30 Gy). Before script implementation, an average of 30.1 Gy was delivered to the salvageable cases, with an average predicted dose of 20.3 Gy. After implementation, an average of 18.7 Gy was delivered to salvageable cases, with an average predicted dose of 17.2 Gy. In the prostate cases, the rectum model excess was reduced from δ = 0.28 ± 0.20 to δ = 0.07 ± 0.15. On surveying dosimetrists at the end of the study, most reported that the script both improved their IMRT planning (8 of 10) and increased their efficiency (6 of 10). This tool proved successful in increasing normal tissue sparing and reducing interclinician variability, providing effective quality control of the IMRT plan development process. Copyright © 2011 Elsevier Inc. All rights reserved.

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

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

Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia

2009-01-01

The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and themore » software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.« less

Environmental Implementation Plan

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

Not Available

1994-02-01

The Environmental Implementation Plan (EIP) is a dynamic long-range environmental-protection plan for SRS. The EIP communicates the current and future (five year) environmental plans from individual organizations and divisions as well as site environmental initiatives which are designed to protect the environment and meet or exceed compliance with changing environmental/ regulatory requirements. Communication with all site organizations is essential for making the site environmental planning process work. Demonstrating environmental excellence is a high priority embodied in DOE and WSRC policy. Because of your support and participation in the three EIP initiatives; Reflections, Sectional Revision, and Integrated Planning, improvements are beingmore » made to the EIP and SRS environmental protection programs. I appreciate the ``Partnership in Environmental Excellence`` formed by the environmental coordinators and professionals who work daily toward our goal of compliance and environmental excellence. I look forward to seeing continued success and improvement in our environmental protection programs through combined efforts of all site organizations to protect our employees, the public health, and the environment. Together, we will achieve our site vision for SRS to be the recognized model for Environmental Excellence in the DOE Nuclear Weapons Complex.« less

Recce mission planning

NASA Astrophysics Data System (ADS)

York, Andrew M.

2000-11-01

The ever increasing sophistication of reconnaissance sensors reinforces the importance of timely, accurate, and equally sophisticated mission planning capabilities. Precision targeting and zero-tolerance for collateral damage and civilian casualties, stress the need for accuracy and timeliness. Recent events have highlighted the need for improvement in current planning procedures and systems. Annotating printed maps takes time and does not allow flexibility for rapid changes required in today's conflicts. We must give aircrew the ability to accurately navigate their aircraft to an area of interest, correctly position the sensor to obtain the required sensor coverage, adapt missions as required, and ensure mission success. The growth in automated mission planning system capability and the expansion of those systems to include dedicated and integrated reconnaissance modules, helps to overcome current limitations. Mission planning systems, coupled with extensive integrated visualization capabilities, allow aircrew to not only plan accurately and quickly, but know precisely when they will locate the target and visualize what the sensor will see during its operation. This paper will provide a broad overview of the current capabilities and describe how automated mission planning and visualization systems can improve and enhance the reconnaissance planning process and contribute to mission success. Think about the ultimate objective of the reconnaissance mission as we consider areas that technology can offer improvement. As we briefly review the fundamentals, remember where and how TAC RECCE systems will be used. Try to put yourself in the mindset of those who are on the front lines, working long hours at increasingly demanding tasks, trying to become familiar with new operating areas and equipment, while striving to minimize risk and optimize mission success. Technical advancements that can reduce the TAC RECCE timeline, simplify operations and instill Warfighter confidence, ultimately improve the desired outcome.

Shuttle operations era planning for flight operations

NASA Technical Reports Server (NTRS)

Holt, J. D.; Beckman, D. A.

1984-01-01

The Space Transportation System (STS) provides routine access to space for a wide range of customers in which cargos vary from single payloads on dedicated flights to multiple payloads that share Shuttle resources. This paper describes the flight operations planning process from payload introduction through flight assignment to execution of the payload objectives and the changes that have been introduced to improve that process. Particular attention is given to the factors that influence the amount of preflight preparation necessary to satisfy customer requirements. The partnership between the STS operations team and the customer is described in terms of their functions and responsibilities in the development of a flight plan. A description of the Mission Control Center (MCC) and payload support capabilities completes the overview of Shuttle flight operations.

Use of information systems in Air Force medical treatment facilities in strategic planning and decision-making.

PubMed

Yap, Glenn A; Platonova, Elena A; Musa, Philip F

2006-02-01

An exploratory study used Ansoff's strategic planning model as a framework to assess perceived effectiveness of information systems in supporting strategic business plan development at Air Force medical treatment facilities (MTFs). Results showed information systems were most effective in supporting historical trend analysis, strategic business plans appeared to be a balance of operational and strategic plans, and facilities perceived a greater need for new clinical, vice administrative, information systems to support strategic planning processes. Administrators believed information systems should not be developed at the local level and perceived information systems have the greatest impact on improving clinical quality outcomes, followed by ability to deliver cost effective care and finally, ability to increase market share.

The Building Wellness project: a case history of partnership, power sharing, and compromise.

PubMed

Jones, Drew; Franklin, Charla; Butler, Brittany T; Williams, Pluscedia; Wells, Kenneth B; Rodríguez, Michael A

2006-01-01

The Institute of Medicine has recommended development of community-focused strategies to alleviate the disproportionate burden of illness on minorities, including depression. So far, limited data exist on the process of developing such partnerships within diverse racial/ethnic environments as they strive to develop community-driven, evidence-based action plans to improve the quality of outreach services. We describe such an effort around depression in south Los Angeles and explore the issues of the process in the hopes of informing future partnership development. Community meetings, presentations, feedback, discussion groups, and consensus-based action items were implemented over an 18-month period. A writing subcommittee was designated to develop a description of the group's work and process, as well as the diverse perspectives in the partnership. Data sources included meeting minutes, materials for members and community feedback presentations, scribe notes, and the reflections of the authors. Development was seen on the formal group level, in the process, and on the realization of three categories of action plans. Designed to assist social service caseworkers in the recognition of and referral for depression, the action plans included developing a website, a tool kit (modified Delphi process), and a one-page depression "fact sheet" with region-specific referrals. Through the process of developing a means to combat depression in a racially/ ethnically diverse population, the community is not only better informed about depression but has become a true partner with the academic element in adapting these programs for local service providers, resulting in improved understanding of the partnership process.

Organisational development in general practice: lessons from practice and professional development plans (PPDPs)

PubMed Central

Elwyn, Glyn; Hocking, Paul

2000-01-01

Background Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices) that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towards integrated care processes. Providing incentives for attendance at passive educational events and promoting 'teamwork' without first identifying organisational priorities are interventions that have proved to be ineffective at changing clinical processes. A practice and professional development plan feasibility study was evaluated in Wales and provided the experiential basis for a summary of the lessons learnt on how best to guide organisational development systems for primary medical care. Results Practice and professional development plans are hybrids produced by the combination of ideas from management (the applied behavioural science of organisational development) and education (self-directed adult learning theories) and, in conceptual terms, address the lack of effectiveness of passive educational strategies by making interventions relevant to identified system wide needs. In the intervention, each practice participated in a series of multidisciplinary workshops (minimum 4) where the process outcome was the production of a practice development plan and a set of personal portfolios, and the final outcome was a realised organisational change. It was apparent during the project that organisational admission to a process of developmental planning needed to be a stepwise process, where initial interest can lead to a fuller understanding, which subsequently develops into motivation and ownership, sufficient to complete the exercise. The advantages of introducing expert external facilitation were clear: evaluations of internal group processes were possible, strategic issues could be raised and explored and financial probity ensured. These areas are much more difficult to examine when only internal stakeholders are engaged in a planning process. Conclusions It is not possible to introduce practice and professional development plans (organisational development and organisational learning projects) in a publicly funded health care system without first addressing existing educational and management structures. Existing systems are based on educational credits for attendance and emerging accountability frameworks (criteria checklists) for clinical governance. Moving to systems that are less summative and more formative, and based on the philosophies of continual quality improvement, require changes to be made in the relevant support systems in order achieve policy proposals. PMID:11178111

Combining administrative data feedback, reflection and action planning to engage primary care professionals in quality improvement: qualitative assessment of short term program outcomes.

