Computer program CDCID: an automated quality control program using CDC update

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

Singer, G.L.; Aguilar, F.

1984-04-01

A computer program, CDCID, has been developed in coordination with a quality control program to provide a highly automated method of documenting changes to computer codes at EG and G Idaho, Inc. The method uses the standard CDC UPDATE program in such a manner that updates and their associated documentation are easily made and retrieved in various formats. The method allows each card image of a source program to point to the document which describes it, who created the card, and when it was created. The method described is applicable to the quality control of computer programs in general. Themore » computer program described is executable only on CDC computing systems, but the program could be modified and applied to any computing system with an adequate updating program.« less

GC-C-IRMS in routine doping control practice: 3 years of drug testing data, quality control and evolution of the method.

PubMed

Polet, Michael; Van Eenoo, Peter

2015-06-01

In order to detect the misuse of endogenous anabolic steroids, doping control laboratories require methods that allow differentiation between endogenous steroids and their synthetic copies. Gas chromatography combustion isotope ratio mass spectrometry (GC-C-IRMS) is capable of measuring the carbon isotope ratio of urinary steroids and this allows differentiation between both. GC-C-IRMS and its application to doping control has evolved a lot during the last decade and so have the World Anti-Doping Agency (WADA) technical documents that describe how GC-C-IRMS should be applied. Especially the WADA technical document of 2014 introduced a number of obligatory quality controls and a fixed methodology that should be used by all the doping control laboratories. This document imposed more uniform methods between the laboratories in order to decrease the interlaboratory standard deviation and acquire similar results for the analysis of the same urine samples. In this paper, 3 years of drug testing data of our GC-C-IRMS method in routine doping control practice is described, with an emphasis on the new WADA technical document and its implementation. Useful data for other doping control laboratories is presented focussing on general method setup, quality control and data collected from routine samples. The paper concentrates on how IRMS results shift or remain similar by switching to the 2014 WADA technical document and gives insight in a straightforward approach to calculate the measurement uncertainty.

Announcement—guidance document for acquiring reliable data in ecological restoration projects

USGS Publications Warehouse

Stapanian, Martin A.; Rodriguez, Karen; Lewis, Timothy E.; Blume, Louis; Palmer, Craig J.; Walters, Lynn; Schofield, Judith; Amos, Molly M.; Bucher, Adam

2016-01-01

The Laurentian Great Lakes are undergoing intensive ecological restoration in Canada and the United States. In the United States, an interagency committee was formed to facilitate implementation of quality practices for federally funded restoration projects in the Great Lakes basin. The Committee's responsibilities include developing a guidance document that will provide a common approach to the application of quality assurance and quality control (QA/QC) practices for restoration projects. The document will serve as a “how-to” guide for ensuring data quality during each aspect of ecological restoration projects. In addition, the document will provide suggestions on linking QA/QC data with the routine project data and hints on creating detailed supporting documentation. Finally, the document will advocate integrating all components of the project, including QA/QC applications, into an overarching decision-support framework. The guidance document is expected to be released by the U.S. EPA Great Lakes National Program Office in 2017.

Quality Control Study of the GSL Reinsurance System. Final Report.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

A quality control plan for the U.S. Department of Education's Guaranteed Student Loan (GSL) reinsurance process was developed. To identify existing errors, systems documentation and past analyses of the reinsurance system were analyzed, and interviews were conducted. Corrective actions were proposed, and a quality control checklist was developed…

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

Sailer, S.J.

This Quality Assurance Project Plan (QAPJP) specifies the quality of data necessary and the characterization techniques employed at the Idaho National Engineering Laboratory (INEL) to meet the objectives of the Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) Transuranic Waste Characterization Quality Assurance Program Plan (QAPP) requirements. This QAPJP is written to conform with the requirements and guidelines specified in the QAPP and the associated documents referenced in the QAPP. This QAPJP is one of a set of five interrelated QAPjPs that describe the INEL Transuranic Waste Characterization Program (TWCP). Each of the five facilities participating in the TWCPmore » has a QAPJP that describes the activities applicable to that particular facility. This QAPJP describes the roles and responsibilities of the Idaho Chemical Processing Plant (ICPP) Analytical Chemistry Laboratory (ACL) in the TWCP. Data quality objectives and quality assurance objectives are explained. Sample analysis procedures and associated quality assurance measures are also addressed; these include: sample chain of custody; data validation; usability and reporting; documentation and records; audits and 0385 assessments; laboratory QC samples; and instrument testing, inspection, maintenance and calibration. Finally, administrative quality control measures, such as document control, control of nonconformances, variances and QA status reporting are described.« less

75 FR 32858 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Control of Nitrogen...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

... Boilers and Process Heaters at Petroleum Refineries Correction In rule document 2010-13377 beginning on... limitations for Control [Insert page number any industrial boiler or Requirements. where the document process...

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Issues in Commercial Document Delivery.

ERIC Educational Resources Information Center

Marcinko, Randall Wayne

1997-01-01

Discusses (1) the history of document delivery; (2) the delivery process--end-user request, intermediary request, vendor reference, citation verification, obtaining document and source relations, quality control, transferring document to client, customer service and status, invoicing and billing, research and development, and copyright; and (3)…

[Essential guidelines for Quality Management System].

PubMed

Daunizeau, A

2013-06-01

The guidelines describe the essential parts of the quality management system to fulfil the requirements of the standard EN ISO 15 189. It includes mainly the organisation, the definition of responsibilities, training of personnel, the document control, the quality control, identification and control of nonconformities, corrective actions, preventive actions and evaluation, as audits and the management review.

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 493.1425 - Standard; Testing personnel responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... laboratory's quality control policies, document all quality control activities, instrument and procedural... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing Moderate Complexity Testing § 493.1425 Standard; Testing personnel...

9 CFR 318.309 - Finished product inspection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... microbiological contamination; (2) An FSIS-approved total quality control system; (3) Alternative documented... associated with microbial contamination, where there is no approved total quality control system, or where... Office of Management and Budget under control number 0583-0015) [51 FR 45619, Dec. 19, 1986, as amended...

The Effect of Structured Decision-Making Techniques and Gender on Student Reaction and Quality of Written Documents.

ERIC Educational Resources Information Center

Neal, Joan; Echternacht, Lonnie

1995-01-01

Experimental groups used four decision-making techniques--reverse brainstorming (RS), dialectical inquiry (DI), devil's advocacy (DA), and consensus--in evaluating writing assignments. Control group produced a better quality document. Student reaction to negative features of RS, DI, and DA were not significant. (SK)

Nonlinear filtering for character recognition in low quality document images

NASA Astrophysics Data System (ADS)

Diaz-Escobar, Julia; Kober, Vitaly

2014-09-01

Optical character recognition in scanned printed documents is a well-studied task, where the captured conditions like sheet position, illumination, contrast and resolution are controlled. Nowadays, it is more practical to use mobile devices for document capture than a scanner. So as a consequence, the quality of document images is often poor owing to presence of geometric distortions, nonhomogeneous illumination, low resolution, etc. In this work we propose to use multiple adaptive nonlinear composite filters for detection and classification of characters. Computer simulation results obtained with the proposed system are presented and discussed.

Method for Examination and Documentation of Basic Information and Metadata from Published Reports Relevant to the Study of Stormwater Runoff Quality

USGS Publications Warehouse

Dionne, Shannon G.; Granato, Gregory E.; Tana, Cameron K.

1999-01-01

A readily accessible archive of information that is valid, current, and technically defensible is needed to make informed highway-planning, design, and management decisions. The National Highway Runoff Water-Quality Data and Methodology Synthesis (NDAMS) is a cataloging and assessment of the documentation of information relevant to highway-runoff water quality available in published reports. The report review process is based on the NDAMS review sheet, which was designed by the USGS with input from the FHWA, State transportation agencies, and the regulatory community. The report-review process is designed to determine the technical merit of the existing literature in terms of current requirements for data documentation, data quality, quality assurance and quality control (QA/QC), and technical issues that may affect the use of historical data. To facilitate the review process, the NDAMS review sheet is divided into 12 sections: (1) administrative review information, (2) investigation and report information, (3) temporal information, (4) location information (5) water-quality-monitoring information, (6) sample-handling methods, (7) constituent information, (8) sampling focus and matrix, (9) flow monitoring methods, (10) field QA/QC, (11) laboratory, and (12) uncertainty/error analysis. This report describes the NDAMS report reviews and metadata documentation methods and provides an overview of the approach and of the quality-assurance and quality-control program used to implement the review process. Detailed information, including a glossary of relevant terms, a copy of the report-review sheets, and reportreview instructions are completely documented in a series of three appendixes included with this report. Therefore the reviews are repeatable and the methods can be used by transportation research organizations to catalog new reports as they are published.

Pocket change: a simple educational intervention increases hospitalist documentation of comorbidities and improves hospital quality performance measures.

PubMed

Sparks, Rachel; Salskov, Alex H; Chang, Anita S; Wentworth, Kelly L; Gupta, Pritha P; Staiger, Thomas O; Anawalt, Bradley D

2015-01-01

Complete documentation of patient comorbidities in the medical record is important for clinical care, hospital reimbursement, and quality performance measures. We designed a pocket card reminder and brief educational intervention aimed at hospitalists with the goal of improving documentation of 6 common comorbidities present on admission: coagulation abnormalities, metastatic cancer, anemia, fluid and electrolyte abnormalities, malnutrition, and obesity. Two internal medicine inpatient teams led by 10 hospitalist physicians at an academic medical center received the educational intervention and pocket card reminder (n = 520 admissions). Two internal medicine teams led by nonhospitalist physicians served as a control group (n = 590 admissions). Levels of documentation of 6 common comorbidities, expected length of stay, and expected mortality were measured at baseline and during the 9-month study period. The intervention was associated with increased documentation of anemia, fluid and electrolyte abnormalities, malnutrition, and obesity in the intervention group, both compared to baseline and compared to the control group during the study period. The expected length of stay increased in the intervention group during the study period. A simple educational intervention and pocket card reminder were associated with improved documentation and hospital quality measures at an academic medical center.

9 CFR 381.309 - Finished product inspection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FSIS-approved total quality control system; or (3) Alternative documented procedures that will ensure... contamination, where there is no approved total quality control system, or where the establishment has no... Office of Management and Budget under control number 0583-0015) [51 FR 45634, Dec. 19, 1986, as amended...

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.

Standard procedures and quality-control practices for the U.S. Geological Survey National Field Quality Assurance Program from 1982 through 1993

USGS Publications Warehouse

Stanley, D.L.

1995-01-01

The U.S. Geological Survey operates the National Field Quality Assurance Program to provide quality- assurance reference samples to field personnel who make water-quality field measurements. The program monitors the accuracy and precision of pH, specific conductance, and alkalinity field measurements. This report documents the operational procedures and quality-control techniques used in operating the quality-assurance program.

VERIFICATION TESTING OF AIR POLLUTION CONTROL TECHNOLOGY QUALITY MANAGEMENT PLAN

EPA Science Inventory

This document is the basis for quality assurance for the Air Pollution Control Technology Verification Center (APCT Center) operated under the U.S. Environmental Protection Agency (EPA). It describes the policies, organizational structure, responsibilities, procedures, and qualit...

Web-based X-ray quality control documentation.

PubMed

David, George; Burnett, Lou Ann; Schenkel, Robert

2003-01-01

The department of radiology at the Medical College of Georgia Hospital and Clinics has developed an equipment quality control web site. Our goal is to provide immediate access to virtually all medical physics survey data. The web site is designed to assist equipment engineers, department management and technologists. By improving communications and access to equipment documentation, we believe productivity is enhanced. The creation of the quality control web site was accomplished in three distinct steps. First, survey data had to be placed in a computer format. The second step was to convert these various computer files to a format supported by commercial web browsers. Third, a comprehensive home page had to be designed to provide convenient access to the multitude of surveys done in the various x-ray rooms. Because we had spent years previously fine-tuning the computerization of the medical physics quality control program, most survey documentation was already in spreadsheet or database format. A major technical decision was the method of conversion of survey spreadsheet and database files into documentation appropriate for the web. After an unsatisfactory experience with a HyperText Markup Language (HTML) converter (packaged with spreadsheet and database software), we tried creating Portable Document Format (PDF) files using Adobe Acrobat software. This process preserves the original formatting of the document and takes no longer than conventional printing; therefore, it has been very successful. Although the PDF file generated by Adobe Acrobat is a proprietary format, it can be displayed through a conventional web browser using the freely distributed Adobe Acrobat Reader program that is available for virtually all platforms. Once a user installs the software, it is automatically invoked by the web browser whenever the user follows a link to a file with a PDF extension. Although no confidential patient information is available on the web site, our legal department recommended that we secure the site in order to keep out those wishing to make mischief. Our interim solution has not been to password protect the page, which we feared would hinder access for occasional legitimate users, but also not to provide links to it from other hospital and department pages. Utility and productivity were improved and time and money were saved by making radiological equipment quality control documentation instantly available on-line.

Guidance and Control Software Project Data - Volume 1: Planning Documents

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the planning documents from the GCS project. Volume 1 contains five appendices: A. Plan for Software Aspects of Certification for the Guidance and Control Software Project; B. Software Development Standards for the Guidance and Control Software Project; C. Software Verification Plan for the Guidance and Control Software Project; D. Software Configuration Management Plan for the Guidance and Control Software Project; and E. Software Quality Assurance Activities.

75 FR 9572 - Submission for OMB Review; Comment Request: Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

... Quality Control Reviews'' OMB control number 0584-0074. The document contained incorrect burden hours. The... methodology and assumptions used; (c) ways to enhance the quality, utility and clarity of the information to... information unless the collection of information displays a currently valid OMB control number and the agency...

75 FR 68364 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... European Protocol for the Quality Control of the Physical and Technical Aspects of Mammography Screening... entitled ``Physical Laboratory Testing, Breast Compression System'' to follow the Mammography Quality...] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document...

78 FR 12052 - Agency Information Collection Activities: Proposed Collection; Comment Request; Ambient Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... pollution control agencies, and tribal entities which collect and report ambient air quality data for the..., documenting episodes and initiating episode controls, air quality trends assessment, and air pollution.... Although the state and local air pollution control agencies and tribal entities are responsible for the...

Predictors of maternal depression in the first year postpartum: marital status and mediating role of relationship quality.

PubMed

Akincigil, Ayse; Munch, Shari; Niemczyk, Kristen C

2010-01-01

Existing literature has documented the associations between marital status and maternal depression within the first year postpartum. Using data that is representative of urban non-marital births in the United States with a large over-sample of non-marital births, we investigate the association of maternal depression with not only marital status but also relationship quality with the father of the baby. Quality is independently associated with maternal depression after controlling for marital status and other variables that have been documented as risk factors for maternal depression. In addition, relationship quality explains away the associations between marital status and maternal depression. After controlling for relationship quality, single women were no more likely to be depressed compared to married or cohabiting women.

42 CFR 493.1495 - Standard; Testing personnel responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... samples are tested in the same manner as patient specimens; (3) Adhere to the laboratory's quality control policies, document all quality control activities, instrument and procedural calibrations and maintenance... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

Guidelines for Controlling Indoor Air Quality Problems Associated with Kilns, Copiers, and Welding in Schools. Technical Bulletin.

ERIC Educational Resources Information Center

Turner, Ronald W.; And Others

Guidelines for controlling indoor air quality problems associated with kilns, copiers, and welding in schools are provided in this document. Individual sections on kilns, duplicating equipment, and welding operations contain information on the following: sources of contaminants; health effects; methods of control; ventilation strategies; and…

QUALITY CONTROL - VARIABILITY IN PROTOCOLS

EPA Science Inventory

The EPA Risk Reduction Engineering Laboratory’s Quality Assurance Office, which published the popular pocket guide Preparing Perfect Project Plans, is now introducing another quality assurance reference aid. The document Variability in Protocols (VIP) was initially designed as a ...

Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support

PubMed Central

2014-01-01

Background Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. Methods We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Results Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). Conclusions CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed to determine if it results in improved care. PMID:24645674

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

PubMed

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed to determine if it results in improved care.

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

PubMed

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

2015-09-01

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

7 CFR 634.25 - Contracting.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.25 Contracting... agrees to apply his or her water-quality plan. Any person who controls, or shares control, of the farm... basic contract document, special provisions as needed, the participant's water-quality plan, schedule of...

7 CFR 634.25 - Contracting.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.25 Contracting... agrees to apply his or her water-quality plan. Any person who controls, or shares control, of the farm... basic contract document, special provisions as needed, the participant's water-quality plan, schedule of...

7 CFR 634.25 - Contracting.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.25 Contracting... agrees to apply his or her water-quality plan. Any person who controls, or shares control, of the farm... basic contract document, special provisions as needed, the participant's water-quality plan, schedule of...

Quality at a Glance

DTIC Science & Technology

1990-01-01

This document contains summaries of fifteen of the well known books which underlie the Total Quality Management philosophy. Members of the DCASR St Louis staff offer comments and opinions on how the authors have presented the quality concept in todays business environment. Keywords: TQM (Total Quality Management ), Quality concepts, Statistical process control.

Is Your Biobank Up to Standards? A Review of the National Canadian Tissue Repository Network Required Operational Practice Standards and the Controlled Documents of a Certified Biobank.

PubMed

Hartman, Victoria; Castillo-Pelayo, Tania; Babinszky, Sindy; Dee, Simon; Leblanc, Jodi; Matzke, Lise; O'Donoghue, Sheila; Carpenter, Jane; Carter, Candace; Rush, Amanda; Byrne, Jennifer; Barnes, Rebecca; Mes-Messons, Anne-Marie; Watson, Peter

2018-02-01

Ongoing quality management is an essential part of biobank operations and the creation of high quality biospecimen resources. Adhering to the standards of a national biobanking network is a way to reduce variability between individual biobank processes, resulting in cross biobank compatibility and more consistent support for health researchers. The Canadian Tissue Repository Network (CTRNet) implemented a set of required operational practices (ROPs) in 2011 and these serve as the standards and basis for the CTRNet biobank certification program. A review of these 13 ROPs covering 314 directives was conducted after 5 years to identify areas for revision and update, leading to changes to 7/314 directives (2.3%). A review of all internal controlled documents (including policies, standard operating procedures and guides, and forms for actions and processes) used by the BC Cancer Agency's Tumor Tissue Repository (BCCA-TTR) to conform to these ROPs was then conducted. Changes were made to 20/106 (19%) of BCCA-TTR documents. We conclude that a substantial fraction of internal controlled documents require updates at regular intervals to accommodate changes in best practices. Reviewing documentation is an essential aspect of keeping up to date with best practices and ensuring the quality of biospecimens and data managed by biobanks.

Comparison of handheld computer-assisted and conventional paper chart documentation of medical records. A randomized, controlled trial.

PubMed

Stengel, Dirk; Bauwens, Kai; Walter, Martin; Köpfer, Thilo; Ekkernkamp, Axel

2004-03-01

Daily documentation and maintenance of medical record quality is a crucial issue in orthopaedic surgery. The purpose of the present study was to determine whether the introduction of a handheld computer could improve both the quantitative and qualitative aspects of medical records. A series of consecutive patients who were admitted for the first time to a thirty-six-bed orthopaedic ward of an academic teaching hospital for a planned operation or any other treatment of an acute injury or chronic condition were randomized to daily documentation of their clinical charts on a handheld computer or on conventional paper forms. The electronic documentation consisted of a specially designed software package on a handheld computer for bedside use with structured decision trees for examination, obtaining a history, and coding. In the control arm, chart notes were compiled on standard paper forms and were subsequently entered into the hospital's information system. The number of documented ICD (International Classification of Diseases) diagnoses was the primary end point for sample size calculations. All patient charts were reread by an expert panel consisting of two surgeons and the surgical quality assurance manager. These experts assigned quality ratings to the different documentation systems by scrutinizing the extent and accuracy of the patient histories and the physical findings as assessed by daily chart notes. Eighty patients were randomized to one of the two documentation arms, and seventy-eight (forty-seven men and thirty-one women) of them were eligible for final analysis. Documentation with the handheld computer increased the median number of diagnoses per patients from four to nine (p < 0.0001), but it produced some overcoding for false or redundant items. Documentation quality ratings improved significantly with the introduction of the handheld device (p < 0.01) with respect to the correct assessment of a patient's progress and translation into ICD diagnoses. Various learning curve effects were observed with different operators. Study physicians assigned slightly better practicability ratings to the handheld device. The preliminary data from this study suggest that handheld computers may improve the quality of hospital charts in orthopaedic surgery. Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.

TECHNICAL GUIDANCE DOCUMENT: THE FABRICATION OF POLYETHYLENE FML FIELD SEAMS

EPA Science Inventory

This technical guidance document is meant to augment the numerous construction quality control and construction assurance (CQC and CQA) guidelines that are presently available for high density polyethylene (HDPE) liner installation and inspection.

Government Contract Law Cases.

DTIC Science & Technology

1983-10-01

have no power of supervision or control ere the fact otherwise, we would cease to have a popular nment, but instead would be governed by a group of...article. The principal question presented is appellant’s right to repudiate the contract without liability. The operative questions controlling our...and quality control actions. Paragraph 5 of the document read as follows: THE TRAINING, DOCUMENTATION, SOFTWARE, PACKAGING QUOTED WILL BE DGC

Volume 3 - Area Sources and Area Source Method Abstracts

EPA Pesticide Factsheets

Nonpoint (area) source emission reference materials from the EIIP. Provides nonpoint source guidance on planning, emissions estimation, data collection, inventory documentation and reporting, and quality assurance/quality control.

Quality Control Technician.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This document contains 18 units to consider for use in a tech prep competency profile for the occupation of quality control technician. All the units listed will not necessarily apply to every situation or tech prep consortium, nor will all the competencies within each unit be appropriate. Several units appear within each specific occupation and…

Making Quality Sense: A Guide to Quality, Tools and Techniques, Awards and the Thinking Behind Them.

ERIC Educational Resources Information Center

Owen, Jane

This document is intended to guide further education colleges and work-based learning providers through some of the commonly used tools, techniques, and theories of quality management. The following are among the topics discussed: (1) various ways of defining quality; methods used by organizations to achieve quality (quality control, quality…

Indiana Air Pollution Control Board Approves a Modification on a PSD Permit for General Motors in which Two Coal-Fired Boilers are Forgiven a SO2 Control Requirement

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Auditing of chromatographic data.

PubMed

Mabie, J T

1998-01-01

During a data audit, it is important to ensure that there is clear documentation and an audit trail. The Quality Assurance Unit should review all areas, including the laboratory, during the conduct of the sample analyses. The analytical methodology that is developed should be documented prior to sample analyses. This is an important document for the auditor, as it is the instrumental piece used by the laboratory personnel to maintain integrity throughout the process. It is expected that this document will give insight into the sample analysis, run controls, run sequencing, instrument parameters, and acceptance criteria for the samples. The sample analysis and all supporting documentation should be audited in conjunction with this written analytical method and any supporting Standard Operating Procedures to ensure the quality and integrity of the data.

Technical Document on Control of Nitrogen Oxides From Municipal Waste Combustors

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

78 FR 57631 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request; Ambient...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-19

..., tribal entities, environmental groups, academic institutions, industrial groups) use the ambient air... System (AQS) database. Quality assurance/quality control records and monitoring network documentation are...

Maturity method demonstration : final report.

DOT National Transportation Integrated Search

2003-07-01

The concrete maturity method is a quality control/quality assurance tool that can be used to assist contractors and transportation officials in producing cost-efficient, durable concrete structures. This report documents the findings of an investigat...

Analysis And Control System For Automated Welding

NASA Technical Reports Server (NTRS)

Powell, Bradley W.; Burroughs, Ivan A.; Kennedy, Larry Z.; Rodgers, Michael H.; Goode, K. Wayne

1994-01-01

Automated variable-polarity plasma arc (VPPA) welding apparatus operates under electronic supervision by welding analysis and control system. System performs all major monitoring and controlling functions. It acquires, analyzes, and displays weld-quality data in real time and adjusts process parameters accordingly. Also records pertinent data for use in post-weld analysis and documentation of quality. System includes optoelectronic sensors and data processors that provide feedback control of welding process.

Sci-Fri AM: Quality, Safety, and Professional Issues 01: CPQR Technical Quality Control Suite Development including Quality Control Workload Results

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

Malkoske, Kyle; Nielsen, Michelle; Brown, Erika

A close partnership between the Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist’s (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) has resulted in the development of a suite of Technical Quality Control (TQC) Guidelines for radiation treatment equipment, that outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. The framework includes consolidation of existing guidelines and/or literature by expert reviewers, structured stages of public review, external field-testing and ratification by COMP. The adopted framework for the development and maintenance of themore » TQCs ensures the guidelines incorporate input from the medical physics community during development, measures the workload required to perform the QC tests outlined in each TQC, and remain relevant (i.e. “living documents”) through subsequent planned reviews and updates. This presentation will show the Multi-Leaf Linear Accelerator document as an example of how feedback and cross-national work to achieve a robust guidance document. During field-testing, each technology was tested at multiple centres in a variety of clinic environments. As part of the defined feedback, workload data was captured. This lead to average time associated with testing as defined in each TQC document. As a result, for a medium-sized centre comprising 6 linear accelerators and a comprehensive brachytherapy program, we evaluate the physics workload to 1.5 full-time equivalent physicist per year to complete all QC tests listed in this suite.« less

Math Problems for Water Quality Control Personnel, Instructor's Manual. Second Edition.

ERIC Educational Resources Information Center

Delvecchio, Fred; Brutsch, Gloria

This document is the instructor's manual for a course in mathematics for water quality control personnel. It is designed so a program may be designed for a specific facility. The problem structures are arranged alphabetically by treatment process. Charts, graphs and/or drawings representing familiar data forms contain the necessary information to…

Math Problems for Water Quality Control Personnel, Student Workbook. Second Edition.

ERIC Educational Resources Information Center

Delvecchio, Fred; Brutsch, Gloria

This document is the student workbook for a course in mathematics for water quality control personnel. This version contains complete problems, answers and references. Problems are arranged alphabetically by treatment process. Charts, graphs, and drawings represent data forms an operator might see in a plant containing information necessary for…

Master Pump Shutdown MPS Software Quality Assurance Plan (SQAP)

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

BEVINS, R.R.

2000-09-20

The MPSS Software Quality Assurance (SQAP) describes the tools and strategy used in the development of the MPSS software. The document also describes the methodology for controlling and managing changes to the software.

Guidelines for software inspections

NASA Technical Reports Server (NTRS)

1983-01-01

Quality control inspections are software problem finding procedures which provide defect removal as well as improvements in software functionality, maintenance, quality, and development and testing methodology is discussed. The many side benefits include education, documentation, training, and scheduling.

Electrical, Electronic, and Electromechanical (EEE) parts management and control requirements for NASA space flight programs

NASA Technical Reports Server (NTRS)

1989-01-01

This document establishes electrical, electronic, and electromechanical (EEE) parts management and control requirements for contractors providing and maintaining space flight and mission-essential or critical ground support equipment for NASA space flight programs. Although the text is worded 'the contractor shall,' the requirements are also to be used by NASA Headquarters and field installations for developing program/project parts management and control requirements for in-house and contracted efforts. This document places increased emphasis on parts programs to ensure that reliability and quality are considered through adequate consideration of the selection, control, and application of parts. It is the intent of this document to identify disciplines that can be implemented to obtain reliable parts which meet mission needs. The parts management and control requirements described in this document are to be selectively applied, based on equipment class and mission needs. Individual equipment needs should be evaluated to determine the extent to which each requirement should be implemented on a procurement. Utilization of this document does not preclude the usage of other documents. The entire process of developing and implementing requirements is referred to as 'tailoring' the program for a specific project. Some factors that should be considered in this tailoring process include program phase, equipment category and criticality, equipment complexity, and mission requirements. Parts management and control requirements advocated by this document directly support the concept of 'reliability by design' and are an integral part of system reliability and maintainability. Achieving the required availability and mission success objectives during operation depends on the attention given reliability and maintainability in the design phase. Consequently, it is intended that the requirements described in this document are consistent with those of NASA publications, 'Reliability Program Requirements for Aeronautical and Space System Contractors,' NHB 5300.4(1A-l); 'Maintainability Program Requirements for Space Systems,' NHB 5300.4(1E); and 'Quality Program Provisions for Aeronautical and Space System Contractors,' NHB 5300.4(1B).

Engaging staff to improve quality and safety in an austere medical environment: a case-control study in two Sierra Leonean hospitals.

PubMed

Rosen, Michael A; Chima, Adaora M; Sampson, John B; Jackson, Eric V; Koka, Rahul; Marx, Megan K; Kamara, Thaim B; Ogbuagu, Onyebuchi U; Lee, Benjamin H

2015-08-01

Inadequate observance of basic processes in patient care such as patient monitoring and documentation practices are potential impediments to the timely diagnoses and management of patients. These gaps exist in low resource settings such as Sierra Leone and can be attributed to a myriad of factors such as workforce and technology deficiencies. In the study site, only 12.4% of four critical vital signs were documented in the pre-intervention period. Implement a failure mode and effects analysis (FMEA) to improve documentation of four patient vital signs: temperature, blood pressure, pulse rate and respiratory rate. FMEA was implemented among a subpopulation of health workers who are involved in monitoring and documenting patient vital signs. Pre- and post-FMEA monitoring and documentation practice were compared with a control site. Participants identified a four-step process to monitoring and documenting vital signs, three categories of failure modes and four potential solutions. Based on 2100 patient days of documentation compliance data from 147 patients between July and November 2012, staff members at the study site were 1.79 times more likely to document all four patient vital signs in the post-implementation period (95% CI [1.35, 2.38]). FMEA is a feasible and effective strategy for improving quality and safety in an austere medical environment. Documentation compliance improved at the intervention facility. To evaluate the scalability and sustainability of this approach, programs targeting the development of these types of process improvement skills in local staff should be evaluated. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Quality Assurance Project Plan - Modeling the Impact of Hydraulic Fracturing on Water Resources Based on Water Acquisition Scenarios

EPA Pesticide Factsheets

This planning document describes the quality assurance/quality control activities and technical requirements that will be used during the research study. The goal of this project is to evaluate the potential impacts of large volume water withdrawals.

Inherent Control - Hot-Mix Asphalt Industry

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Application for a Pollution Control Project Exemption - Potlatch Corporation, Lewiston

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Operational Guidance on Control Technology for New and Modified MWC's

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Tennessee Gas Pipeline Pollution Control Project

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Calculation of Cost Effectiveness of Emission Control Systems

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

General Electric (GE ) Silicones, Request for Pollution Control Project Exclusion

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Pollution Control Technical Manual

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

NOx Controls For Existing Utility Boilers

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Pollution Control Projects and New Source Review (NSR) Applicability

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control, September 18, 1995 Letter to Peter Hamlin

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control for Maplewood Landfill and Industrial Power Generating Corporation

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Inherent Controls on Ready Mix Cement Silos

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

PSD Question Concerning Common Control, Alliant Energy and Climax Molybdenum

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

PowerSecure Common Control Determination

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Kamine Development Corporation Request for a PSD Innovative Control Technology Waiver

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Transmittal of OAQPS Interim Control Policy Statement

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

PowerSecure Common Control Determination

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control Question -- Dupont and Dupont Dow Elastomers

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

A Regulation for the Control of Atmospheric Pollution, Amended Version.