PubMed

Vachon, Brigitte; Désorcy, Bruno; Gaboury, Isabelle; Camirand, Michel; Rodrigue, Jean; Quesnel, Louise; Guimond, Claude; Labelle, Martin; Huynh, Ai-Thuy; Grimshaw, Jeremy

2015-09-18

Improving primary care for chronic disease management requires a coherent, integrated approach to quality improvement. Evidence in the continuing professional development (CPD) field suggests the importance of using strategies such as feedback delivery, reflective practice and action planning to facilitate recognition of gaps and service improvement needs. Our study explored the outcomes of a CPD intervention, named the COMPAS Project, which consists of a three-hour workshop composed of three main activities: feedback, critical reflection and action planning. The feedback intervention is delivered face-to-face and presents performance indicators extracted from clinical-administrative databases. This aim of this study was to assess the short term outcomes of this intervention to engage primary care professional in continuous quality improvement (QI). In order to develop an understanding of our intervention and of its short term outcomes, a program evaluation approach was used. Ten COMPAS workshops on diabetes management were directly observed and qualitative data was collected to assess the intervention short term outcomes. Data from both sources were combined to describe the characteristics of action plans developed by professionals. Two independent coders analysed the content of these plans to assess if they promoted engagement in QI and interprofessional collaboration. During the ten workshops held, 26 interprofessional work teams were formed. Twenty-two of them developed a QI project they could implement themselves and that targeted aspects of their own practice they perceived in need of change. Most frequently prioritized strategies for change were improvement of systematic clientele follow-up, medication compliance, care pathway and support to improve adoption of healthier life habits. Twenty-one out of 22 action plans were found to target some level of improvement of interprofessional collaboration in primary care. Our study results demonstrate that the COMPAS intervention enabled professionals to target priorities for practice improvements and to develop action plans that promote interprofessional collaboration. The COMPAS intervention aims to increase capability for continuous QI, readiness to implement process of care changes and team shared goals but available resources, climate and culture for change and leadership, are also important required conditions to successfully implement these practice changes. We think that the proposed approach can be very useful to support and engage primary care professionals in the planning stage of quality improvement projects since it combines key successful ingredients: feedback, reflection and planning of action.

SU-F-T-256: 4D IMRT Planning Using An Early Prototype GPU-Enabled Eclipse Workstation

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

Hagan, A; Modiri, A; Sawant, A

Purpose: True 4D IMRT planning, based on simultaneous spatiotemporal optimization has been shown to significantly improve plan quality in lung radiotherapy. However, the high computational complexity associated with such planning represents a significant barrier to widespread clinical deployment. We introduce an early prototype GPU-enabled Eclipse workstation for inverse planning. To our knowledge, this is the first GPUintegrated Eclipse system demonstrating the potential for clinical translation of GPU computing on a major commercially-available TPS. Methods: The prototype system comprised of four NVIDIA Tesla K80 GPUs, with a maximum processing capability of 8.5 Tflops per K80 card. The system architecture consisted ofmore » three key modules: (i) a GPU-based inverse planning module using a highly-parallelizable, swarm intelligence-based global optimization algorithm, (ii) a GPU-based open-source b-spline deformable image registration module, Elastix, and (iii) a CUDA-based data management module. For evaluation, aperture fluence weights in an IMRT plan were optimized over 9 beams,166 apertures and 10 respiratory phases (14940 variables) for a lung cancer case (GTV = 95 cc, right lower lobe, 15 mm cranio-caudal motion). Sensitivity of the planning time and memory expense to parameter variations was quantified. Results: GPU-based inverse planning was significantly accelerated compared to its CPU counterpart (36 vs 488 min, for 10 phases, 10 search agents and 10 iterations). The optimized IMRT plan significantly improved OAR sparing compared to the original internal target volume (ITV)-based clinical plan, while maintaining prescribed tumor coverage. The dose-sparing improvements were: Esophagus Dmax 50%, Heart Dmax 42% and Spinal cord Dmax 25%. Conclusion: Our early prototype system demonstrates that through massive parallelization, computationally intense tasks such as 4D treatment planning can be accomplished in clinically feasible timeframes. With further optimization, such systems are expected to enable the eventual clinical translation of higher-dimensional and complex treatment planning strategies to significantly improve plan quality. This work was partially supported through research funding from National Institutes of Health (R01CA169102) and Varian Medical Systems, Palo Alto, CA, USA.« less

SU-D-BRC-02: Application of Six Sigma Approach to Improve the Efficiency of Patient-Specific QA in Proton Therapy

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

LAH, J; Shin, D; Manger, R

Purpose: To show how the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) can be used for improving and optimizing the efficiency of patient-specific QA process by designing site-specific range tolerances. Methods: The Six Sigma tools (process flow diagram, cause and effect, capability analysis, Pareto chart, and control chart) were utilized to determine the steps that need focus for improving the patient-specific QA process. The patient-specific range QA plans were selected according to 7 treatment site groups, a total of 1437 cases. The process capability index, Cpm was used to guide the tolerance design of patient site-specific range. We also analyzed the financial impactmore » of this project. Results: Our results suggested that the patient range measurements were non-capable at the current tolerance level of ±1 mm in clinical proton plans. The optimized tolerances were calculated for treatment sites. Control charts for the patient QA time were constructed to compare QA time before and after the new tolerances were implemented. It is found that overall processing time was decreased by 24.3% after establishing new site-specific range tolerances. The QA failure for whole process in proton therapy would lead up to a 46% increase in total cost. This result can also predict how costs are affected by changes in adopting the tolerance design. Conclusion: We often believe that the quality and performance of proton therapy can easily be improved by merely tightening some or all of its tolerance requirements. This can become costly, however, and it is not necessarily a guarantee of better performance. The tolerance design is not a task to be undertaken without careful thought. The Six Sigma DMAIC can be used to improve the QA process by setting optimized tolerances. When tolerance design is optimized, the quality is reasonably balanced with time and cost demands.« less

Development of a Comprehensive and Interactive Tool to Inform State Violence and Injury Prevention Plans.

PubMed

Wilson, Lauren; Deokar, Angela J; Zaesim, Araya; Thomas, Karen; Kresnow-Sedacca, Marcie-Jo

The Center of Disease Control and Prevention's Core State Violence and Injury Prevention Program (Core SVIPP) provides an opportunity for states to engage with their partners to implement, evaluate, and disseminate strategies that lead to the reduction and prevention of injury and violence. Core SVIPP requires awardees to develop or update their state injury and violence plans. Currently, literature informing state planning efforts is limited, especially regarding materials related to injury and violence. Presumably, plans that are higher quality result in having a greater impact on preventing injury and violence, and literature to improve quality would benefit prevention programming. (1) To create a comprehensive injury-specific index to aid in the development and revision of state injury and violence prevention plans, and (2) to assess the reliability and utility of this index. Through an iterative development process, a workgroup of subject matter experts created the Violence and Injury Prevention: Comprehensive Index Tool (VIP:CIT). The tool was pilot tested on 3 state injury and violence prevention plans and assessed for initial usability. Following revisions to the tool (ie, a rubric was developed to further delineate consistent criteria for rating; items were added and clarified), the same state plans were reassessed to test interrater reliability and tool utility. For the second assessment, reliability of the VIP:CIT improved, indicating that the rubric was a useful addition. Qualitative feedback from states suggested that the tool significantly helped guide plan development and communicate about planning processes. The final VIP:CIT is a tool that can help increase plan quality, decrease the research-to-practice gap, and increase connectivity to emerging public health paradigms. The tool provides an example of tailoring guidance materials to reflect academic literature, and it can be easily adapted to other topic areas to promote quality of strategic plans for numerous outcomes.

Development of a Comprehensive and Interactive Tool to Inform State Violence and Injury Prevention Plans

PubMed Central

Wilson, Lauren; Deokar, Angela J.; Zaesim, Araya; Thomas, Karen; Kresnow-Sedacca, Marcie-jo

2018-01-01

Context The Center of Disease Control and Prevention’s Core State Violence and Injury Prevention Program (Core SVIPP) provides an opportunity for states to engage with their partners to implement, evaluate, and disseminate strategies that lead to the reduction and prevention of injury and violence. Core SVIPP requires awardees to develop or update their state injury and violence plans. Currently, literature informing state planning efforts is limited, especially regarding materials related to injury and violence. Presumably, plans that are higher quality result in having a greater impact on preventing injury and violence, and literature to improve quality would benefit prevention programming. Objective (1) To create a comprehensive injury-specific index to aid in the development and revision of state injury and violence prevention plans, and (2) to assess the reliability and utility of this index. Design Through an iterative development process, a workgroup of subject matter experts created the Violence and Injury Prevention: Comprehensive Index Tool (VIP:CIT). The tool was pilot tested on 3 state injury and violence prevention plans and assessed for initial usability. Following revisions to the tool (ie, a rubric was developed to further delineate consistent criteria for rating; items were added and clarified), the same state plans were reassessed to test interrater reliability and tool utility. Results For the second assessment, reliability of the VIP:CIT improved, indicating that the rubric was a useful addition. Qualitative feedback from states suggested that the tool significantly helped guide plan development and communicate about planning processes. Conclusion The final VIP:CIT is a tool that can help increase plan quality, decrease the research-to-practice gap, and increase connectivity to emerging public health paradigms. The tool provides an example of tailoring guidance materials to reflect academic literature, and it can be easily adapted to other topic areas to promote quality of strategic plans for numerous outcomes. PMID:29189505

IT strategic planning in hospitals: from theory to practice.

PubMed

Jaana, Mirou; Teitelbaum, Mari; Roffey, Tyson

2014-07-01

To date, IT strategic planning has been mostly theory-based with limited information on "best practices" in this area. This study presents the process and outcomes of IT strategic planning undertaken at a pediatric hospital (PH) in Canada. A five-stage sequential and incremental process was adopted. Various tools / approaches were used including review of existing documentation, internal survey (n = 111), fifteen interviews, and twelve workshops. IT strategic planning was informed by 230 individuals (12 percent of hospital community) and revealed consistency in the themes and concerns raised by participants (e.g., slow IT projects delivery rate, lack of understanding of IT priorities, strained communication with IT staff). Mobile and remote access to patients' information, and an integrated EMR were identified as top priorities. The methodology and used approach revealed effective, improved internal relationships, and ensured commitment to the final IT strategic plan. Several lessons were learned including: maintaining a dynamic approach capable of adapting to the fast technology evolution; involving stakeholders and ensuring continuous communication; using effective research tools to support strategic planning; and grounding the process and final product in existing models. This study contributes to the development of "best practices" in IT strategic planning, and illustrates "how" to apply the theoretical principles in this area. This is especially important as IT leaders are encouraged to integrate evidence-based management into their decision making and practices. The methodology and lessons learned may inform practitioners in other hospitals planning to engage in IT strategic planning in the future.

Integrated urban water planning: big picture planning is good for the wallet and the environment.

PubMed

Anderson, J; Iyaduri, R

2003-01-01

The demands on governments and local authorities are changing in response to community expectations for environmentally sustainable outcomes. To reverse declining water quality in rivers and ensure sustainable use in the 21st century, the State Government in New South Wales has introduced a package of Water Reforms. The introduction of integrated water, sewerage and drainage planning is one of the Water Reform initiatives. Traditionally, government and local authorities have managed their water supply, sewerage and stormwater drainage systems as separate entities. Integrated urban water planning is a structured planning process to evaluate concurrently the opportunities to improve the management of water, sewerage and drainage services within an urban area in ways which are consistent with broader catchment and river management objectives. The New South Wales Department of Land & Water Conservation (DLWC) has developed an integrated urban water planning process through a number of recent pilot studies. The process links urban water management objectives to overall catchment and river management objectives. DLWC is currently developing a set of guidelines for integrated urban water plans. DLWC has developed the Integrated Urban Water Planning methodology through three pilot studies in the New South Wales towns of Finley, Goulburn and Bombala. The pilot studies have shown that an integrated approach to water, sewerage and stormwater planning can identify opportunities that are not apparent when separate strategies are developed for each service. The result is better-integrated, more sustainable solutions, and substantial cost savings for local communities.

Automated high-dose rate brachytherapy treatment planning for a single-channel vaginal cylinder applicator

NASA Astrophysics Data System (ADS)

Zhou, Yuhong; Klages, Peter; Tan, Jun; Chi, Yujie; Stojadinovic, Strahinja; Yang, Ming; Hrycushko, Brian; Medin, Paul; Pompos, Arnold; Jiang, Steve; Albuquerque, Kevin; Jia, Xun

2017-06-01

High dose rate (HDR) brachytherapy treatment planning is conventionally performed manually and/or with aids of preplanned templates. In general, the standard of care would be elevated by conducting an automated process to improve treatment planning efficiency, eliminate human error, and reduce plan quality variations. Thus, our group is developing AutoBrachy, an automated HDR brachytherapy planning suite of modules used to augment a clinical treatment planning system. This paper describes our proof-of-concept module for vaginal cylinder HDR planning that has been fully developed. After a patient CT scan is acquired, the cylinder applicator is automatically segmented using image-processing techniques. The target CTV is generated based on physician-specified treatment depth and length. Locations of the dose calculation point, apex point and vaginal surface point, as well as the central applicator channel coordinates, and the corresponding dwell positions are determined according to their geometric relationship with the applicator and written to a structure file. Dwell times are computed through iterative quadratic optimization techniques. The planning information is then transferred to the treatment planning system through a DICOM-RT interface. The entire process was tested for nine patients. The AutoBrachy cylindrical applicator module was able to generate treatment plans for these cases with clinical grade quality. Computation times varied between 1 and 3 min on an Intel Xeon CPU E3-1226 v3 processor. All geometric components in the automated treatment plans were generated accurately. The applicator channel tip positions agreed with the manually identified positions with submillimeter deviations and the channel orientations between the plans agreed within less than 1 degree. The automatically generated plans obtained clinically acceptable quality.

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

Training Community Modeling and Simulation Business Plan: 2009 Edition

DTIC Science & Technology

2010-04-01

strategic information assurance 33 33 Provide crisis action procedures training 34 34 Provide the IC SOF-specific training at the operational level... information and products • Collaborative analysis processes • Dissemination of information throughout a command and to subordinates by redundant means...centric M&S capabilities will improve training for information warfare, assist with training for homeland defense operations, crisis -management plan- ning

Total Cost of Ownership, System Acceptance and Perceived Success of Enterprise Resource Planning Software: Simulating a Dynamic Feedback Perspective of ERP in the Higher Education Environment

ERIC Educational Resources Information Center

Fryling, Meg

2010-01-01

Enterprise Research Planning (ERP) software is advertised as the product that will "run the enterprise", improving data access and accuracy as well as enhancing business process efficiency. Unfortunately, organizations often make implementation decisions with little consideration for the maintenance phase of an ERP, resulting in significant…

SSC San Diego Strategic Plan. Revision 3

DTIC Science & Technology

2001-11-01

information dominance ; Core Values - Customers, Employees, Excellence, Teamwork, and Flexibility; Leadership Philosophy; Core Competencies, and Six Strategic Objectives - 1) Lead and Promote the C4ISR Vision; 2) Develop a Strategic Business Development Process; 3) Strengthen Our Core Competencies; 4) Prepare Our Workforce for the Future; 5) Improve Corporate Business Operations; 6) Improve Our Internal

School Effectiveness: Problem-Solving and Managing Conflict.