ERIC Educational Resources Information Center

Puerto Rico Environmental Quality Board, San Juan.

Nine articles, related to the preservation of the natural quality of the air, and to prevention, elimination and control of atmospheric pollution in the Commonwealth of Puerto Rico, are contained in this document. These articles were written and enacted by the Environmental Quality Board in accordance with Law No. 9, approved June 18, 1970 -…

22 CFR 96.40 - Fee policies and procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices... parent(s), the agency or person itemizes and discloses in writing the following information for each... documents and for any translation of documents related to the adoption, along with information on whether...

22 CFR 96.40 - Fee policies and procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices... parent(s), the agency or person itemizes and discloses in writing the following information for each... documents and for any translation of documents related to the adoption, along with information on whether...

22 CFR 96.40 - Fee policies and procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices... parent(s), the agency or person itemizes and discloses in writing the following information for each... documents and for any translation of documents related to the adoption, along with information on whether...

Analytic Methods Used in Quality Control in a Compounding Pharmacy.

PubMed

Allen, Loyd V

2017-01-01

Analytical testing will no doubt become a more important part of pharmaceutical compounding as the public and regulatory agencies demand increasing documentation of the quality of compounded preparations. Compounding pharmacists must decide what types of testing and what amount of testing to include in their quality-control programs, and whether testing should be done in-house or outsourced. Like pharmaceutical compounding, analytical testing should be performed only by those who are appropriately trained and qualified. This article discusses the analytical methods that are used in quality control in a compounding pharmacy. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Quality assurance: Importance of systems and standard operating procedures

PubMed Central

Manghani, Kishu

2011-01-01

It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company. PMID:21584180

Quality assurance: Importance of systems and standard operating procedures.

PubMed

Manghani, Kishu

2011-01-01

It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company.

Duly noted: Lessons from a two-site intervention to assess and improve the quality of clinical documentation in the electronic health record.

PubMed

Fanucchi, Laura; Yan, Donglin; Conigliaro, Rosemarie L

2016-07-06

Communication errors are identified as a root cause contributing to a majority of sentinel events. The clinical note is a cornerstone of physician communication, yet there are few published interventions on teaching note writing in the electronic health record (EHR). This is a prospective, two-site, quality improvement project to assess and improve the quality of clinical documentation in the EHR using a validated assessment tool. Internal Medicine (IM) residents at the University of Kentucky College of Medicine (UK) and Montefiore Medical Center/Albert Einstein College of Medicine (MMC) received one of two interventions during an inpatient ward month: either a lecture, or a lecture and individual feedback on progress notes. A third group of residents in each program served as control. Notes were evaluated with the Physician Documentation Quality Instrument 9 (PDQI-9). Due to a significant difference in baseline PDQI-9 scores at MMC, the sites were not combined. Of 75 residents at the UK site, 22 were eligible, 20 (91%) enrolled, 76 notes in total were scored. Of 156 residents at MMC, 22 were eligible, 18 (82%) enrolled, 40 notes in total were scored. Note quality did not improve as measured by the PDQI-9. This educational quality improvement project did not improve the quality of clinical documentation as measured by the PDQI-9. This project underscores the difficulty in improving note quality. Further efforts should explore more effective educational tools to improve the quality of clinical documentation in the EHR.

Mosquito Lagoon environmental resources inventory

NASA Technical Reports Server (NTRS)

Provancha, Jane A.; Hall, Carlton R.; Oddy, Donna M.

1992-01-01

This document provides a synopsis of biotic and abiotic data collected in the Mosquito Lagoon area in relation to water quality. A holistic ecological approach was used in this review to allow for summaries of climate, land use, vegetation, geohydrology, water quality, fishes, sea turtles, wading birds, marine mammals, invertebrates, shellfish, and mosquito control. The document includes a bibliographic database list of 157 citations that have references to the Mosquito Lagoon, many of which were utilized in development of the text.

Environmental Justice analysis in Hydraulic Fracturing Analysis, June 13, 2011

EPA Pesticide Factsheets

This planning document describes the quality assurance/quality control activities and technical requirements that will be used during the research study, using an index-based approach to compare a nationally representative set of well sites fractured.

ISO 9000: The Librarian's Role.

ERIC Educational Resources Information Center

Dobson, Chris; Ernst, Carolyn

1999-01-01

Describes the special library's role in implementing ISO 9000 (i.e., a series of international quality-assurance standards developed by the International Organization of Standards). Topics discussed include document and data control, keeping the standards current, documentation of procedures, the ISO 9000 audit, and benefits for the library. (MES)

Quality control system preparation for photogrammetric and laser scanning missions of Spanish national plan of aerial orthophotogpaphy (PNOA). (Polish Title: Opracowanie systemu kontroli jakości realizacji nalotów fotogrametrycznych i skaningowych dla hiszpańskiego narodowego planu ortofotomapy lotniczej (PNOA))

NASA Astrophysics Data System (ADS)

Rzonca, A.

2013-12-01

The paper presents the state of the art of quality control of photogrammetric and laser scanning data captured by airborne sensors. The described subject is very important for photogrammetric and LiDAR project execution, because the data quality a prior decides about the final product quality. On the other hand, precise and effective quality control process allows to execute the missions without wide margin of safety, especially in case of the mountain areas projects. For introduction, the author presents theoretical background of the quality control, basing on his own experience, instructions and technical documentation. He describes several variants of organization solutions. Basically, there are two main approaches: quality control of the captured data and the control of discrepancies of the flight plan and its results of its execution. Both of them are able to use test of control and analysis of the data. The test is an automatic algorithm controlling the data and generating the control report. Analysis is a less complicated process, that is based on documentation, data and metadata manual check. The example of quality control system for large area project was presented. The project is being realized periodically for the territory of all Spain and named National Plan of Aerial Orthophotography (Plan Nacional de Ortofotografía Aérea, PNOA). The system of the internal control guarantees its results soon after the flight and informs the flight team of the company. It allows to correct all the errors shortly after the flight and it might stop transferring the data to another team or company, for further data processing. The described system of data quality control contains geometrical and radiometrical control of photogrammetric data and geometrical control of LiDAR data. According to all specified parameters, it checks all of them and generates the reports. They are very helpful in case of some errors or low quality data. The paper includes the author experience in the field of data quality control, presents the conclusions and suggestions of the organization and technical aspects, with a short definition of the necessary control software.

Guidebook: Quality Assurance/Quality Control Procedures for Submission of Data for the Land Disposal Restrictions (LDR) Program

EPA Pesticide Factsheets

This document explains how to generate data which characterizes the performance of hazardous waste treatment systems in terms of the composition of treated hazardous waste streams plus treatment system operation and design.

Development and Exchange of Instructional Resources in Water Quality Control Programs, IV: Selecting Instructional Media and Instructional Systems.

ERIC Educational Resources Information Center

Durham, W. Harry; And Others

This document is one of a series of reports which reviews instructional materials and equipment for water and wastewater treatment plant personnel. A system is presented to assist in standardizing the production of lesson plans and instructional materials in the water quality control field. A procedure for selecting appropriate instructional media…

Quality Control for Interviews to Obtain Dietary Recalls from Children for Research Studies

PubMed Central

SHAFFER, NICOLE M.; THOMPSON, WILLIAM O.; BAGLIO, MICHELLE L.; GUINN, CAROLINE H.; FRYE, FRANCESCA H. A.

2005-01-01

Quality control is an important aspect of a study because the quality of data collected provides a foundation for the conclusions drawn from the study. For studies that include interviews, establishing quality control for interviews is critical in ascertaining whether interviews are conducted according to protocol. Despite the importance of quality control for interviews, few studies adequately document the quality control procedures used during data collection. This article reviews quality control for interviews and describes methods and results of quality control for interviews from two of our studies regarding the accuracy of children's dietary recalls; the focus is on quality control regarding interviewer performance during the interview, and examples are provided from studies with children. For our two studies, every interview was audio recorded and transcribed. The audio recording and typed transcript from one interview conducted by each research dietitian either weekly or daily were randomly selected and reviewed by another research dietitian, who completed a standardized quality control for interviews checklist. Major strengths of the methods of quality control for interviews in our two studies include: (a) interviews obtained for data collection were randomly selected for quality control for interviews, and (b) quality control for interviews was assessed on a regular basis throughout data collection. The methods of quality control for interviews described may help researchers design appropriate methods of quality control for interviews for future studies. PMID:15389417

Manufacture and quality control of interconnecting wire harnesses, Volume 3

NASA Technical Reports Server (NTRS)

1972-01-01

The document covers interconnecting wire harnesses defined in the design standard, including type 6, enclosed in TFE heat shrink tubing; and type 7, flexible armored. Knowledge gained through experience on the Saturn 5 program coupled with recent advances in techniques, materials, and processes was incorporated into this document.

The Savannah River Site's Groundwater Monitoring Program

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted during the first quarter of 1992. It includes the analytical data, field data, data review, quality control, and other documentation for this program; provides a record of the program's activities; and serves as an official document of the analytical results.

Texas Air Control Board Inquiry Regarding Allowable Emissions in PSD NAAQS Analyses

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control Determination for Ocean County Landfill and Manchester Renewable Power Corp./LES

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Ozone Control Strategy - Regional Office Review of Potential in Improvements In New Source Review (NSR) Regulations

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Criteria for Determining whether Equipment is Air Pollution Control Equipment or Process Equipment

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

PSD Analysis for SIP Relaxation in Metropolitan Boston Air Pollution Control District - Eastman Gelatin

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Project Quality Assurance Plan for research and development services provided by Oak Ridge National Laboratory in support of the Westinghouse Materials Company of Ohio Operable Unit 1 Stabilization Development and Treatability Studies Program

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

Gilliam, T.M.

1991-05-01

This Project Quality Assurance Plan (PQAP) sets forth the quality assurance (QA) requirements that are applied to those elements of the Westinghouse Materials Company of Ohio (WMCO) Operable Unit 1 support at Oak Ridge National Laboratory (ORNL) project that involve research and development (R D) performed at ORNL. This is in compliance with the applicable criteria of 10 CFR Part 50, Appendix B, ANSI/ASME NQA-1, as specified by Department of Energy (DOE) Oak Ridge Operations (ORO) Order 5700.6B. For this application, NQA-1 is the core QA Program requirements document. QA policy, normally found in the requirements document, is contained herein.more » The requirements of this PQAP apply to project activities that affect the quality and reliability/credibility of research, development, and investigative data and documentation. These activities include the functions of attaining quality objectives and assuring that an appropriate QA program scope is established. The scope of activities affecting quality includes organization; personnel training and qualifications; design control; procurement; material handling and storage; operating procedures; testing, surveillance, and auditing; R D investigative activities and documentation; deficiencies; corrective actions; and QA record keeping. 12 figs.« less

Pollution Control Projects and New Source Review (NSR) Applicability

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control, September 18, 1995 Letter to Peter Hamlin

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control Determination for Ocean County Landfill and Manchester Renewable Power Corp./LES

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Common Control for Maplewood Landfill and Industrial Power Generating Corporation

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Interpreting and Reporting Radiological Water-Quality Data

USGS Publications Warehouse

McCurdy, David E.; Garbarino, John R.; Mullin, Ann H.

2008-01-01

This document provides information to U.S. Geological Survey (USGS) Water Science Centers on interpreting and reporting radiological results for samples of environmental matrices, most notably water. The information provided is intended to be broadly useful throughout the United States, but it is recommended that scientists who work at sites containing radioactive hazardous wastes need to consult additional sources for more detailed information. The document is largely based on recognized national standards and guidance documents for radioanalytical sample processing, most notably the Multi-Agency Radiological Laboratory Analytical Protocols Manual (MARLAP), and on documents published by the U.S. Environmental Protection Agency and the American National Standards Institute. It does not include discussion of standard USGS practices including field quality-control sample analysis, interpretive report policies, and related issues, all of which shall always be included in any effort by the Water Science Centers. The use of 'shall' in this report signifies a policy requirement of the USGS Office of Water Quality.

PACS quality control and automatic problem notifier

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice C.; Jones, Douglas; Frost, Meryll M.; Staab, Edward V.

1997-05-01

One side effect of installing a clinical PACS Is that users become dependent upon the technology and in some cases it can be very difficult to revert back to a film based system if components fail. The nature of system failures range from slow deterioration of function as seen in the loss of monitor luminance through sudden catastrophic loss of the entire PACS networks. This paper describes the quality control procedures in place at the University of Florida and the automatic notification system that alerts PACS personnel when a failure has happened or is anticipated. The goal is to recover from a failure with a minimum of downtime and no data loss. Routine quality control is practiced on all aspects of PACS, from acquisition, through network routing, through display, and including archiving. Whenever possible, the system components perform self and between platform checks for active processes, file system status, errors in log files, and system uptime. When an error is detected or a exception occurs, an automatic page is sent to a pager with a diagnostic code. Documentation on each code, trouble shooting procedures, and repairs are kept on an intranet server accessible only to people involved in maintaining the PACS. In addition to the automatic paging system for error conditions, acquisition is assured by an automatic fax report sent on a daily basis to all technologists acquiring PACS images to be used as a cross check that all studies are archived prior to being removed from the acquisition systems. Daily quality control is preformed to assure that studies can be moved from each acquisition and contrast adjustment. The results of selected quality control reports will be presented. The intranet documentation server will be described with the automatic pager system. Monitor quality control reports will be described and the cost of quality control will be quantified. As PACS is accepted as a clinical tool, the same standards of quality control must be established as are expected on other equipment used in the diagnostic process.

Quality Control in Clinical Laboratory Samples

DTIC Science & Technology

2015-01-01

is able to find and correct flaws in the analytical processes of a lab before potentially incorrect patient resu lts are released. According to...verifi es that the results produced are accurate and precise . Clinical labs use management of documentation as well as inco rporation of a continuous...improvement process to streamline the overall quality control process . QC samples are expected to be identical and tested identically to patient

40 CFR 131.38 - Establishment of numeric criteria for priority toxic pollutants for the State of California.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Great Lakes Water Quality Initiative Criteria Documents for the Protection of Aquatic Life in Ambient... water quality criteria to protect against acute effects in aquatic life and is the highest instream... any aquatic life or human health use classifications in the Water Quality Control Plans for the...

National Water Quality Inventory, 1975 Report to Congress.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Water Programs.

This document summarizes state submissions and provides a national overview of water quality as requested in Section 305(b) of the 1972 Federal Water Pollution Control Act Amendments (P.L. 92-500). This report provides the first opportunity for states to summarize their water quality and to report to EPA and Congress. Chapters of this report deal…

Local Quality Work in an Age of Accountability--Between Autonomy and Control

ERIC Educational Resources Information Center

Bergh, Andreas

2015-01-01

This article analyses a specific part of the actions taken to improve the quality of Swedish education, namely the expectations formulated in national policy documents for the quality work that local authorities, schools and teachers are supposed to undertake. For the empirical analysis of how these expectations have changed over the last two…

[Document management systems to support quality management systems at university hospitals - an interview-based study].

PubMed

Holderried, Martin; Bökel, Ann-Catrin; Ochsmann, Elke

2018-05-01

In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring. In total, 25 university hospitals agreed to participate in this study, 19 of which have been working with a digital DMS for about six years on average. There was a great variety among the IT systems used. Document management and usability of the DMS as well as its integration into existing IT structures were key decision-making criteria for the selection of a digital DMS. In general, the long-term usability of the DMS is supported by regular evaluation of one's own requirements for the system, administration and training programs. In addition, DMS have a positive effect on patient safety and the quality of medical care. Copyright © 2018. Published by Elsevier GmbH.

A Method of Retrospective Computerized System Validation for Drug Manufacturing Software Considering Modifications

NASA Astrophysics Data System (ADS)

Takahashi, Masakazu; Fukue, Yoshinori

This paper proposes a Retrospective Computerized System Validation (RCSV) method for Drug Manufacturing Software (DMSW) that relates to drug production considering software modification. Because DMSW that is used for quality management and facility control affects big impact to quality of drugs, regulatory agency required proofs of adequacy for DMSW's functions and performance based on developed documents and test results. Especially, the work that explains adequacy for previously developed DMSW based on existing documents and operational records is called RCSV. When modifying RCSV conducted DMSW, it was difficult to secure consistency between developed documents and test results for modified DMSW parts and existing documents and operational records for non-modified DMSW parts. This made conducting RCSV difficult. In this paper, we proposed (a) definition of documents architecture, (b) definition of descriptive items and levels in the documents, (c) management of design information using database, (d) exhaustive testing, and (e) integrated RCSV procedure. As a result, we could conduct adequate RCSV securing consistency.

ICAM (Conceptual Design for Computer-Integrated Manufacturing. Volume 2. Part 6. Task B - Establishment of the Factory of the Future Conceptual Framework Conceptual Framework Document, (MMR)

DTIC Science & Technology

1984-06-29

effort that requires hard copy documentation. As a result, there are generally numerous delays in providing current quality information. In the FoF...process have had fixed controls or were based on " hard -coded" information. A template, for example, is hard -coded information defining the shape of a...represents soft-coded control information. (Although manual handling of punch tapes still possess some of the limitations of " hard -coded" controls

Electron/proton spectrometer certification documentation analyses

NASA Technical Reports Server (NTRS)

Gleeson, P.

1972-01-01

A compilation of analyses generated during the development of the electron-proton spectrometer for the Skylab program is presented. The data documents the analyses required by the electron-proton spectrometer verification plan. The verification plan was generated to satisfy the ancillary hardware requirements of the Apollo Applications program. The certification of the spectrometer requires that various tests, inspections, and analyses be documented, approved, and accepted by reliability and quality control personnel of the spectrometer development program.

How to improve vital sign data quality for use in clinical decision support systems? A qualitative study in nine Swedish emergency departments.

PubMed

Skyttberg, Niclas; Vicente, Joana; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2016-06-04

Vital sign data are important for clinical decision making in emergency care. Clinical Decision Support Systems (CDSS) have been advocated to increase patient safety and quality of care. However, the efficiency of CDSS depends on the quality of the underlying vital sign data. Therefore, possible factors affecting vital sign data quality need to be understood. This study aims to explore the factors affecting vital sign data quality in Swedish emergency departments and to determine in how far clinicians perceive vital sign data to be fit for use in clinical decision support systems. A further aim of the study is to provide recommendations on how to improve vital sign data quality in emergency departments. Semi-structured interviews were conducted with sixteen physicians and nurses from nine hospitals and vital sign documentation templates were collected and analysed. Follow-up interviews and process observations were done at three of the hospitals to verify the results. Content analysis with constant comparison of the data was used to analyse and categorize the collected data. Factors related to care process and information technology were perceived to affect vital sign data quality. Despite electronic health records (EHRs) being available in all hospitals, these were not always used for vital sign documentation. Only four out of nine sites had a completely digitalized vital sign documentation flow and paper-based triage records were perceived to provide a better mobile workflow support than EHRs. Observed documentation practices resulted in low currency, completeness, and interoperability of the vital signs. To improve vital sign data quality, we propose to standardize the care process, improve the digital documentation support, provide workflow support, ensure interoperability and perform quality control. Vital sign data quality in Swedish emergency departments is currently not fit for use by CDSS. To address both technical and organisational challenges, we propose five steps for vital sign data quality improvement to be implemented in emergency care settings.

Request for Confirmation of the Definition of a 100-Ton Source as Applied to Controls in the Gasoline Storage and Marketing Chain

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Applicability of Section 169 of the CAA (PSD) in Respect to the Control of Hydrogen Sulfide Emissions from New Geothermal Power Plants in California

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Flares at the Steamboat Butte Operations Facility and E-5 Tank Battery are Used to Control Pollution and are Not Inherent to the Process

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Order Responding to 2002 Petitions Requesting the Administartor Object to North River Water Pollution Control Plant's Title V Permit

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Applicability of Maximum Achievable Control Technology Standard Monitoring to Satisfy Title V Periodic or Compliance Assurance Monitoring

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Question on Timing When Control Equipment Must Be In Operation In Order To Limit PTE For Title V Purposes

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

SU-F-T-234: Quality Improvements in the Electronic Medical Record of Patients Treated with High Dose-Rate Brachytherapy

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

Diener, T; Wilkinson, D

Purpose: To improve workflow efficiency and patient safety by assessing the quality control documentation for HDR brachytherapy within our Electronic Medical Record System (Mosaiq). Methods: A list of parameters based on NRC regulations, our quality management program (QMP), recommendations of the ACR and the American Brachytherapy Society, and HDR treatment planning risks identified in our previous FMEA study was made. Next, the parameter entries were classified according to the type of data input—manual, electronic, or both. Manual entry included the electronic Brachytherapy Treatment Record (BTR) and pre-treatment Mosaiq Assessments list. Oncentra Treatment Reports (OTR) from the Oncentra Treatment Control Systemmore » constituted the electronic data. The OTR includes a Pre-treatment Report for each fraction, and a Treatment Summary Report at the completion of treatment. Each entry was then examined for appropriateness and completeness of data; adjustments and additions as necessary were then made. Results: Ten out of twenty-one recorded treatment parameters were identified to be documented within both the BTR and OTR. Of these ten redundancies, eight were changed from recorded values to a simple checklist in the BTR to avoid recording errors. The other redundancies were kept in both documents due to their value to ensuring patient safety. An edit was made to the current BTR quality assessment; this change revises the definition of a medical event in accordance with ODH Regulation 3701:1-58-101. One addition was made to the current QMP documents regarding HDR. This addition requires a physician to be present through the duration of HDR treatment in accordance with ODH Regulation 3701:1-58-59; Paragraph (F); Section (2); Subsection (a). Conclusion: Careful examination of HDR documentation that originates from different sources can help to improve the accuracy and reliability of the documents. In addition, there may be a small improvement in efficiency due to elimination of unnecessary redundancies.« less

Use of Electronic Documentation for Quality Improvement in Hospice

PubMed Central

Cagle, John G.; Rokoske, Franziska S.; Durham, Danielle; Schenck, Anna P.; Spence, Carol; Hanson, Laura C.

2015-01-01

Little evidence exists on the use of electronic documentation in hospice and its relationship to quality improvement practices. The purposes of this study were to: (1) estimate the prevalence of electronic documentation use in hospice; (2) identify organizational characteristics associated with use of electronic documentation; and (3) determine whether quality measurement practices differed based on documentation format (electronic vs. nonelectronic). Surveys concerning the use of electronic documentation for quality improvement practices and the monitoring of quality-related care and outcomes were collected from 653 hospices. Users of electronic documentation were able to monitor a wider range of quality-related data than users of nonelectronic documentation. Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of electronic documentation. Use of electronic documentation may help hospices to monitor quality and compliance. PMID:22267819

10 CFR Appendix B to Part 50 - Quality Assurance Criteria for Nuclear Power Plants and Fuel Reprocessing Plants

Code of Federal Regulations, 2012 CFR

2012-01-01

... executing. III. Design Control Measures shall be established to assure that applicable regulatory... control of design interfaces and for coordination among participating design organizations. These measures..., approval, release, distribution, and revision of documents involving design interfaces. The design control...

10 CFR Appendix B to Part 50 - Quality Assurance Criteria for Nuclear Power Plants and Fuel Reprocessing Plants

Code of Federal Regulations, 2013 CFR

2013-01-01

... executing. III. Design Control Measures shall be established to assure that applicable regulatory... control of design interfaces and for coordination among participating design organizations. These measures..., approval, release, distribution, and revision of documents involving design interfaces. The design control...

Quality Assurance and Quality Control, Part 2.

PubMed

Akers, Michael J

2015-01-01

The tragedy surrounding the New England Compounding Center and contaminated steroid syringe preparations clearly points out what can happen if quality-assurance and quality-control procedures are not strictly practiced in the compounding of sterile preparations. This article is part 2 of a two-part article on requirements to comply with United States Pharmacopeia general chapters <797> and <1163> with respect to quality assurance of compounded sterile preparations. Part 1 covered documentation requirements, inspection procedures, compounding accuracy checks, and part of a discussion on bacterial endotoxin testing. Part 2 covers sterility testing, the completion from part 1 on bacterial endotoxin testing, a brief dicussion of United States Pharmacopeia <1163>, and advances in pharmaceutical quality systems.

Document Preparation (for Filming). ERIC Processing Manual, Appendix B.

ERIC Educational Resources Information Center

Brandhorst, Ted, Ed.; And Others

The technical report or "fugitive" literature collected by ERIC is produced using a wide variety of printing techniques, many formats, and variable degrees of quality control. Since the documents processed by ERIC go on to be microfilmed and reproduced in microfiche and paper copy for sale to users, it is essential that the ERIC document…

Development and Exchange of Instructional Resources in Water Quality Control Programs, II: Instructional Materials Available.

ERIC Educational Resources Information Center

Austin, John H.

This document is one in a series of reports which reviews instructional materials and equipment for water and wastewater treatment plant personnel. Approximately 900 items are listed in this document along with guidelines for the production of instructional materials. Information is provided regarding the source, type of material, intended…

The Savannah River Site's groundwater monitoring program

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted by EPD/EMS in the first quarter of 1991. In includes the analytical data, field data, data review, quality control, and other documentation for this program, provides a record of the program's activities and rationale, and serves as an official document of the analytical results.

The Savannah River Site`s Groundwater Monitoring Program. First quarter 1992

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted during the first quarter of 1992. It includes the analytical data, field data, data review, quality control, and other documentation for this program; provides a record of the program`s activities; and serves as an official document of the analytical results.

Double shell tanks (DST) chemistry control data quality objectives

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

BANNING, D.L.

2001-10-09

One of the main functions of the River Protection Project is to store the Hanford Site tank waste until the Waste Treatment Plant (WTP) is ready to receive and process the waste. Waste from the older single-shell tanks is being transferred to the newer double-shell tanks (DSTs). Therefore, the integrity of the DSTs must be maintained until the waste from all tanks has been retrieved and transferred to the WTP. To help maintain the integrity of the DSTs over the life of the project, specific chemistry limits have been established to control corrosion of the DSTs. These waste chemistry limitsmore » are presented in the Technical Safety Requirements (TSR) document HNF-SD-WM-TSR-006, Sec. 5 . IS, Rev 2B (CHG 200 I). In order to control the chemistry in the DSTs, the Chemistry Control Program will require analyses of the tank waste. This document describes the Data Quality Objective (DUO) process undertaken to ensure appropriate data will be collected to control the waste chemistry in the DSTs. The DQO process was implemented in accordance with Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. Ib, Vol. IV, Section 4.16, (Banning 2001) and the U.S. Environmental Protection Agency EPA QA/G4, Guidance for the Data Quality Objectives Process (EPA 1994), with some modifications to accommodate project or tank specific requirements and constraints.« less

Research Notes - Openness and Evolvability - Documentation Quality Assessment

DTIC Science & Technology

2016-08-01

UNCLASSIFIED UNCLASSIFIED Notes – Openness and Evolvability – Documentation Quality Assessment Michael Haddy* and Adam Sbrana...Methods and Processes. This set of Research Notes focusses on Documentation Quality Assessment. This work was undertaken from the late 1990s to 2007...1 2. DOCUMENTATION QUALITY ASSESSMENT ......................................................... 1 2.1 Documentation Quality Assessment

30 CFR 7.7 - Quality assurance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... or other nationally recognized standards and use instruments accurate to at least one significant figure beyond the desired accuracy. (c) Control production documentation so that the product is...

30 CFR 7.7 - Quality assurance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... or other nationally recognized standards and use instruments accurate to at least one significant figure beyond the desired accuracy. (c) Control production documentation so that the product is...

30 CFR 7.7 - Quality assurance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... or other nationally recognized standards and use instruments accurate to at least one significant figure beyond the desired accuracy. (c) Control production documentation so that the product is...

30 CFR 7.7 - Quality assurance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... or other nationally recognized standards and use instruments accurate to at least one significant figure beyond the desired accuracy. (c) Control production documentation so that the product is...

Management of infection control in dental practice.

PubMed

Smith, A; Creanor, S; Hurrell, D; Bagg, J; McCowan, M

2009-04-01

This was an observational study in which the management policies and procedures associated with infection control and instrument decontamination were examined in 179 dental surgeries by a team of trained surveyors. Information relating to the management of a wide range of infection control procedures, in particular the decontamination of dental instruments, was collected by interview and by examination of practice documentation. This study found that although the majority of surgeries (70%) claimed to have a management policy on infection control, only 50% of these were documented. For infection control policies, 79% of surgeries had access to the British Dental Association Advice Sheet A12. Infection control policies were claimed to be present in 89% of surgeries, of which 62% were documented. Seventy-seven per cent of staff claimed to have received specific infection control training, but for instrument decontamination this was provided mainly by demonstration (97%) or observed practice (88%). Many dental nurses (74%) and dental practitioners (57%) did not recognise the symbol used to designate a single-use device. Audit of infection control or decontamination activities was undertaken in 11% of surgeries. The majority of surgeries have policies and procedures for the management of infection control in dental practice, but in many instances these are not documented. The training of staff in infection control and its documentation is poorly managed and consideration should be given to development of quality management systems for use in dental practice.

Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation

PubMed Central

Hammond, Kenric W.; Efthimiadis, Efthimis N.; Weir, Charlene R.; Embi, Peter J.; Thielke, Stephen M.; Laundry, Ryan M.; Hedeen, Ashley

2010-01-01

Background: Concerns exist about the quality of electronic health care documentation. Prior studies have focused on physicians. This investigation studied document quality perceptions of practitioners (including physicians), nurses and administrative staff. Methods: An instrument developed from staff interviews and literature sources was administered to 110 practitioners, nurses and administrative staff. Short, long and original versions of records were rated. Results: Length transformation did not affect quality ratings. On several scales practitioners rated notes less favorably than administrators or nurses. The original source document was associated with the quality rating, as was tf·idf, a relevance statistic computed from document text. Tf·idf was strongly associated with practitioner quality ratings. Conclusion: Document quality estimates were not sensitive to modifying redundancy in documents. Some perceptions of quality differ by role. Intrinsic document properties are associated with staff judgments of document quality. For practitioners, the tf·idf statistic was strongly associated with the quality dimensions evaluated. PMID:21346983

Quantitative and qualitative analysis of study-related patient information sheets in randomised neuro-oncology phase III-trials.