ERIC Educational Resources Information Center

Minnesota State Dept. of Education, St. Paul.

This module discusses the theory and practice of school improvement and outlines a nine-step systematic problem-solving process for developing an action plan addressing school improvement goals. The first section describes a general model for the study of the school as a social system, as developed by Getzels and Thelen (1960). The second section…

Continuous Quality Improvement Tools for Effective Teaching.

ERIC Educational Resources Information Center

Cornesky, Robert A.

This manual presents 15 Continuous Quality Improvement (CQI) tools and techniques necessary for effective teaching. By using the tools and techniques of CQI, teachers will be able to help themselves and their students to focus on the classroom processes. This will permit the teacher and students to plan, organize, implement, and make decisions…

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,…

Supervision that Improves Teaching: Strategies and Techniques. Second Edition

ERIC Educational Resources Information Center

Sullivan, Susan; Glanz, Jeffrey

2004-01-01

In this exciting, new edition of "Supervision That Improves Teaching," the authors have taken their reflective clinical supervision process to a new level, with the planning conference now the heart of the supervision cycle. Sullivan and Glanz have addressed the dilemmas of preserving meaningful supervision in an era of high-stakes…

Ninety to Nothing: a PDSA quality improvement project.

PubMed

Prybutok, Gayle Linda

2018-05-14

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

Planning and Evaluation Framework: A Five Year Program for the Department of Libraries, Commonwealth of Kentucky.

ERIC Educational Resources Information Center

Kentucky State Dept. of Libraries, Frankfort.

This document is the beginning of a process. The objects of the process are to improve decisions between alternate choices in the development of statewide library services. Secondary functions are to develop the tools for providing information relevant to decisions, to measure and monitor services, and to aid in the communication process. The…

The development and evaluation of a succession planning programme in nursing, in Australia.

PubMed

Brunero, Scott; Kerr, Suzie; Jastrzab, Grazyna

2009-07-01

This study reports on a locally organized model of succession planning in a 550-bed general hospital. Within healthcare, succession planning has traditionally been considered for people at the executive director level and little research has been published with nurses working at the clinical level. A succession planning model was developed from the literature and through a process of consultation with senior staff. The model was then evaluated from a customer satisfaction, programme progress, effective placement and organizational results perspectives. Nurses who were successful in obtaining a new role were surveyed after 6 weeks in the position. Descriptive statistics, including numbers of placements and types of positions filled, were recorded. A checklist for conducting a programme evaluation of succession planning was also used. Twenty-five nurses participated, with 31 positions succeeded to. Nurses reported positively that the programme was beneficial, increased their sense of career planning and gave them a greater understanding of their career pathway. The succession planning programme provided an opportunity for the organization to identify new leaders. The study outcomes have identified potential improvements to the way succession planning is conducted at the hospital. Nurse Managers are in key positions to develop effective succession planning models. This study offers a process for managers to develop effective succession planning programmes within their organization.

78 FR 47003 - Draft National Spatial Data Infrastructure Strategic Plan; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... NSDI.'' Executive Order 12906 describes the NSDI as ``the technology, policies, standards, and human resources necessary to acquire, process, store, distribute, and improve utilization of geospatial data...

Assessing and Improving Student Organizations: Resources for Facilitators CD-ROM. The Assessing and Improving Student Organization (AISO) Program

ERIC Educational Resources Information Center

Nolfi, Tricia; Ruben, Brent D.

2010-01-01

This companion to the "Guide for Students" and "Student Workbook" includes the complete set of PowerPoint slides, a PDF of the Facilitator's Guide in PPT (PowerPoint) slide show format, and PDFs of all scoring sheets, handouts and project planning guides needed for the AISO (Assessing and Improving Student Organization) process. The Assessing and…

Advancing the integration of hospital IT. Pitfalls and perspectives when replacing specialized software for high-risk environments with enterprise system extensions.

PubMed

Engelmann, Carsten; Ametowobla, Dzifa

2017-05-17

Planning and controlling surgical operations hugely impacts upon productivity, patient safety, and surgeons' careers. Established, specialized software for this task is being increasingly replaced by "Operating Room (OR)-modules" appended to enterprise-wide resource planning (ERP) systems. As a result, usability problems are re-emerging and require developers' attention. Systematic evaluation of the functionality and social repercussions of a global, market-leading IT business control system (SAP R3, Germany), adapted for real-time OR process steering. Field study involving document analyses, interviews, and a 73-item survey addressed to 77 qualified (> 1-year system experience) senior planning executives (end users; "planners") working in surgical departments of university hospitals. Planners reported that 57% of electronic operation requests contained contradictory information. Key screens contained clinically irrelevant areas (36 +/- 29%). Compared to the legacy system, users reported either no improvements or worse performance, in regard to co-ordination of OR stakeholders, intra-day program changes, and safety. Planners concluded that the ERP-planning module was "non-intuitive" (66%), increased planning work (56%, p=0.002), and did not impact upon either organizational mishap spectrum or frequency. Interviews evidenced intra-institutional power shifts due to increased system complexity. Planners resented e.g. a trend towards increased personal culpability for mishap. Highly complex enterprise system extensions may not be directly suited to specific process steering tasks in a high risk/low error-environment like the OR. In view of surgeons' high primary task load, the repeated call for simpler IT is an imperative for ERP extensions. System design should consider a) that current OR IT suffers from an input limitation regarding planning-relevant real-time data, and b) that there are social processes that strongly affect planning and particularly ERP use beyond algorithms. Real improvement of clinical IT tools requires their independent evaluation according to standards developed for pharmaceutical subjects.

[Integration of the nursing process in the electronic health record in an university hospital].

PubMed

Guadarrama-Ortega, D; Delgado-Sánchez, P; Martínez-Piedrola, M; López-Poves, E M; Acevedo-García, M; Noguera-Quijada, C; Camacho-Pastor, J L

To describe the process of implementation of Individualized Care Plan in the Electronic Health Record and its impact on the University Hospital Alcorcón Foundation. Working groups of staff nurses who analyzed activities usually performed to create a catalog of diagnoses, outcomes and interventions. A group of referents that refined the catalog to make it manageable was created. A training plan, nursing assessment forms and the Nursing Discharge Report were designed. In February 2016 the new methodology was implemented in inpatient units of adults. Between 74.86 and 88.18% of the patients underwent a care plan with the new methodology. Between 69.41 and 76.25% of patients are discharged with a Nursing Discharge Report accordance with regulations. An increase of 24.1% of patients with Nursing Discharge Report after implantation is observed (P=.000; RR: 1.46; 95% CI 1.36-1.56). A total of 116 nurses has been trained. In the study conditions, the use of nursing taxonomies has generated thinking skills and allowed nurses to issue judgments, ensure quality of care, and implementing interventions with a planned results. The nursing taxonomy and care plan in the Electronic Health Record have increased interprofessional communication to improve continuity of care through improved Nursing Discharge Report. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

PubMed

Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

2016-01-01

Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services that meet the needs of the population and contribute to service and system improvement and innovation.

Improving energy audit process and report outcomes through planning initiatives

NASA Astrophysics Data System (ADS)

Sprau Coulter, Tabitha L.

Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first participating in a pre-audit planning activity that aligned the owner's priorities with the data collection. A comparative analysis was then used to evaluate the effects of the pre-audit planning activity in developing a more strategic method for collecting data and representing findings in an energy audit report to a facility owner. The case studies demonstrated that pre-audit planning has the potential to improve the efficiency of an energy audit process through reductions in transition time waste. The cases also demonstrated the value of audit report designs that are perceived by owners to be project specific vs. generic. The research demonstrated the ability to influence and alter an auditors' behavior through participating in a pre-audit planning activity. It also shows the potential benefits of using the House of Quality as a method of aligning data collection with owner's goals and priorities to develop reports that have increased value.

Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

PubMed

Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

2011-04-01

The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Analysing the external supply chain risk driver competitiveness: a risk mitigation framework and business continuity plan.

PubMed

Blos, Mauricio F; Wee, Hui-Ming; Yang, Joshua

2010-11-01

Innovation challenges for handling supply chain risks have become one of the most important drivers in business competitiveness and differentiation. This study analyses competitiveness at the external supply chain level as a driver of risks and provides a framework for mitigating these risks. The mitigation framework, also called the supply chain continuity framework, provides insight into six stages of the business continuity planning (BCP) process life cycle (risk mitigation management, business impact analysis, supply continuity strategy development, supply continuity plan development, supply continuity plan testing and supply continuity plan maintenance), together with the operational constructs: customer service, inventory management, flexibility, time to market, ordering cycle time and quality. The purpose of the BCP process life cycle and operational constructs working together is to emphasise the way in which a supply chain can deal with disruption risks and, consequently, bring competitive advantage. Future research will consider the new risk scenarios and analyse the consequences to promote the improvement of supply chain resilience.

SU-F-T-100: Development and Implementation of a Treatment Planning Tracking System Into the Radiation Oncology Clinic

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

Kabat, C; Cline, K; Li, Y

Purpose: With increasing numbers of cancer patients being diagnosed and the complexity of radiotherapy treatments rising it’s paramount that patient plan development continues to stay fluid within the clinic. In order to maintain a high standard of care and clinical efficiency the establishment of a tracking system for patient plan development allows healthcare providers to view real time plan progression and drive clinical workflow. In addition, it provides statistical datasets which can further identify inefficiencies within the clinic. Methods: An application was developed utilizing Microsoft’s ODBC SQL database engine to track patient plan status throughout the treatment planning process whilemore » also managing key factors pertaining to the patient’s treatment. Pertinent information is accessible to staff in many locations, including tracking monitors within dosimetry, the clinic network for both computers and handheld devices, and through email notifications. Plans are initiated with a CT and continually tracked through planning stages until final approval by staff. Patient’s status is dynamically updated by the physicians, dosimetrists, and medical physicists based on the stage of the patient’s plan. Results: Our application has been running over a six month period with all patients being processed through the system. Modifications have been made to allow for new features to be implemented along with additional tracking parameters. Based on in-house feedback, the application has been supportive in streamlining patient plans through the treatment planning process and data has been accumulating to further improve procedures within the clinic. Conclusion: Over time the clinic will continue to track data with this application. As data accumulates the clinic will be able to highlight inefficiencies within the workflow and adapt accordingly. We will add in new features to help support the treatment planning process in the future.« less

Forming social capital--does participatory planning foster trust in institutions?

PubMed

Menzel, Susanne; Buchecker, Matthias; Schulz, Tobias

2013-12-15

Participatory planning that includes interest groups and municipal representatives has been presented as a means to deal with the increasing difficulty to reach arrangements due to progressively scarce land resources. Under dispute is whether collaborative forms of planning augment social capital or whether they might actually cause the destruction of such a valuable social commodity. In this paper we focus on trust in institution as a specific dimension of social capital because we argue that this is one of the effects the convenors of such participatory planning procedures are most interested in. We pursue a pre-post design and survey advisory group members of five on-going river-related planning processes in Switzerland. Controlling for generalised trust, we investigate how trust in institutions is affected over time by the quality of such processes and the degree of participation they offer. We find that generalised trust is highly correlated with initial levels of trust and so is process quality. Particularly the latter finding challenges the usually assumed direction of causality according to which process quality influences trust building. Additionally, we find a positive (non-significant) effect of process quality on changes in trust, while a higher degree of participation rather seems to hinder trust building. We suppose this indicates that under the conditions of limited time and resources more attention should be paid to how to improve the quality of participatory processes than putting much effort in increasing the degree of participation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Business continuity, emergency planning and special needs: How to protect the vulnerable.

PubMed

Reilly, Daniel

2015-01-01

Emergencies and disasters affect all segments of the population. Some segments are more at risk during the emergency response and recovery efforts owing to vulnerabilities that increase the risk of harm. These vulnerabilities are due to individuals' disabilities, which must be incorporated into emergency and business continuity planning. Some disabilities are obvious, such as impaired vision, hearing or mobility, while other are less evident, but equally disabling, such as cognitive disorders, geographical or language isolation, and numerous age-related factors. Taken together when creating emergency or business continuity plans, the issues identified as disabilities can be grouped by functionality and termed as special needs. This paper will detail the identification of special needs populations, explain how these persons are vulnerable during the emergency or disaster response and recovery process, and provide examples of how to partner with individuals within identified special needs populations to improve the planning process.

Using a nursing balanced scorecard approach to measure and optimize nursing performance.

PubMed

Jeffs, Lianne; Merkley, Jane; Richardson, Sandy; Eli, Jackie; McAllister, Mary

2011-04-01

The authors give an overview of one healthcare organization's experience in developing a nursing strategic plan and nursing balanced scorecard (NBS) using a focused planning process involving strategy mapping. The NBS is being used at this organization to manage the nursing strategic plan by leveraging and improving nursing processes and organizational capabilities as required, based on data and transparent communication of performance results to key stakeholders. Key strategies and insights may help other nurse leaders in developing or refining strategic approaches to measuring nursing performance. Vital to the success of an organization's strategic plan are ongoing endorsement, engagement and visibility of senior leaders. Quality of decisions made depends on the organization's ability to collect data from multiple sources using standardized definitions, mine data and extract them for statistical analysis and effectively present them in a compelling and understandable way to users and decision-makers.

Improving discharge care: the potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before-after pilot study.

PubMed

Cadilhac, Dominique A; Andrew, Nadine E; Stroil Salama, Enna; Hill, Kelvin; Middleton, Sandy; Horton, Eleanor; Meade, Ian; Kuhle, Sarah; Nelson, Mark R; Grimley, Rohan

2017-08-04

Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes. Clinicians from a 'top-ranked' hospital participated in a focus group to elicit their success factors. Two pilot hospitals then participated in the organisational intervention that was designed with experts and consumers. Hospital clinicians involved in discharge care for stroke and patients admitted with acute stroke or transient ischaemic attack. A four-stage, multifaceted organisational intervention that included data reviews, education and facilitated action planning. Three discharge processes collected in Queensland hospitals within the Australian Stroke Clinical Registry were used to select study hospitals: (1) discharge care plan; (2) antihypertensive medication prescription and (3) antiplatelet medication prescription (ischaemic events only). Primary measure: composite outcome. Secondary measures: individual adherence changes for each discharge process; sensitivity analyses. The performance outcomes were compared 3 months before the intervention (preintervention), 3 months postintervention and at 12 months (sustainability). Data from 1289 episodes of care from the two pilot hospitals were analysed. Improvements from preintervention adherence were: antiplatelet therapy (88%vs96%, p=0.02); antihypertensive prescription (61%vs79%, p<0.001); discharge planning (72%vs94%, p<0.001); composite outcome (73%vs89%, p<0.001). There was an insignificant decay effect over the 12-month sustainability period (composite outcome: 89% postintervention vs 85% sustainability period, p=0.08). Discharge care in hospitals may be effectively improved and sustained through a staged and peer-informed, organisational intervention. The intervention warrants further application and trialling on a larger scale. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Defining conservation targets on a landscape-scale

USGS Publications Warehouse

Benscoter, A.M.; Romañach, Stephanie; Brandt, Laura A.