PubMed

Reinert, Christiane; Kremmler, Lukas; Burock, Susen; Bogdahn, Ulrich; Wick, Wolfgang; Gleiter, Christoph H; Koller, Michael; Hau, Peter

2014-01-01

In randomised controlled trials (RCTs), patient informed consent documents are an essential cornerstone of the study flow. However, these documents are often oversized in format and content. Clinical experience suggests that study information sheets are often not used as an aid to decision-making due to their complexity. We analysed nine patient informed consent documents from clinical neuro-oncological phase III-studies running at a German Brain Tumour Centre with the objective to investigate the quality of these documents. Text length, formal layout, readability, application of ethical and legal requirements, scientific evidence and social aspects were used as rating categories. Results were assessed quantitatively by two independents investigators and were depicted using net diagrams. All patient informed consent documents were of insufficient quality in all categories except that ethical and legal requirements were fulfilled. Notably, graduate levels were required to read and understand five of nine consent documents. Quality deficits were consistent between the individual study information texts. Irrespective of formal aspects, a document that is intended to inform and motivate patients to participate in a study needs to be well-structured and understandable. We therefore strongly mandate to re-design patient informed consent documents in a patient-friendly way. Specifically, standardised components with a scientific foundation should be provided that could be retrieved at various times, adapted to the mode of treatment and the patient's knowledge, and could weigh information dependent of the stage of treatment decision. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Quality control of laser imagers].

PubMed

Winkelbauer, F; Ammann, M; Gerstner, N; Imhof, H

1992-11-01

Multiformat imagers based on laser systems are used for documentation in an increasing number of investigations. The specific problems of quality control are explained and the persistence of film processing in these imager systems of different configuration with (Machine 1: 3M-Laser-Imager-Plus M952 with connected 3M Film-Processor, 3M-Film IRB, X-Rax Chemical Mixer 3M-XPM, 3M-Developer and Fixer) or without (Machine 2: 3M-Laser-Imager-Plus M952 with separate DuPont-Cronex Film-processor, Kodak IR-Film, Kodak Automixer, Kodak-Developer and Fixer) connected film processing unit are investigated. In our checking based on DIN 6868 and ONORM S 5240 we found persistence of film processing in the equipment with directly adapted film processing unit according to DIN and ONORM. The checking of film persistence as demanded by DIN 6868 in these equipment could therefore be performed in longer periods. Systems with conventional darkroom processing comparatively show plain increased fluctuation, and hence the demanded daily control is essential to guarantee appropriate reaction and constant quality of documentation.

Results-driven approach to improving quality and productivity

Treesearch

John Dramm

2000-01-01

Quality control (QC) programs do not often realize their full potential. Elaborate and expensive QC programs can easily get side tracked by the process of building a program with promises of “Someday, this will all pay off.” Training employees in QC methods is no guarantee that quality will improve. Several documented cases show that such activity-centered efforts...

Guidance and Control Software Project Data - Volume 2: Development Documents

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the development documents from the GCS project. Volume 2 contains three appendices: A. Guidance and Control Software Development Specification; B. Design Description for the Pluto Implementation of the Guidance and Control Software; and C. Source Code for the Pluto Implementation of the Guidance and Control Software

Opinion in Frank J. Kelley, Michigan Natural Resources Commission, Michigan Air Pollution Control Commissions, and David F. Hales V. Albar Industries, C.A. No. 88-CV-10302-FL, E.D. Michigan, February 7, 1989

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2011-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use: procedure for adoption of International Chemical Reference Substances; WHO good practices for pharmaceutical microbiology laboratories; good manufacturing practices: main principles for pharmaceutical products; good manufacturing practices for blood establishments (jointly with the Expert Committee on Biological Standardization); guidelines on good manufacturing practices for heating, ventilation and air-conditioning systems for non-sterile pharmaceutical dosage forms; good manufacturing practices for sterile pharmaceutical products; guidelines on transfer of technology in pharmaceutical manufacturing; good pharmacy practice: standards for quality of pharmacy services (joint FIP/WHO); model guidance for the storage and transport of time- and temperature-sensitive pharmaceutical products (jointly with the Expert Committee on Biological Standardization); procedure for prequalification of pharmaceutical products; guide on submission of documentation for prequalification of innovator finished pharmaceutical products approved by stringent regulatory authorities; prequalification of quality control laboratories: procedure for assessing the acceptability, in principle, of quality control laboratories for use by United Nations agencies; guidelines for preparing a laboratory information file; guidelines for drafting a site master file; guidelines on submission of documentation for a multisource (generic) finished product: general format: preparation of product dossiers in common technical document format.

The Savannah River Site`s groundwater monitoring program. First quarter 1991

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted by EPD/EMS in the first quarter of 1991. In includes the analytical data, field data, data review, quality control, and other documentation for this program, provides a record of the program`s activities and rationale, and serves as an official document of the analytical results.

Manufacturing and quality control of interconnecting wire harnesses, Volume 4

NASA Technical Reports Server (NTRS)

1972-01-01

The document covers interconnecting wire harnesses defined in the design standard, including type 8, flat conductor cable. Volume breadth covers installations of groups of harnesses in a major assembly and the associated post installation inspections and electrical tests. Knowledge gained through experience on the Saturn 5 program coupled with recent advances in techniques, materials, and processes was incorporated into this document.

A Descriptive Analysis of End-of-Life Conversations With Long-Term Glioblastoma Survivors.

PubMed

Miranda, Stephen P; Bernacki, Rachelle E; Paladino, Joanna M; Norden, Andrew D; Kavanagh, Jane E; Palmor, Marissa C; Block, Susan D

2018-05-01

Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. To describe the prevalence, timing, and quality of documented SI conversations and evaluate their focus on patient goals/priorities. Thirty-three patients with GBM enrolled in the control group of a randomized controlled trial of a communication intervention and were followed for 2 years or until death. At baseline, all patients answered a validated question about preferences for life-extending versus comfort-focused care and completed a Life Priorities Survey about their goals/priorities. In this secondary analysis, retrospective chart review was performed for 18 patients with GBM who died. Documented SI conversations were systematically identified and evaluated using a codebook reflecting 4 domains: prognosis, goals/priorities, end-of-life planning, and life-sustaining treatments. Patient goals/priorities were compared to documentation. At baseline, 16 of 24 patients preferred life-extending care. In the Life Priorities Survey, goals/priorities most frequently ranked among the top 3 were "Live as long as possible," "Be mentally aware," "Provide support for family," "Be independent," and "Be at peace." Fifteen of 18 patients had at least 1 documented SI conversation (range: 1-4). Median timing of the first documented SI conversation was 84 days before death (range: 29-231; interquartile range: 46-119). Fifteen patients had documentation about end-of-life planning, with "hospice" and "palliative care" most frequently documented. Five of 18 patients had documentation about their goals. Patients with GBM had multiple goals/priorities with potential treatment implications, but documentation showed SI conversations occurred relatively late and infrequently reflected patient goals/priorities.

Draft Guidelines for State and Areawide Water Quality Management Program Development.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC.

This document discusses the draft guidelines formulated by the Environmental Protection Agency (EPA) to assist the states in establishing a management program to integrate water quality and other resource management decisions. These guidelines are pfovided so that the long range goals of the Federal Water Pollution Control Act Amendments of 1972…

Guidance and Control Software Project Data - Volume 3: Verification Documents

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the verification documents from the GCS project. Volume 3 contains four appendices: A. Software Verification Cases and Procedures for the Guidance and Control Software Project; B. Software Verification Results for the Pluto Implementation of the Guidance and Control Software; C. Review Records for the Pluto Implementation of the Guidance and Control Software; and D. Test Results Logs for the Pluto Implementation of the Guidance and Control Software.

Save medical personnel's time by improved user interfaces.

PubMed

Kindler, H

1997-01-01

Common objectives in the industrial countries are the improvement of quality of care, clinical effectiveness, and cost control. Cost control, in particular, has been addressed through the introduction of case mix systems for reimbursement by social-security institutions. More data is required to enable quality improvement, increases in clinical effectiveness and for juridical reasons. At first glance, this documentation effort is contradictory to cost reduction. However, integrated services for resource management based on better documentation should help to reduce costs. The clerical effort for documentation should be decreased by providing a co-operative working environment for healthcare professionals applying sophisticated human-computer interface technology. Additional services, e.g., automatic report generation, increase the efficiency of healthcare personnel. Modelling the medical work flow forms an essential prerequisite for integrated resource management services and for co-operative user interfaces. A user interface aware of the work flow provides intelligent assistance by offering the appropriate tools at the right moment. Nowadays there is a trend to client/server systems with relational databases or object-oriented databases as repository. The work flows used for controlling purposes and to steer the user interfaces must be represented in the repository.

Review of nuclear pharmacy practice in hospitals

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

Kawada, T.K.; Tubis, M.; Ebenkamp, T.

1982-02-01

An operational profile for nuclear pharmacy practice is presented, and the technical and professional role of nuclear pharmacists is reviewed. Key aspects of nuclear pharmacy practice in hospitals discussed are the basic facilities and equipment for the preparation, quality control, and distribution of radioactive drug products. Standards for receiving, storing, and processing radioactive material are described. The elements of a radiopharmaceutical quality assurance program, including the working procedures, documentation systems, data analysis, and specific control tests, are presented. Details of dose preparation and administration and systems of inventory control for radioactive products are outlined.

How changing quality management influenced PGME accreditation: a focus on decentralization and quality improvement.

PubMed

Akdemir, Nesibe; Lombarts, Kiki M J M H; Paternotte, Emma; Schreuder, Bas; Scheele, Fedde

2017-06-02

Evaluating the quality of postgraduate medical education (PGME) programs through accreditation is common practice worldwide. Accreditation is shaped by educational quality and quality management. An appropriate accreditation design is important, as it may drive improvements in training. Moreover, accreditors determine whether a PGME program passes the assessment, which may have major consequences, such as starting, continuing or discontinuing PGME. However, there is limited evidence for the benefits of different choices in accreditation design. Therefore, this study aims to explain how changing views on educational quality and quality management have impacted the design of the PGME accreditation system in the Netherlands. To determine the historical development of the Dutch PGME accreditation system, we conducted a document analysis of accreditation documents spanning the past 50 years and a vision document outlining the future system. A template analysis technique was used to identify the main elements of the system. Four themes in the Dutch PGME accreditation system were identified: (1) objectives of accreditation, (2) PGME quality domains, (3) quality management approaches and (4) actors' responsibilities. Major shifts have taken place regarding decentralization, residency performance and physician practice outcomes, and quality improvement. Decentralization of the responsibilities of the accreditor was absent in 1966, but this has been slowly changing since 1999. In the future system, there will be nearly a maximum degree of decentralization. A focus on outcomes and quality improvement has been introduced in the current system. The number of formal documents striving for quality assurance has increased enormously over the past 50 years, which has led to increased bureaucracy. The future system needs to decrease the number of standards to focus on measurable outcomes and to strive for quality improvement. The challenge for accreditors is to find the right balance between trusting and controlling medical professionals. Their choices will be reflected in the accreditation design. The four themes could enhance international comparisons and encourage better choices in the design of accreditation systems.

Rocky Mountain Arsenal, Sanitary Sewer Interim Response Action, Construction Documents for New Sanitary Sewer Construction. Volume 2

DTIC Science & Technology

1990-05-01

curves ; test reports; test cylinders: samples, O&M manuals including parts lists; certifications; warranties and other such required submittals...purpose. 14.4.3. Authority and responsibilities of all quality control personnel. 14.4.4. Schedule of Use of inspection personnel by types and phase of...quality control program shall include four phases of inspection and tests. The Contracting Officer’s representative shall be notified at least 24

Getting Ready for Inspection of Investigational Site at Short Notice

PubMed Central

Talele, Rajendra

2010-01-01

India is becoming an attractive destination for drug development and clinical research. This is evidenced by the three fold increment in clinical trial applications in last four years to the office of Drugs Controller General of India (DCGI). This upward trend is collaborative efforts of all stake holders and the quality of Indian data. Therefore to sustain this trend, it is important that stake holders such as Regulators, Sponsor, CRO, Monitor, Investigators and trial subjects required maintaining high standards of data and conduct of clinical trials. Indian regulations and the role of DCGI in quality check for Indian clinical trials is always a topic of discussion in various forums. A recent move by DCGI for conducting random inspections of investigational sites and companies at short notice, checking their compliance in accordance with the guidelines, and taking action against non-complier is welcomed. This will certainly increase over quality of the clinical trials. Quality of clinical trial conduct is measured on essential documents for their appropriateness and its correctness. It is observed that the stakeholders engaged in multitasking often overlook the requirements or appropriateness of the document due to their focused approach on a specific activity which is on priority. This can lead to serious quality problem and issues. Understanding of the process and documents reviewed by auditor is important to maintain such high quality. The proper planning and time management working on essential documents can minimize the quality issues, and we can be always ready for any type of inspection, announced or unannounced, or “short notice”. PMID:21829785

CHEMICAL LEUCODERMA: INDIAN SCENARIO, PROGNOSIS, AND TREATMENT

PubMed Central

Bajaj, A K; Saraswat, Abir; Srivastav, P K

2010-01-01

Chemical leucoderma is an industrial disorder in developed countries and the common causative chemicals are phenols and catechols. Due to stringent controls and preventive measures the incidence has come down. In the recent past various chemicals in consumer products have also been documented to produce depigmentation. In India due to lax quality control measures chemical leucoderma due to consumer items is not uncommon.The various consumer items documented to cause contact depigmentation are sticker bindis, rain shoes, plastic chappals, hair dye/ black henna(kali mehndi), alta, wallets and even mobile plastic covers. PMID:21063517

Review and comparison of quality standards, guidelines and regulations for laboratories.

PubMed

Datema, Tjeerd A M; Oskam, Linda; Klatser, Paul R

2012-01-01

The variety and number of laboratory quality standards, guidelines and regulations (hereafter: quality documents) makes it difficult to choose the most suitable one for establishing and maintaining a laboratory quality management system. There is a need to compare the characteristics, suitability and applicability of quality documents in view of the increasing efforts to introduce quality management in laboratories, especially in clinical diagnostic laboratories in low income and middle income countries. This may provide valuable insights for policy makers developing national laboratory policies, and for laboratory managers and quality officers in choosing the most appropriate quality document for upgrading their laboratories. We reviewed the history of quality document development and then selected a subset based on their current use. We analysed these documents following a framework for comparison of quality documents that was adapted from the Clinical Laboratory Standards Institute guideline GP26 Quality management system model for clinical laboratory services . Differences were identified between national and international, and non-clinical and clinical quality documents. The most salient findings were the absence of provisions on occurrence management and customer service in almost all non-clinical quality documents, a low number of safety requirements aimed at protecting laboratory personnel in international quality documents and no requirements regarding ethical behaviour in almost all quality documents. Each laboratory needs to investigate whether national regulatory standards are present. These are preferred as they most closely suit the needs of laboratories in the country. A laboratory should always use both a standard and a guideline: a standard sums up the requirements to a quality management system, a guideline describes how quality management can be integrated in the laboratory processes.

Machine-Readable Data Files in the Social Sciences: An Anthropologist and a Librarian Look at the Issues.

ERIC Educational Resources Information Center

Bernard, H. Russell; Jones, Ray

1984-01-01

Focuses on problems in making machine-readable data files (MRDFs) accessible and in using them: quality of data in MRDFs themselves (social scientists' concern) and accessibility--availability of bibliographic control, quality of documentation, level of user skills (librarians' concern). Skills needed by social scientists and librarians are…

Indicators in Perspective. The Use of Quality Indicators in Vocational Education and Training. CEDEFOP Document.

ERIC Educational Resources Information Center

Van den Berghe, Wouter

Indicators are used in quite different ways in vocational education and training, from control and accountability to performance and quality purposes. A classification model has been proposed in which many indicators can fit. It is based on two important dimensions of indicators: (1) the "message" relating to the information content,…

A framework for developing research protocols for evaluation of microbial hazards and controls during production that pertain to the quality of agricultural water contacting fresh produce that may be consumed raw.