2015-01-01

Conservation planning, the process of deciding how to protect, conserve, enhance and(or) minimize loss of natural and cultural resources, is a fundamental process to achieve conservation success in a time of rapid environmental change. Conservation targets, the measurable expressions of desired resource conditions, are an important tool in biological planning to achieve effective outcomes. Conservation targets provide a focus for planning, design, conservation action, and collaborative monitoring of environmental trends to guide landscape-scale conservation to improve the quality and quantity of key ecological and cultural resources. It is essential to have an iterative and inclusive method to define conservation targets that is replicable and allows for the evaluation of the effectiveness of conservation targets over time. In this document, we describe a process that can be implemented to achieve landscape-scale conservation, which includes defining conservation targets. We also describe what has been accomplished to date (September 2015) through this process for the Peninsular Florida Landscape Conservation Cooperative (PFLCC).

The Telecommunications and Data Aquisition Report

NASA Technical Reports Server (NTRS)

Posner, E. C. (Editor)

1983-01-01

Tracking and ground-based navigation techniques are discussed in relation to DSN advanced systems. Network data processing and productivity are studied to improve management planning methods. Project activities for upgrading DSN facilities are presented.

Vocational rehabilitation: facilitating evidence based practice through participatory action research.

PubMed

Maciver, Donald; Prior, Susan; Forsyth, Kirsty; Walsh, Mike; Meiklejohn, Allison; Irvine, Linda; Pentland, Duncan

2013-04-01

Improving vocational rehabilitation in line with the current evidence base is an area of considerable interest. Aims To describe the strategies used by a multidisciplinary team in the initial stages of a participatory action research (PAR) approach to improving a vocational rehabilitation service. A literature review and PAR process were completed. One hundred and fifteen participants engaged in multifaceted data collection and analysis, building consensus around key principles for a new vocational rehabilitation service. A synthesis of our literature review and PAR process was developed into a set of principles for practice which we plan to implement across the service. We have developed methodologies in interdisciplinary collaborations spanning statutory and non-statutory services. We have developed a set of principles for practice and detailed plans for implementation are being drawn up to inform provision in the future.

Healthcare improvement as planned system change or complex responsive processes? a longitudinal case study in general practice

PubMed Central

2013-01-01

Background Interest in how to implement evidence-based practices into routine health care has never been greater. Primary care faces challenges in managing the increasing burden of chronic disease in an ageing population. Reliable prescriptions for translating knowledge into practice, however, remain elusive, despite intense research and publication activity. This study seeks to explore this dilemma in general practice by challenging the current way of thinking about healthcare improvement and asking what can be learned by looking at change through a complexity lens. Methods This paper reports the local level of an embedded case study of organisational change for better chronic illness care over more than a decade. We used interviews, document review and direct observation to explore how improved chronic illness care developed in one practice. This formed a critical case to compare, using pattern matching logic, to the common prescription for local implementation of best evidence and a rival explanation drawn from complexity sciences interpreted through modern sociology and psychology. Results The practice changed continuously over more than a decade to deliver better chronic illness care in line with research findings and policy initiatives – re-designing care processes, developing community linkages, supporting patient self-management, using guidelines and clinical information systems, and integrating nurses into the practice team. None of these improvements was designed and implemented according to an explicit plan in response to a documented gap in chronic disease care. The process that led to high quality chronic illness care exhibited clear complexity elements of co-evolution, non-linearity, self-organisation, emergence and edge of chaos dynamics in a network of agents and relationships where a stable yet evolving way of organizing emerged from local level communicative interaction, power relating and values based choices. Conclusions The current discourse of implementation science as planned system change did not match organisational reality in this critical case of improvement in general practice. Complexity concepts translated in human terms as complex responsive processes of relating fit the pattern of change more accurately. They do not provide just another fashionable blueprint for change but inform how researchers, policymakers and providers participate in improving healthcare. PMID:23617833

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.

Plan-graph Based Heuristics for Conformant Probabilistic Planning

NASA Technical Reports Server (NTRS)

Ramakrishnan, Salesh; Pollack, Martha E.; Smith, David E.

2004-01-01

In this paper, we introduce plan-graph based heuristics to solve a variation of the conformant probabilistic planning (CPP) problem. In many real-world problems, it is the case that the sensors are unreliable or take too many resources to provide knowledge about the environment. These domains are better modeled as conformant planning problems. POMDP based techniques are currently the most successful approach for solving CPP but have the limitation of state- space explosion. Recent advances in deterministic and conformant planning have shown that plan-graphs can be used to enhance the performance significantly. We show that this enhancement can also be translated to CPP. We describe our process for developing the plan-graph heuristics and estimating the probability of a partial plan. We compare the performance of our planner PVHPOP when used with different heuristics. We also perform a comparison with a POMDP solver to show over a order of magnitude improvement in performance.

Merging long range transportation planning with public health: a case study from Utah's Wasatch Front.

PubMed

Burbidge, Shaunna K

2010-01-01

US transportation systems have been identified as a problem for public health, as they often encourage automobile transportation and discourage physical activity. This paper provides a case study examination of the Public Health Component of the Wasatch Front Regional Council's Regional Transportation Plan. This plan provides an example of what transportation planners at Utah's largest metropolitan planning organization (MPO) are doing to encourage physical activity through transportation. Existing active living research was used to guide recommendations using a process that included a comprehensive literature review and a review of existing state programs, advisory group and stakeholder meetings, and policy recommendations based on existing local conditions. Stakeholders from a diversity of background and interests came together with one common goal: to improve public health. Based on this collaborative process, nine policy approaches were specifically recommended for approval and integration in the Wasatch Front Regional Transportation Plan. By using current research as a guide and integrating a variety of interests, the Wasatch Front Regional Council is setting a new standard for a collaborative multi-modal focus in transportation planning, which can be replicated nationwide.

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.

Plan for Quality to Improve Patient Safety at the Point of Care

PubMed Central

Ehrmeyer, Sharon S.

2011-01-01

The U.S. Institute of Medicine (IOM) much publicized report in “To Err is Human” (2000, National Academy Press) stated that as many as 98 000 hospitalized patients in the U.S. die each year due to preventable medical errors. This revelation about medical error and patient safety focused the public and the medical community's attention on errors in healthcare delivery including laboratory and point-of-care-testing (POCT). Errors introduced anywhere in the POCT process clearly can impact quality and place patient's safety at risk. While POCT performed by or near the patient reduces the potential of some errors, the process presents many challenges to quality with its multiple tests sites, test menus, testing devices and non-laboratory analysts, who often have little understanding of quality testing. Incoherent or no regulations and the rapid availability of test results for immediate clinical intervention can further amplify errors. System planning and management of the entire POCT process are essential to reduce errors and improve quality and patient safety. PMID:21808107

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

Universitywide Program Review: Evolving a Process for Program Improvement and Institutional Planning. Professional File. Number 128, Winter 2012

ERIC Educational Resources Information Center

Nelson, Kristi A.; Nicholas, Mark C.

2012-01-01

The President of the University of Cincinnati charged the Academic Coordinating Committee (ACC), a universitywide governance body, to conduct a comprehensive review of degree programs by designing a process with multiple outcomes: building an academically stronger university; ensuring consistency with the institution's capacity and academic…

Planning and scheduling lessons learned study, executive summary

NASA Technical Reports Server (NTRS)

Robinson, Toni

1990-01-01

The study was performed to document the lessons on planning and scheduling activities for a number of missions and institutional facilities in such a way that they can be applied to future missions; to provide recommendations to both projects and Code 500 that will improve the end-to-end planning and scheduling process; and to identify what, if any, mission characteristics might be related to certain lessons learned. The results are a series of recommendations of both a managerial and technical nature related to the underlying lessons learned.