PubMed

Harris, Linda J; Bender, Jeff; Bihn, Elizabeth A; Blessington, Tyann; Danyluk, Michelle D; Delaquis, Pascal; Goodridge, Lawrence; Ibekwe, A Mark; Ilic, Sanja; Kniel, Kali; Lejeune, Jeffrey T; Schaffner, Donald W; Stoeckel, Don; Suslow, Trevor V

2012-12-01

Agricultural water may contact fresh produce during irrigation and/or when crop protection sprays (e.g., cooling to prevent sunburn, frost protection, and agrochemical mixtures) are applied. This document provides a framework for designing research studies that would add to our understanding of preharvest microbial food safety hazards and control measures pertaining to agricultural water. Researchers will be able to use this document to design studies, to anticipate the scope and detail of data required, and to evaluate previously published work. This document should also be useful for evaluating the strength of existing data and thus should aid in identifying future research needs. Use of this document by the research community may lead to greater consistency or comparability than currently exists among research studies, which may ultimately facilitate direct comparison of hazards and efficacy of controls among different commodities, conditions, and practices.

Continuous integration and quality control for scientific software

NASA Astrophysics Data System (ADS)

Neidhardt, A.; Ettl, M.; Brisken, W.; Dassing, R.

2013-08-01

Modern software has to be stable, portable, fast and reliable. This is going to be also more and more important for scientific software. But this requires a sophisticated way to inspect, check and evaluate the quality of source code with a suitable, automated infrastructure. A centralized server with a software repository and a version control system is one essential part, to manage the code basis and to control the different development versions. While each project can be compiled separately, the whole code basis can also be compiled with one central “Makefile”. This is used to create automated, nightly builds. Additionally all sources are inspected automatically with static code analysis and inspection tools, which check well-none error situations, memory and resource leaks, performance issues, or style issues. In combination with an automatic documentation generator it is possible to create the developer documentation directly from the code and the inline comments. All reports and generated information are presented as HTML page on a Web server. Because this environment increased the stability and quality of the software of the Geodetic Observatory Wettzell tremendously, it is now also available for scientific communities. One regular customer is already the developer group of the DiFX software correlator project.

Ozone: Stage Two Vapor Recovery Rule and Guidance

EPA Pesticide Factsheets

This page includes the guidance document, fact sheet, memorandum, and final rule on removing Stage II Gasoline Vapor Control Programs from State Implementation Plans (SIP) for the Ozone National Ambient Air Quality Standards (NAAQS)

Air Pollution Affects Community Health

ERIC Educational Resources Information Center

Shy, Carl M.; Finklea, John F.

1973-01-01

Community Health and Environmental Surveillance System (CHESS), a nationwide program relating community health to environmental quality, is designed to evaluate existing environmental standards, obtain health intelligence for new standards, and document health benefits of air pollution control. (BL)

40 CFR 51.370 - Compliance with recall notices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Administrator. The State shall update its list of unresolved recalls on a quarterly basis at a minimum. (2) The... database, the quality control methods used to insure that recall repairs are properly documented and...

40 CFR 51.370 - Compliance with recall notices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Administrator. The State shall update its list of unresolved recalls on a quarterly basis at a minimum. (2) The... database, the quality control methods used to insure that recall repairs are properly documented and...

40 CFR 51.370 - Compliance with recall notices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Administrator. The State shall update its list of unresolved recalls on a quarterly basis at a minimum. (2) The... database, the quality control methods used to insure that recall repairs are properly documented and...

40 CFR 51.370 - Compliance with recall notices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Administrator. The State shall update its list of unresolved recalls on a quarterly basis at a minimum. (2) The... database, the quality control methods used to insure that recall repairs are properly documented and...

40 CFR 51.370 - Compliance with recall notices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Administrator. The State shall update its list of unresolved recalls on a quarterly basis at a minimum. (2) The... database, the quality control methods used to insure that recall repairs are properly documented and...

Survey of the prevalence and methodology of quality assurance for B-mode ultrasound image quality among veterinary sonographers.

PubMed

Hoscheit, Larry P; Heng, Hock Gan; Lim, Chee Kin; Weng, Hsin-Yi

2018-05-01

Image quality in B-mode ultrasound is important as it reflects the diagnostic accuracy and diagnostic information provided during clinical scanning. Quality assurance programs for B-mode ultrasound systems/components are comprised of initial quality acceptance testing and subsequent regularly scheduled quality control testing. The importance of quality assurance programs for B-mode ultrasound image quality using ultrasound phantoms is well documented in the human medical and medical physics literature. The purpose of this prospective, cross-sectional, survey study was to determine the prevalence and methodology of quality acceptance testing and quality control testing of image quality for ultrasound system/components among veterinary sonographers. An online electronic survey was sent to 1497 members of veterinary imaging organizations: the American College of Veterinary Radiology, the Veterinary Ultrasound Society, and the European Association of Veterinary Diagnostic Imaging, and a total of 167 responses were received. The results showed that the percentages of veterinary sonographers performing quality acceptance testing and quality control testing are 42% (64/151; 95% confidence interval 34-52%) and 26% (40/156: 95% confidence interval 19-33%) respectively. Of the respondents who claimed to have quality acceptance testing or quality control testing of image quality in place for their ultrasound system/components, 0% have performed quality acceptance testing or quality control testing correctly (quality acceptance testing 95% confidence interval: 0-6%, quality control testing 95% confidence interval: 0-11%). Further education and guidelines are recommended for veterinary sonographers in the area of quality acceptance testing and quality control testing for B-mode ultrasound equipment/components. © 2018 American College of Veterinary Radiology.

Summary of results of NASA F-15 flight research program

NASA Technical Reports Server (NTRS)

Burcham, F. W., Jr.; Trippensee, G. A.; Fisher, D. F.; Putnam, T. W.

1986-01-01

NASA conducted a multidisciplinary flight research program on the F-15 airplane. The program began in 1976 when two preproduction airplanes were obtained from the U.S. Air Force. Major projects involved stability and control, handling qualities, propulsion, aerodynamics, propulsion controls, and integrated propulsion-flight controls. Several government agencies and aerospace contractors were involved. In excess of 330 flights were flown, and over 85 papers and reports were published. This document describes the overall program, the projects, and the key results. The F-15 was demonstrated to be an excellent flight research vehicle, producing high-quality results.

SUPERFUND TREATABILITY CLEARINGHOUSE: SOIL STABILIZATION PILOT STUDY, UNITED CHROME NPL SITE PILOT STUDY AND HEALTH AND SAFETY PROGRAM, UNITED CHROME NPL SITE PILOT STUDY

EPA Science Inventory

This document is a project plan for a pilot study at the United Chrome NPL site, Corvallis, Oregon and includes the health and safety and quality assurance/quality control plans. The plan reports results of a bench-scale study of the treatment process as iieasured by the ...

Bridging the Research-to-Practice Gap in Education: A Software-Mediated Approach for Improving Classroom Instruction

ERIC Educational Resources Information Center

Weston, Mark E.; Bain, Alan

2015-01-01

This study reports findings from a matched-comparison, repeated-measure for intact groups design of the mediating effect of a suite of software on the quality of classroom instruction provided to students by teachers. The quality of instruction provided by teachers in the treatment and control groups was documented via observations that were…

Controlling Air Pollution; A Primer on Stationary Source Control Techniques.

ERIC Educational Resources Information Center

Corman, Rena

This companion document to "Air Pollution Primer" is written for the nonexpert in air pollution; however, it does assume a familiarity with air pollution problems. This work is oriented toward providing the reader with knowledge about current and proposed air quality legislation and knowledge about available technology to meet these standards for…

Do Health Reforms to Improve Quality Have Long-Term Effects? Results of a Follow-Up on a Randomized Policy Experiment in the Philippines.

PubMed

Quimbo, Stella; Wagner, Natascha; Florentino, Jhiedon; Solon, Orville; Peabody, John

2016-02-01

We tracked doctors who had previously participated in a randomized policy experiment in the Philippines. The original experiment involved 30 district hospitals divided equally into one control site and two intervention sites that increased insurance payments (full insurance support for children under 5 years old) or made bonus payments to hospital staff. During the 3 years of the intervention, quality-as measured by clinical performance and value vignettes-improved and was sustained in both intervention sites compared with controls. Five years after the interventions were discontinued, we remeasured the quality of care of the doctors. We found that the intervention sites continued to have significantly higher quality compared with the control sites. The previously documented quality improvement in intervention sites appears to be sustained; moreover, it was subject to a very low (less than 1% per year) rate of decay in quality scores. Copyright © 2015 John Wiley & Sons, Ltd.

SWiFT Software Quality Assurance Plan.

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

Berg, Jonathan Charles

This document describes the software development practice areas and processes which contribute to the ability of SWiFT software developers to provide quality software. These processes are designed to satisfy the requirements set forth by the Sandia Software Quality Assurance Program (SSQAP). APPROVALS SWiFT Software Quality Assurance Plan (SAND2016-0765) approved by: Department Manager SWiFT Site Lead Dave Minster (6121) Date Jonathan White (6121) Date SWiFT Controls Engineer Jonathan Berg (6121) Date CHANGE HISTORY Issue Date Originator(s) Description A 2016/01/27 Jon Berg (06121) Initial release of the SWiFT Software Quality Assurance Plan

Documenting an ISO 9000 Quality System.

ERIC Educational Resources Information Center

Fisher, Barry

1995-01-01

Discusses six steps to follow when documenting an ISO 9000 quality system: using ISO 9000 to develop a quality system, identifying a company's business processes, analyzing the business processes; describing the procedures, writing the quality manual, and working to the documented procedures. (SR)

Manufacture and quality control of interconnecting wire hardnesses, Volume 1

NASA Technical Reports Server (NTRS)

1972-01-01

A standard is presented for manufacture, installation, and quality control of eight types of interconnecting wire harnesses. The processes, process controls, and inspection and test requirements reflected are based on acknowledgment of harness design requirements, acknowledgment of harness installation requirements, identification of the various parts, materials, etc., utilized in harness manufacture, and formulation of a typical manufacturing flow diagram for identification of each manufacturing and quality control process, operation, inspection, and test. The document covers interconnecting wire harnesses defined in the design standard, including type 1, enclosed in fluorocarbon elastomer convolute, tubing; type 2, enclosed in TFE convolute tubing lines with fiberglass braid; type 3, enclosed in TFE convolute tubing; and type 5, combination of types 3 and 4. Knowledge gained through experience on the Saturn 5 program coupled with recent advances in techniques, materials, and processes was incorporated.

Unlicensed pharmaceutical preparations for clinical patient care: Ensuring safety.

PubMed

de Wilde, Sofieke; de Jong, Maria G H; Le Brun, Paul P H; Guchelaar, Henk-Jan; Schimmel, Kirsten J M

2018-01-01

Most medicinal products dispensed to patients have marketing authorization (MA) to ensure high quality of the product, safety, and efficacy. However, in daily practice, to treat patients adequately, there is a medical need for drugs that do not hold MA. To meet this medical need, medicinal products are used in clinical care without MA (unlicensed), such as products prepared by (local) pharmacies: the pharmaceutical preparations. Three types of pharmaceutical preparations are distinguished: (i) reconstitution in excess of summary of product characteristics; (ii) adaptation of a licensed medicinal product (outside its official labeling); (iii) medicinal products from an active pharmaceutical ingredient. Although unlicensed, patients may expect the same quality for these unlicensed pharmaceutical preparations as for the licensed medicinal products. To assure this quality, a proper risk-benefit assessment and proper documentation in (centralized) patient registries and linking to a national pharmacovigilance database should be in place. Based on a risk assessment matrix, requirements for quality assurance can be determined, which has impact on the level of documentation of a pharmaceutical preparation. In this paper, the approach for good documentation including quality assurance and benefit-risk assessment will be discussed and possibilities for patient registries are described to make these crucial preparations available for regular patient care. KEY POINTS Ensuring pharmaceutical quality and performing a proper benefit-risk assessment will guarantee safe use of pharmaceutical preparations. Good documentation of (ultra-)orphan treatments can be collected in centralized patient registries and should be combined with existing information in (inter)national databases and self-reflection of patients. Linking patient registries to a centralized database for adverse drug events is highly recommended as it increases safety control of the (ultra) orphan pharmaceutical preparations. Copyright © 2017 John Wiley & Sons, Ltd.

Improving the Quality of Electronic Documentation in Critical Care Nursing

ERIC Educational Resources Information Center

Stevens, Brent

2017-01-01

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…

Quality assurance and quality control in mammography: a review of available guidance worldwide.

PubMed

Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos

2013-10-01

Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources. •An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.

Spectrum analysis on quality requirements consideration in software design documents.

PubMed

Kaiya, Haruhiko; Umemura, Masahiro; Ogata, Shinpei; Kaijiri, Kenji

2013-12-01

Software quality requirements defined in the requirements analysis stage should be implemented in the final products, such as source codes and system deployment. To guarantee this meta-requirement, quality requirements should be considered in the intermediate stages, such as the design stage or the architectural definition stage. We propose a novel method for checking whether quality requirements are considered in the design stage. In this method, a technique called "spectrum analysis for quality requirements" is applied not only to requirements specifications but also to design documents. The technique enables us to derive the spectrum of a document, and quality requirements considerations in the document are numerically represented in the spectrum. We can thus objectively identify whether the considerations of quality requirements in a requirements document are adapted to its design document. To validate the method, we applied it to commercial software systems with the help of a supporting tool, and we confirmed that the method worked well.

Quality in End User Documentation.

ERIC Educational Resources Information Center

Morrison, Ronald

1994-01-01

Discusses quality in end-user documentation for computer applications and explains four approaches to improving quality in end-user documents. Highlights include online help, usability testing, technical writing elements, statistical approaches, and concepts relating to software quality that are also applicable to user manuals. (LRW)

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

PubMed

Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

2013-01-01

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived. Copyright © 2013. Published by Elsevier GmbH.

STOVL Control Integration Program

NASA Technical Reports Server (NTRS)

Weiss, C.; Mcdowell, P.; Watts, S.

1994-01-01

An integrated flight/propulsion control for an advanced vector thrust supersonic STOVL aircraft, was developed by Pratt & Whitney and McDonnell Douglas Aerospace East. The IFPC design was based upon the partitioning of the global requirements into flight control and propulsion control requirements. To validate the design, aircraft and engine models were also developed for use on a NASA Ames piloted simulator. Different flight control implementations, evaluated for their handling qualities, are documented in the report along with the propulsion control, engine model, and aircraft model.

Guidelines for the detection of Trichinella larvae at the slaughterhouse in a quality assurance system.

PubMed

Rossi, Patrizia; Pozio, Edoardo

2008-01-01

The European Community Regulation (EC) No. 2075/2005 lays down specific rules on official controls for the detection of Trichinella in fresh meat for human consumption, recommending the pooled-sample digestion method as the reference method. The aim of this document is to provide specific guidance to implement an appropriate Trichinella digestion method by a laboratory accredited according to the ISO/IEC 17025:2005 international standard, and performing microbiological testing following the EA-04/10:2002 international guideline. Technical requirements for the correct implementation of the method, such as the personnel competence, specific equipments and reagents, validation of the method, reference materials, sampling, quality assurance of results and quality control of performance are provided, pointing out the critical control points for the correct implementation of the digestion method.

Overview of the US EPA/SERDP/ESTCP: Laboratory, Field ...

EPA Pesticide Factsheets

Passive sampling can be used for applications at contaminated sediment sites including performing assessments of contaminant bioavailability (i.e., freely dissolved concentration (Cfree)), conducting remedial investigations and feasibility studies, and assessing the potential for contaminant bioaccumulation. Previous research articles and documents have discussed many aspects of passive sampling however no definitive guidance on the laboratory, field and analytical procedures for using passive sampling at contaminated sediment sites has been provided. The document discussed in this presentation provides passive sampler users with the guidance necessary to apply the technology to evaluate contaminated sediments. Contaminants discussed include polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and the metals, cadmium, copper, nickel, lead and zinc. The document is divided into sections including discussions of different types of samplers used commonly in the United States, the selection and use of performance reference compounds (PRCs), the extraction and instrumental analysis of passive samplers, data analysis and quality assurance/quality control, and a list of passive sampling related references. The document is not intended to serve as a series of standard operating procedures (SOPs) but rather seeks to provide users with the information needed to develop their own SOPs. The document also includes the names of selected passive sam

PRE-QUALITY ASSURANCE PROJECT PLAN (QAPP) AGREEMENT (PQA) (HANDOUT)

EPA Science Inventory

The Land Remediation and Pollution Control Division (LRPCD) QA Manager strives to assist LRPCD researchers in developing functional planning documents for their research projects. As part of the planning process, several pieces of information are needed, including information re...

Illinois Manufacturing Technology Curriculum.

ERIC Educational Resources Information Center

Cliffe, Roger; And Others

This manufacturing technology curriculum involves students in learning problem-solving, communication, team building, quality control, safety, math, science, and technical skills. The document begins with a section on implementation, which gives background information on the purposes and development of the curriculum, explains its rationale,…

FQC Dashboard: integrates FastQC results into a web-based, interactive, and extensible FASTQ quality control tool.

PubMed

Brown, Joseph; Pirrung, Meg; McCue, Lee Ann

2017-06-09

FQC is software that facilitates quality control of FASTQ files by carrying out a QC protocol using FastQC, parsing results, and aggregating quality metrics into an interactive dashboard designed to richly summarize individual sequencing runs. The dashboard groups samples in dropdowns for navigation among the data sets, utilizes human-readable configuration files to manipulate the pages and tabs, and is extensible with CSV data. FQC is implemented in Python 3 and Javascript, and is maintained under an MIT license. Documentation and source code is available at: https://github.com/pnnl/fqc . joseph.brown@pnnl.gov. © The Author(s) 2017. Published by Oxford University Press.

Xyce parallel electronic simulator design.

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

Thornquist, Heidi K.; Rankin, Eric Lamont; Mei, Ting

2010-09-01

This document is the Xyce Circuit Simulator developer guide. Xyce has been designed from the 'ground up' to be a SPICE-compatible, distributed memory parallel circuit simulator. While it is in many respects a research code, Xyce is intended to be a production simulator. As such, having software quality engineering (SQE) procedures in place to insure a high level of code quality and robustness are essential. Version control, issue tracking customer support, C++ style guildlines and the Xyce release process are all described. The Xyce Parallel Electronic Simulator has been under development at Sandia since 1999. Historically, Xyce has mostly beenmore » funded by ASC, the original focus of Xyce development has primarily been related to circuits for nuclear weapons. However, this has not been the only focus and it is expected that the project will diversify. Like many ASC projects, Xyce is a group development effort, which involves a number of researchers, engineers, scientists, mathmaticians and computer scientists. In addition to diversity of background, it is to be expected on long term projects for there to be a certain amount of staff turnover, as people move on to different projects. As a result, it is very important that the project maintain high software quality standards. The point of this document is to formally document a number of the software quality practices followed by the Xyce team in one place. Also, it is hoped that this document will be a good source of information for new developers.« less

Use of the MATRIXx Integrated Toolkit on the Microwave Anisotropy Probe Attitude Control System

NASA Technical Reports Server (NTRS)

Ward, David K.; Andrews, Stephen F.; McComas, David C.; ODonnell, James R., Jr.

1999-01-01

Recent advances in analytical software tools allow the analysis, simulation, flight code, and documentation of an algorithm to be generated from a single source, all within one integrated analytical design package. NASA's Microwave Anisotropy Probe project has used one such package, Integrated Systems' MATRIXx suite, in the design of the spacecraft's Attitude Control System. The project's experience with the linear analysis, simulation, code generation, and documentation tools will be presented and compared with more traditional development tools. In particular, the quality of the flight software generated will be examined in detail. Finally, lessons learned on each of the tools will be shared.

Relevance of Google-customized search engine vs. CISMeF quality-controlled health gateway.

PubMed

Gehanno, Jean-François; Kerdelhue, Gaétan; Sakji, Saoussen; Massari, Philippe; Joubert, Michel; Darmoni, Stéfan J

2009-01-01

CISMeF (acronym for Catalog and Index of French Language Health Resources on the Internet) is a quality-controlled health gateway conceived to catalog and index the most important and quality-controlled sources of institutional health information in French. The goal of this study is to compare the relevance of results provided by this gateway from a small set of documents selected and described by human experts to those provided by a search engine from a large set of automatically indexed and ranked resources. The Google-Customized search engine (CSE) was used. The evaluation was made using the 10th first results of 15 queries and two blinded physician evaluators. There was no significant difference between the relevance of information retrieval in CISMeF and Google CSE. In conclusion, automatic indexing does not lead to lower relevance than a manual MeSH indexing and may help to cope with the increasing number of references to be indexed in a controlled health quality gateway.

[Establishment of Quality Control System of Nucleic Acid Detection for Ebola Virus in Sierra Leone-China Friendship Biological Safety Laboratory].

PubMed

Wang, Qin; Zhang, Yong; Nie, Kai; Wang, Huanyu; Du, Haijun; Song, Jingdong; Xiao, Kang; Lei, Wenwen; Guo, Jianqiang; Wei, Hejiang; Cai, Kun; Wang, Yanhai; Wu, Jiang; Gerald, Bangura; Kamara, Idrissa Laybohr; Liang, Mifang; Wu, Guizhen; Dong, Xiaoping

2016-03-01

The quality control process throughout the Ebola virus nucleic acid detection in Sierra Leone-China Friendship Biological Safety Laboratory (SLE-CHN Biosafety Lab) was described in detail, in order to comprehensively display the scientific, rigorous, accurate and efficient practice in detection of Ebola virus of first batch detection team in SLE-CHN Biosafety Lab. Firstly, the key points of laboratory quality control system was described, including the managements and organizing, quality control documents and information management, instrument, reagents and supplies, assessment, facilities design and space allocation, laboratory maintenance and biosecurity. Secondly, the application of quality control methods in the whole process of the Ebola virus detection, including before the test, during the test and after the test, was analyzed. The excellent and professional laboratory staffs, the implementation of humanized management are the cornerstone of the success; High-level biological safety protection is the premise for effective quality control and completion of Ebola virus detection tasks. And professional logistics is prerequisite for launching the laboratory diagnosis of Ebola virus. The establishment and running of SLE-CHN Biosafety Lab has landmark significance for the friendship between Sierra Leone and China, and the lab becomes the most important base for Ebola virus laboratory testing in Sierra Leone.

Summary of inorganic compositional data for groundwater, soil-water, and surface-water samples collected at the Headgate Draw subsurface drip irrigation site, Johnson County, Wyoming

USGS Publications Warehouse

Geboy, Nicholas J.; Engle, Mark A.; Schroeder, Karl T.; Zupancic, John W.

2011-01-01

As part of a 5-year project on the impact of subsurface drip irrigation (SDI) application of coalbed-methane (CBM) produced waters, water samples were collected from the Headgate Draw SDI site in the Powder River Basin, Wyoming, USA. This research is part of a larger study to understand short- and long-term impacts on both soil and water quality from the beneficial use of CBM waters to grow forage crops through use of SDI. This document provides a summary of the context, sampling methodology, and quality assurance and quality control documentation of samples collected prior to and over the first year of SDI operation at the site (May 2008-October 2009). This report contains an associated database containing inorganic compositional data, water-quality criteria parameters, and calculated geochemical parameters for samples of groundwater, soil water, surface water, treated CBM waters, and as-received CBM waters collected at the Headgate Draw SDI site.

Supplement to the Second Addendum (1986) to Air Quality Criteria for Particulate Matter and Sulfur Oxides (1982): Assessment of New Findings on Sulfur Dioxide and Acute Exposure Health Effects in Asthmatic Individuals (1994)

EPA Science Inventory

The present Supplement to the Second Addendum (1986) to the document Air Quality Criteria for Particulate Matter and Sulfur Oxides (1982) focuses on evaluation of newly available controlled human exposure studies of acute (a\\1h) sulfur dioxide (SO2) exposure effects on pulmonary ...

Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice.

PubMed

McCarty, Lynn S; Borgert, Christopher J; Mihaich, Ellen M

2012-07-01

There is an ongoing discussion on the provenance of toxicity testing data regarding how best to ensure its validity and credibility. A central argument is whether journal peer-review procedures are superior to Good Laboratory Practice (GLP) standards employed for compliance with regulatory mandates. We sought to evaluate the rationale for regulatory decision making based on peer-review procedures versus GLP standards. We examined pertinent published literature regarding how scientific data quality and validity are evaluated for peer review, GLP compliance, and development of regulations. Some contend that peer review is a coherent, consistent evaluative procedure providing quality control for experimental data generation, analysis, and reporting sufficient to reliably establish relative merit, whereas GLP is seen as merely a tracking process designed to thwart investigator corruption. This view is not supported by published analyses pointing to subjectivity and variability in peer-review processes. Although GLP is not designed to establish relative merit, it is an internationally accepted quality assurance, quality control method for documenting experimental conduct and data. Neither process is completely sufficient for establishing relative scientific soundness. However, changes occurring both in peer-review processes and in regulatory guidance resulting in clearer, more transparent communication of scientific information point to an emerging convergence in ensuring information quality. The solution to determining relative merit lies in developing a well-documented, generally accepted weight-of-evidence scheme to evaluate both peer-reviewed and GLP information used in regulatory decision making where both merit and specific relevance inform the process.

Marky: a tool supporting annotation consistency in multi-user and iterative document annotation projects.

PubMed

Pérez-Pérez, Martín; Glez-Peña, Daniel; Fdez-Riverola, Florentino; Lourenço, Anália

2015-02-01

Document annotation is a key task in the development of Text Mining methods and applications. High quality annotated corpora are invaluable, but their preparation requires a considerable amount of resources and time. Although the existing annotation tools offer good user interaction interfaces to domain experts, project management and quality control abilities are still limited. Therefore, the current work introduces Marky, a new Web-based document annotation tool equipped to manage multi-user and iterative projects, and to evaluate annotation quality throughout the project life cycle. At the core, Marky is a Web application based on the open source CakePHP framework. User interface relies on HTML5 and CSS3 technologies. Rangy library assists in browser-independent implementation of common DOM range and selection tasks, and Ajax and JQuery technologies are used to enhance user-system interaction. Marky grants solid management of inter- and intra-annotator work. Most notably, its annotation tracking system supports systematic and on-demand agreement analysis and annotation amendment. Each annotator may work over documents as usual, but all the annotations made are saved by the tracking system and may be further compared. So, the project administrator is able to evaluate annotation consistency among annotators and across rounds of annotation, while annotators are able to reject or amend subsets of annotations made in previous rounds. As a side effect, the tracking system minimises resource and time consumption. Marky is a novel environment for managing multi-user and iterative document annotation projects. Compared to other tools, Marky offers a similar visually intuitive annotation experience while providing unique means to minimise annotation effort and enforce annotation quality, and therefore corpus consistency. Marky is freely available for non-commercial use at http://sing.ei.uvigo.es/marky. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Data Quality Screening Service

NASA Technical Reports Server (NTRS)

Strub, Richard; Lynnes, Christopher; Hearty, Thomas; Won, Young-In; Fox, Peter; Zednik, Stephan

2013-01-01

A report describes the Data Quality Screening Service (DQSS), which is designed to help automate the filtering of remote sensing data on behalf of science users. Whereas this process often involves much research through quality documents followed by laborious coding, the DQSS is a Web Service that provides data users with data pre-filtered to their particular criteria, while at the same time guiding the user with filtering recommendations of the cognizant data experts. The DQSS design is based on a formal semantic Web ontology that describes data fields and the quality fields for applying quality control within a data product. The accompanying code base handles several remote sensing datasets and quality control schemes for data products stored in Hierarchical Data Format (HDF), a common format for NASA remote sensing data. Together, the ontology and code support a variety of quality control schemes through the implementation of the Boolean expression with simple, reusable conditional expressions as operands. Additional datasets are added to the DQSS simply by registering instances in the ontology if they follow a quality scheme that is already modeled in the ontology. New quality schemes are added by extending the ontology and adding code for each new scheme.

Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

PubMed

Schiff, Gordon D; Reyes Nieva, Harry; Griswold, Paula; Leydon, Nicholas; Ling, Judy; Federico, Frank; Keohane, Carol; Ellis, Bonnie R; Foskett, Cathy; Orav, E John; Yoon, Catherine; Goldmann, Don; Weissman, Joel S; Bates, David W; Biondolillo, Madeleine; Singer, Sara J

2017-08-01

Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Chart reviews conducted at baseline and postintervention for intervention sites. Staff and patient survey data collected at baseline and postintervention for intervention and control sites. Chart reviews demonstrated significant improvements in documentation of abnormal results, patient notification, documentation of an action or treatment plan, and evidence of a completed plan (all P<0.001). Mean days between laboratory test date and evidence of completed action/treatment plan decreased by 19.4 days (P<0.001). Staff surveys showed modest but nonsignificant improvement for intervention practices relative to controls overall and for the 3 high-risk domains that were the focus of PROMISES. A consortium of stakeholders, quality improvement tools, coaches, and learning network decreased selected ambulatory safety risks often seen in malpractice claims.

Enhancing Technology Education Students' Understanding of ISO 9000.

ERIC Educational Resources Information Center

Harding, Kerry A.; Tesolowski, Dennis G.; Simmons, J. Bryan

2000-01-01

Defines ISO 9000, the quality control standard of the International Organization for Standardization (ISO), and looks at the benefits of ISO certification. Looks at the four levels of ISO 9000 and discusses the construction of training courses to prepare ISO documentation. (JOW)

Evaluating Green/Gray Infrastructure for CSO/Stormwater Control

EPA Science Inventory

The NRMRL is conducting this project to evaluate the water quality and quantity benefits of a large-scale application of green infrastructure (low-impact development/best management practices) retrofits in an entire subcatchment. It will document ORD's effort to demonstrate the e...

Manufacturing and quality control of interconnecting wire harnesses, Volume 2

NASA Technical Reports Server (NTRS)

1972-01-01

Interconnecting wire harnesses defined in the design standard are considered, including type 4, open bundle (not enclosed). Knowledge gained through experience on the Saturn 5 program coupled with recent advances in techniques, materials, and processes was incorporated into the document.

Laboratory quality management system: road to accreditation and beyond.

PubMed

Wadhwa, V; Rai, S; Thukral, T; Chopra, M

2012-01-01

This review attempts to clarify the concepts of Laboratory Quality Management System (Lab QMS) for a medical testing and diagnostic laboratory in a holistic way and hopes to expand the horizon beyond quality control (QC) and quality assurance. It provides an insight on accreditation bodies and highlights a glimpse of existing laboratory practices but essentially it takes the reader through the journey of accreditation and during the course of reading and understanding this document, prepares the laboratory for the same. Some of the areas which have not been highlighted previously include: requirement for accreditation consultants, laboratory infrastructure and scope, applying for accreditation, document preparation. This section is well supported with practical illustrations and necessary tables and exhaustive details like preparation of a standard operating procedure and a quality manual. Concept of training and privileging of staff has been clarified and a few of the QC exercises have been dealt with in a novel way. Finally, a practical advice for facing an actual third party assessment and caution needed to prevent post-assessment pitfalls has been dealt with.

Promoting competition in Swedish primary care.