Physician input: a critical strategic-planning tool.

PubMed

Rovinsky, Michael

2002-01-01

To establish effective working relationships with medical staff and community physicians, an IDS must adopt a strategic-planning approach that adequately incorporates physicians' needs and expectations. Research shows that most physicians considered the IDS's market position, the degree to which the IDS can offer physicians practice-enhancing capabilities, and physician involvement in IDS governance to be critical factors for the success of an IDS. By establishing a meaningful role for physicians in the organizational strategic-planning process, an IDS can significantly improve its market position and its relationships with physicians.

Integration of treatment innovation planning and implementation: strategic process models and organizational challenges.

PubMed

Lehman, Wayne E K; Simpson, D Dwayne; Knight, Danica K; Flynn, Patrick M

2011-06-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A two-phase procedural approach is therefore presented based on the integration of Texas Christian University (TCU) models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Benefits and Perceptions of Public Health Accreditation Among Health Departments Not Yet Applying.

PubMed

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

To identify the benefits and perceptions among health departments not yet participating in the public health accreditation program implemented by the Public Health Accreditation Board (PHAB). Quantitative and qualitative data were gathered via Web-based surveys of health departments that had not yet applied for PHAB accreditation (nonapplicants) and health departments that had been accredited for 1 year. Respondents from 150 nonapplicant health departments and 57 health departments that had been accredited for 1 year. The majority of nonapplicant health departments are reportedly conducting a community health assessment (CHA), community health improvement plan (CHIP), and health department strategic plan-3 documents that are required to be in place before applying for PHAB accreditation. To develop these documents, most nonapplicants are reportedly referencing PHAB requirements. The most commonly reported perceived benefits of accreditation among health departments that planned to or were undecided about applying for accreditation were as follows: increased awareness of strengths and weaknesses, stimulated quality improvement (QI) and performance improvement activities, and increased awareness of/focus on QI. Nonapplicants that planned to apply reported a higher level of these perceived benefits. Compared with health departments that had been accredited for 1 year, nonapplicants were more likely to report that their staff had no or limited QI knowledge or familiarity. The PHAB accreditation program has influenced the broader public health field-not solely health departments that have undergone accreditation. Regardless of their intent to apply for accreditation, nonapplicant health departments are reportedly referencing PHAB guidelines for developing the CHA, CHIP, and health department strategic plan. Health departments may experience benefits associated with accreditation prior to their formal involvement in the PHAB accreditation process. The most common challenge for health departments applying for accreditation is identifying the time and resources to dedicate to the process.

Understanding advance care planning as a process of health behavior change.

PubMed

Fried, Terri R; Bullock, Karen; Iannone, Lynne; O'Leary, John R

2009-09-01

To explore whether models of health behavior change can help to inform interventions for advance care planning (ACP). Qualitative cross-sectional study. Community. Sixty-three community-dwelling persons aged 65 and older and 30 caregivers with experience as surrogate decision-makers. In focus groups conducted separately with older persons and caregivers, participants were asked to discuss ways they had planned for future declines in health and why they had or had not engaged in such planning. Transcripts were analyzed using grounded theory. Four themes illustrated the potential of applying models of health behavior change to improve ACP. (1) Participants demonstrated variable readiness to engage in ACP and could be in different stages of readiness for different components of ACP, including consideration of treatment goals, completion of advance directives, and communication with families and physicians. (2) Participants identified a wide range of benefits of and barriers to ACP. (3) Participants used a variety of processes of change to progress through stages of readiness, and ACP was only one of a broader set of behaviors that participants engaged in to prepare for declines in their health or for death. (4) Experience with healthcare decision-making for loved ones was a strong influence on perceptions of susceptibility and engagement in ACP. The variability in participants' readiness, barriers and benefits, perceptions of susceptibility, and use of processes to increase readiness for participating in each component of ACP suggests the utility of customized, stage-specific interventions based on individualized assessments to improve ACP.

Trial of an electronic decision support system to facilitate shared decision making in community mental health.

PubMed

Woltmann, Emily M; Wilkniss, Sandra M; Teachout, Alexandra; McHugo, Gregory J; Drake, Robert E

2011-01-01

Involvement of community mental health consumers in mental health decision making has been consistently associated with improvements in health outcomes. Electronic decision support systems (EDSSs) that support both consumer and provider decision making may be a sustainable way to improve dyadic communication in a field with approximately 50% workforce turnover per year. This study examined the feasibility of such a system and investigated proximal outcomes of the system's performance. A cluster randomized design was used to evaluate an EDSS at three urban community mental health sites. Case managers (N=20) were randomly assigned to the EDSS-supported planning group or to the usual care planning group. Consumers (N=80) were assigned to the same group as their case managers. User satisfaction with the care planning process was assessed for consumers and case managers (possible scores range from 1 to 5, with higher summary scores indicating more satisfaction). Recall of the care plan was assessed for consumers. Linear regression with adjustment for grouping by worker was used to assess satisfaction scores. A Wilcoxon rank-sum test was used to examine knowledge of the care plan. Compared with case managers in the control group, those in the intervention group were significantly more satisfied with the care planning process (mean ± SD score=4.0 ± .5 versus 3.3 ± .5; adjusted p=.01). Compared with consumers in the control group, those in the intervention group had significantly greater recall of their care plans three days after the planning session (mean proportion of plan goals recalled=75% ± 28% versus 57% ± 32%; p=.02). There were no differences between the clients in the intervention and control groups regarding satisfaction. This study demonstrated that clients can build their own care plans and negotiate and revise them with their case managers using an EDSS.

Video: useful tool for delivering family planning messages.

PubMed

Sumarsono, S K

1985-10-01

In 1969, the Government of Indonesia declared that the population explosion was a national problem. The National Family Planning Program was consequently launched to encourage adoption of the ideal of a small, happy and prosperous family norm. Micro-approach messages are composed of the following: physiology of menstruation; reproductive process; healthy pregnancy; rational family planning; rational application of contraceptives; infant and child care; nutrition improvement; increase in breastfeeding; increase in family income; education in family life; family health; and deferred marriage age. Macro-approach messages include: the population problem and its impact on socioeconomic aspects; efforts to cope with the population problem; and improvement of women's lot. In utilizing the media and communication channels, the program encourages the implementation of units and working units of IEC to produce IEC materials; utilizes all possible existing media and IEC channels; maintains the consistent linkage between the activity of mass media and the IEC activities in the field; and encourages the private sector to participate in the production of IEC media and materials. A media production center was set up and carries out the following activities: producing video cassettes for tv broadcasts of family planning drama, family planning news, and tv spots; producing duplicates of the video cassettes for distribution to provinces in support of the video network; producing teaching materials for family planning workers; and transfering family planning films into video cassettes. A video network was developed and includes video monitors in family planning service points such as hospitals, family planning clinics and public places like bus stations. In 1985, the program will be expanded by 50 mobile information units equipped with video monitors. Video has potentials to increase the productivity and effectiveness of the family planning program. The video production process is cheaper and simpler than film production. Video will be very helpful as a communication aid in group meetings. It can also be used as a teaching aid for training.

Supporting local planning and budgeting for maternal, neonatal and child health in the Philippines

PubMed Central

2013-01-01

Background Responsibility for planning and delivery of health services in the Philippines is devolved to the local government level. Given the recognised need to strengthen capacity for local planning and budgeting, we implemented Investment Cases (IC) for Maternal, Neonatal and Child Health (MNCH) in three selected sub-national units: two poor, rural provinces and one highly-urbanised city. The IC combines structured problem-solving by local policymakers and planners to identify key health system constraints and strategies to scale-up critical MNCH interventions with a decision-support model to estimate the cost and impact of different scaling-up scenarios. Methods We outline how the initiative was implemented, the aspects that worked well, and the key limitations identified in the sub-national application of this approach. Results Local officials found the structured analysis of health system constraints helpful to identify problems and select locally appropriate strategies. In particular the process was an improvement on standard approaches that focused only on supply-side issues. However, the lack of data available at the local level is a major impediment to planning. While the majority of the strategies recommended by the IC were incorporated into the 2011 plans and budgets in the three study sites, one key strategy in the participating city was subsequently reversed in 2012. Higher level systemic issues are likely to have influenced use of evidence in plans and budgets and implementation of strategies. Conclusions Efforts should be made to improve locally-representative data through routine information systems for planning and monitoring purposes. Even with sound plans and budgets, evidence is only one factor influencing investments in health. Political considerations at a local level and issues related to decentralisation, influence prioritisation and implementation of plans. In addition to the strengthening of capacity at local level, a parallel process at a higher level of government to relieve fund channelling and coordination issues is critical for any evidence-based planning approach to have a significant impact on health service delivery. PMID:23343218

Improving medication titration in heart failure by embedding a structured medication titration plan.

PubMed

Hickey, Annabel; Suna, Jessica; Marquart, Louise; Denaro, Charles; Javorsky, George; Munns, Andrew; Mudge, Alison; Atherton, John J

2016-12-01

To improve up-titration of medications to target dose in heart failure patients by improving communication from hospital to primary care. This quality improvement project was undertaken within three heart failure disease management (HFDM) services in Queensland, Australia. A structured medication plan was collaboratively designed and implemented in an iterative manner, using methods including awareness raising and education, audit and feedback, integration into existing work practice, and incentive payments. Evaluation was undertaken using sequential audits, and included process measures (use of the titration plan, assignment of responsibility) and outcome measures (proportion of patients achieving target dose) in HFDM service patients with reduced left ventricular ejection fraction. Comparison of the three patient cohorts (pre-intervention cohort A n=96, intervention cohort B n=95, intervention cohort C n=89) showed increase use of the titration plan, a shift to greater primary care responsibility for titration, and an increase in the proportion of patients achieving target doses of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) (A 37% vs B 48% vs C 55%, p=0.051) and beta-blockers (A 38% vs B 33% vs C 51%, p=0.045). Combining all three cohorts, patients not on target doses when discharged from hospital were more likely to achieve target doses of ACEI/ARB (p<0.0001) and beta blockers (p<0.0001) within six months if they received a medication titration plan. A medication titration plan was successfully implemented in three HFDM services and improved transitional communication and achievement of target doses of evidence-based therapies within six months of hospital discharge. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs

NASA Astrophysics Data System (ADS)

Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Jiang Graves, Yan; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

2013-12-01

Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using our in-house optimization engine. This work was originally presented at the 54th AAPM annual meeting in Charlotte, NC, July 29-August 2, 2012.

Turning education into action: Impact of a collective social education approach to improve nurses' ability to recognize and accurately assess delirium in hospitalized older patients.

PubMed

Travers, Catherine; Henderson, Amanda; Graham, Fred; Beattie, Elizabeth

2018-03-01

Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium. Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium. At the outset, the CogChamps were provided with comprehensive education about dementia and delirium from a multidisciplinary team of clinicians. Their knowledge was assessed to ascertain they had the requisite understanding to engage in education as a collective social process, namely, with each other and their local teams. Following this, they developed ward specific Action Plans in collaboration with their teams aimed at educating and evaluating ward nurses' ability to accurately assess and care for patients for delirium. The plans were implemented over five months. The broader nursing teams' knowledge was assessed, together with their ability to accurately assess patients for delirium. Each ward implemented their Action Plan to varying degrees and key achievements included the education of a majority of ward nurses about delirium and the certification of the majority as competent to assess patients for delirium using the Confusion Assessment Method. Two wards collected pre-and post-audit data that demonstrated a substantial improvement in delirium screening rates. The education process led by CogChamps and supported by educators and clinical experts provides an example of successfully educating nurses about delirium and improving screening rates of patients for delirium. ACTRN 12617000563369. Copyright © 2018 Elsevier Ltd. All rights reserved.

Opportunities lost and found: experiences of patients with cerebral palsy and their parents transitioning from pediatric to adult healthcare.

PubMed

DiFazio, Rachel L; Harris, Marie; Vessey, Judith A; Glader, Laurie; Shanske, Susan

2014-01-01

To describe and define the experiences of adults with cerebral palsy (CP) and parents of adults with CP who have been involved in a transfer of physiatry care from pediatric to adult healthcare and to explore their experiences more generally in the transition from pediatric to adult services. A qualitative research approach was used. Semi-structured focus group interviews were conducted with adults with CP (n=5) and parents of adults with CP (n=8) to explore the health care transition (HCT) process from pediatric to adult healthcare. Four key content domains were used to facilitate the focus groups; 1) Transition Planning, 2) Accessibility of Services, 3) Experience with Adult Providers, and 4) Recommendations for Improving the Transition Process. Conventional content analysis was used to analyze the data. Four themes emerged from the focus groups; Lost in Transition, Roadmap to Care, List of None, and One Stop Shopping. Participants felt lost in the HCT process, requested a transparent transition plan, expressed concern regarding access to adult healthcare, and made recommendations for improvements. Challenges in transitioning from pediatric to adult health care were identified by all participants and several strategies were recommended for improvement.

Using process elicitation and validation to understand and improve chemotherapy ordering and delivery.

PubMed

Mertens, Wilson C; Christov, Stefan C; Avrunin, George S; Clarke, Lori A; Osterweil, Leon J; Cassells, Lucinda J; Marquard, Jenna L

2012-11-01

Chemotherapy ordering and administration, in which errors have potentially severe consequences, was quantitatively and qualitatively evaluated by employing process formalism (or formal process definition), a technique derived from software engineering, to elicit and rigorously describe the process, after which validation techniques were applied to confirm the accuracy of the described process. The chemotherapy ordering and administration process, including exceptional situations and individuals' recognition of and responses to those situations, was elicited through informal, unstructured interviews with members of an interdisciplinary team. The process description (or process definition), written in a notation developed for software quality assessment purposes, guided process validation (which consisted of direct observations and semistructured interviews to confirm the elicited details for the treatment plan portion of the process). The overall process definition yielded 467 steps; 207 steps (44%) were dedicated to handling 59 exceptional situations. Validation yielded 82 unique process events (35 new expected but not yet described steps, 16 new exceptional situations, and 31 new steps in response to exceptional situations). Process participants actively altered the process as ambiguities and conflicts were discovered by the elicitation and validation components of the study. Chemotherapy error rates declined significantly during and after the project, which was conducted from October 2007 through August 2008. Each elicitation method and the subsequent validation discussions contributed uniquely to understanding the chemotherapy treatment plan review process, supporting rapid adoption of changes, improved communication regarding the process, and ensuing error reduction.

DLA-X Total Quality Management (TQM) Implementation Plan

DTIC Science & Technology

1989-07-01

PAGES TOM (Total Quality Management ), Continuous Process Improvement.( .) 4L-- Administration 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Pr.-cr,bed by ANSI Std ,,fl.f 296-102 DLA-X TOTAL QUALITY MANAGEMENT (TQM) IMPLEMENTATION PLAN o...application of proven Total Quality Management techniques. Quality Policy: Responsibility for quality is delegated to every employee ;11 DLA-X. Every