PubMed

Norén, Lars; Ranerup, Agneta

2015-01-01

The purpose of this paper is to examine the role of accreditation documents (ADs) in the competition based on provider quality in a quasi-market for primary healthcare. The paper uses a mixed-method research methodology to analyse two primary healthcare ADs in two Swedish regions. In total, 19 interviews were conducted with actors involved in the creation and use of such documents. This paper points to the crucial role of ADs in the identification of quality differences that influence the competition in primary healthcare. This finding contrasts with the commonly held laissez-faire idea that competition causes providers to develop their own service concepts and where the invisible hand creates quality differences. The paper adds to the discussion with its detailed description of how ADs create competition among primary healthcare providers through selection processes, quality differentiation, and ranking. The paper does not explore quality differences in the medical treatment of patients in primary healthcare centres. The paper provides insights for politicians on how to use ADs to control competition and regulate choice. The paper takes an innovative approach to the examination of how ADs increase the competition in primary healthcare choice.

Inexpensive DAQ based physics labs

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Clark, Shane

2015-11-01

Quality Data Acquisition (DAQ) based physics labs can be designed using microcontrollers and very low cost sensors with minimal lab equipment. A prototype device with several sensors and documentation for a number of DAQ-based labs is showcased. The device connects to a computer through Bluetooth and uses a simple interface to control the DAQ and display real time graphs, storing the data in .txt and .xls formats. A full device including a larger number of sensors combined with software interface and detailed documentation would provide a high quality physics lab education for minimal cost, for instance in high schools lacking lab equipment or students taking online classes. An entire semester’s lab course could be conducted using a single device with a manufacturing cost of under $20.

Quality control management and communication between radiologists and technologists.

PubMed

Nagy, Paul G; Pierce, Benjamin; Otto, Misty; Safdar, Nabile M

2008-06-01

The greatest barrier to quality control (QC) in the digital imaging environment is the lack of communication and documentation between those who interpret images and those who acquire them. Paper-based QC methods are insufficient in a digital image management system. Problem work flow must be incorporated into reengineering efforts when migrating to a digital practice. The authors implemented a Web-based QC feedback tool to document and facilitate the communication of issues identified by radiologists. The goal was to promote a responsive and constructive tool that contributes to a culture of quality. The hypothesis was that by making it easier for radiologists to submit quality issues, the number of QC issues submitted would increase. The authors integrated their Web-based quality tracking system with a clinical picture archiving and communication system so that radiologists could report quality issues without disrupting clinical work flow. Graphical dashboarding techniques aid supervisors in using this database to identify the root causes of different types of issues. Over the initial 12-month rollout period, starting in the general section, the authors recorded 20 times more QC issues submitted by radiologists, accompanied by a rise in technologists' responsiveness to QC issues. For technologists with high numbers of QC issues, the incorporation of data from this tracking system proved useful in performance appraisals and in driving individual improvement. This tool is an example of the types of information technology innovations that can be leveraged to support QC in the digital imaging environment. Initial data suggest that the result is not only an improvement in quality but higher levels of satisfaction for both radiologists and technologists.

Lack of evidence and standardization in care pathway documents for patients with ST-elevated myocardial infarction.

PubMed

Aeyels, Daan; Van Vugt, Stijn; Sinnaeve, Peter R; Panella, Massimiliano; Van Zelm, Ruben; Sermeus, Walter; Vanhaecht, Kris

2016-04-01

Clinical practice variation and the subsequent burden on health care quality has been documented for patients with ST-elevated myocardial infarction (STEMI). Reduction of clinical practice variation is possible by increasing guideline adherence. Care pathway documents can increase guideline adherence by implementing evidence-based key interventions and quality indicators in daily practice. This study aims to examine guideline adherence of care pathway documents for patients with STEMI. Lay-out, size and timeframe of submitted care pathways documents were analysed. Two independent reviewers used a checklist to systematically assess the guideline adherence of care pathway documents. The checklist comprised a set of key interventions and quality indicators extracted from evidence and international guidelines. The checklist distinguished the evidence level for each item and was validated by expert consensus. Results were verified by inviting participating hospitals to provide feedback. Fifteen out of 25 invited hospitals submitted care pathway documents for STEMI. The care pathway documents differed in timeframe, lay-out and size. Analysis of the care pathway documents showed important variation in formalizing adherence to evidence: between hospitals, inclusion of 24 key interventions in care pathway documents varied from 13 to 97%. Inclusion of 11 essential quality indicators varied from 0 to 40%. Care pathway documents for patients with STEMI differ considerably in lay-out, timeframe and size. This study showed variation in, and suboptimal inclusion of, evidence-based key interventions and quality indicators in care pathway documents. The use of these care pathway documents might result in suboptimal quality of care for STEMI patients. © The European Society of Cardiology 2015.

The Effect of a Microprocessor Prosthetic Foot on Function and Quality of Life in Transtibial Amputees Who Are Limited Community Ambulators

DTIC Science & Technology

2017-09-01

parallel, randomized, controlled clinical trial designed to determine if a microprocessor controlled prosthetic foot (MPF), with greater range of...clinical trial designed to determine if a microprocessor controlled prosthetic foot (MPF), with greater range of motion and active power, will...Department of the Army position, policy or decision unless so designated by other documentation. CONTRACTING ORGANIZATION: University of Tennessee

Air pollution and public health: a guidance document for risk managers.

PubMed

Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

2008-01-01

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

Documenting quality improvement and patient safety efforts: the quality portfolio. A statement from the academic hospitalist taskforce.

PubMed

Taylor, Benjamin B; Parekh, Vikas; Estrada, Carlos A; Schleyer, Anneliese; Sharpe, Bradley

2014-01-01

Physicians increasingly investigate, work, and teach to improve the quality of care and safety of care delivery. The Society of General Internal Medicine Academic Hospitalist Task Force sought to develop a practical tool, the quality portfolio, to systematically document quality and safety achievements. The quality portfolio was vetted with internal and external stakeholders including national leaders in academic medicine. The portfolio was refined for implementation to include an outlined framework, detailed instructions for use and an example to guide users. The portfolio has eight categories including: (1) a faculty narrative, (2) leadership and administrative activities, (3) project activities, (4) education and curricula, (5) research and scholarship, (6) honors, awards, and recognition, (7) training and certification, and (8) an appendix. The authors offer this comprehensive, yet practical tool as a method to document quality and safety activities. It is relevant for physicians across disciplines and institutions and may be useful as a standalone document or as an adjunct to traditional promotion documents. As the Next Accreditation System is implemented, academic medical centers will require faculty who can teach and implement the systems-based practice requirements. The quality portfolio is a method to document quality improvement and safety activities.

Establishing a Quality Control System for Stem Cell-Based Medicinal Products in China

PubMed Central

2015-01-01

Stem cell-based medicinal products (SCMPs) are emerging as novel therapeutic products. The success of its development depends on the existence of an effective quality control system, which is constituted by quality control technologies, standards, reference materials, guidelines, and the associated management system in accordance with regulatory requirements along product lifespan. However, a worldwide, effective quality control system specific for SCMPs is still far from established partially due to the limited understanding of stem cell sciences and lack of quality control technologies for accurately assessing the safety and biological effectiveness of SCMPs before clinical use. Even though, based on the existing regulations and current stem cell sciences and technologies, initial actions toward the goal of establishing such a system have been taken as exemplified by recent development of new “interim guidelines” for governing quality control along development of SCMPs and new development of the associated quality control technologies in China. In this review, we first briefly introduced the major institutions involved in the regulation of cell substrates and therapeutic cell products in China and the existing regulatory documents and technical guidelines used as critical references for developing the new interim guidelines. With focus only on nonhematopoietic stem cells, we then discussed the principal quality attributes of SCMPs as well as our thinking of proper testing approaches to be established with relevant evaluation technologies to ensure all quality requirements of SCMPs along different manufacturing processes and development stages. At the end, some regulatory and technical challenges were also discussed with the conclusion that combined efforts should be taken to promote stem cell regulatory sciences to establish the effective quality control system for SCMPs. PMID:25471126

Cistern and planter box monitoring in Camden, NJ revisited ...

EPA Pesticide Factsheets

The Camden County Municipal Utilities Authority installed green infrastructure Stormwater Control Measures at multiple locations around the city of Camden, NJ. The Stormwater Control Measures include raised downspout planter boxes and cisterns. EPA is monitoring a subset of the locations to document the performance of individual Stormwater Control Measures. The selected monitoring sites include two sets of raised downspout planter boxes and five cisterns. These Stormwater Control Measures are being monitored: to investigate their hydrologic performances, to document water consumption patterns of cisterns for a better understanding of the supply and demand relationship, and to analyze cistern water quality. The continuous electronic monitoring devices included time domain reflectometers, rain gauges and pressure transducers. EPA decided to monitor these Stormwater Control Measures for three years and second year monitoring is ongoing. Monitoring data present the internal water flow patterns and media saturation frequency of the raised planter boxes and the capture ratio, water use patterns and water quality analysis of cisterns. Second year monitoring shows larger capture ratio for cisterns compared to the first year data and higher metal concentration at one site. The high metal concentration was later resolved by flushing the cistern and resampling. The presentation will summarize the comparison between first and second year data, providing results from the

Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

PubMed

Noordhuizen, J P; Welpelo, H J

1996-12-01

This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.

Improving and monitoring air quality.

PubMed

DuPont, André

2018-05-01

Since the authorization of the Clean Air Act Amendments of 1990, the air quality in the USA has significantly improved because of strong public support. The lessons learned over the last 25 years are being shared with the policy analysts, technical professionals, and scientist who endeavor to improve air quality in their communities. This paper will review how the USA has achieved the "high" standard of air quality that was envisioned in the early 1990s. This document will describe SO 2 gas emission reduction technology and highlight operation of emission monitoring technology. This paper describes the basic process operation of an air pollution control scrubber. A technical review of measures required to operate and maintain a large-scale pollution control system will be described. Also, the author explains how quality assurance procedures in performance of continuous emission monitoring plays a significant role in reducing air pollution.

7 CFR 1767.70 - Record storage media.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... retention period provided for in the master index of records, unless there is a quality transfer from one... for accuracy and documented. (b) Each borrower shall implement internal control procedures that assure...

Manufacture and quality control of interconnecting wire harnesses

NASA Technical Reports Server (NTRS)

1973-01-01

Four-volume series of documents has been prepared as standard reference. Each volume may be used separately and covers wire and cable preparation as well as harness fabrication and installation. Series should be useful addition to libraries of manufactures of electrical and electronic equipment.

Seal of transparency heritage in the CISMeF quality-controlled health gateway

PubMed Central

Darmoni, SJ; Dahamna, B; Roth-Berghofer, Thomas R

2004-01-01

Background It is an absolute necessity to continually assess the quality of health information on the Internet. Quality-controlled subject gateways are Internet services which apply a selected set of targeted measures to support systematic resource discovery. Methods The CISMeF health gateway became a contributor to the MedCIRCLE project to evaluate 270 health information providers. The transparency heritage consists of using the evaluation performed on providers that are referenced in the CISMeF catalogue for evaluating the documents they publish, thus passing on the transparency label from the publishers to their documents. Results Each site rated in CISMeF has a record in the CISMeF database that generates an RDF into HTML file. The search tool Doc'CISMeF displays information originating from every publisher evaluated with a specific MedCIRCLE button, which is linked to the MedCIRCLE central repository. Starting with 270 websites, this trust heritage has led to 6,480 evaluated resources in CISMeF (49.8% of the 13,012 resources included in CISMeF). Conclusion With the MedCIRCLE project and transparency heritage, CISMeF became an explicit third party. PMID:15367332

Operational excellence (six sigma) philosophy: Application to software quality assurance

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

Lackner, M.

1997-11-01

This report contains viewgraphs on operational excellence philosophy of six sigma applied to software quality assurance. This report outlines the following: goal of six sigma; six sigma tools; manufacturing vs administrative processes; Software quality assurance document inspections; map software quality assurance requirements document; failure mode effects analysis for requirements document; measuring the right response variables; and questions.

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

PubMed

Harding, Keith; Benson, Erica E

2015-01-01

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

[Infrastructure and contents of clinical data management plan].

PubMed

Shen, Tong; Xu, Lie-dong; Fu, Hai-jun; Liu, Yan; He, Jia; Chen, Ping-yan; Song, Yu-fei

2015-11-01

Establishment of quality management system (QMS) plays a critical role in the clinical data management (CDM). The objectives of CDM are to ensure the quality and integrity of the trial data. Thus, every stage or element that may impact the quality outcomes of clinical studies should be in the controlled manner, which is referred to the full life cycle of CDM associated with the data collection, handling and statistical analysis of trial data. Based on the QMS, this paper provides consensus on how to develop a compliant clinical data management plan (CDMP). According to the essential requirements of the CDM, the CDMP should encompass each process of data collection, data capture and cleaning, medical coding, data verification and reconciliation, database monitoring and management, external data transmission and integration, data documentation and data quality assurance and so on. Creating and following up data management plan in each designed data management steps, dynamically record systems used, actions taken, parties involved will build and confirm regulated data management processes, standard operational procedures and effective quality metrics in all data management activities. CDMP is one of most important data management documents that is the solid foundation for clinical data quality.

Control by quality: proposition of a typology.

PubMed

Pujo, P; Pillet, M

The application of Quality tools and methods in industrial management has always had a fundamental impact on the control of production. It influences the behavior of the actors concerned, while introducing the necessary notions and formalizations, especially for production systems with little or no automation, which constitute a large part of the industrial activity. Several quality approaches are applied in the workshop and are implemented at the level of the control. In this paper, the authors present a typology of the various approaches that have successively influenced control, such as statistical process control, quality assurance, and continuous improvement. First the authors present a parallel between production control and quality organizational structure. They note the duality between control, which is aimed at increasing productivity, and quality, which aims to satisfy the needs of the customer. They also note the hierarchical organizational structure of these two systems of management with, at each level, the notion of a feedback loop. This notion is fundamental to any kind of decision making. The paper is organized around the operational, tactical, and strategic levels, by describing for each level the main methods and tools for control by quality. The overview of these tools and methods starts at the operational level, with the Statistical Process Control, the Taguchi technique, and the "six sigma" approach. On the tactical level, we find a quality system approach, with a documented description of the procedures introduced in the firm. The management system can refer here to Quality Assurance, Total Productive Maintenance, or Management by Total Quality. The formalization through procedures of the rules of decision governing the process control enhances the validity of these rules. This leads to the enhancement of their reliability and to their consolidation. All this counterbalances the human, intrinsically fluctuating, behavior of the control operators. Strategic control by quality is then detailed, and the two main approaches, the continuous improvement approach and the proactive improvement approach, are introduced. Finally, the authors observe that at each of the three levels, the continuous process improvement, which is a component of Total Quality, becomes an essential preoccupation for the control. Ultimately, the recursive utilization of the Deming cycle remains the best practice for the control by quality.

Groundwater-quality and quality-control data for two monitoring wells near Pavillion, Wyoming, April and May 2012

USGS Publications Warehouse

Wright, Peter R.; McMahon, Peter B.; Mueller, David K.; Clark, Melanie L.

2012-01-01

In June 2010, the U.S. Environmental Protection Agency installed two deep monitoring wells (MW01 and MW02) near Pavillion, Wyoming, to study groundwater quality. During April and May 2012, the U.S Geological Survey, in cooperation with the Wyoming Department of Environmental Quality, collected groundwater-quality data and quality-control data from monitoring well MW01 and, following well redevelopment, quality-control data for monitoring well MW02. Two groundwater-quality samples were collected from well MW01—one sample was collected after purging about 1.5 borehole volumes, and a second sample was collected after purging 3 borehole volumes. Both samples were collected and processed using methods designed to minimize atmospheric contamination or changes to water chemistry. Groundwater-quality samples were analyzed for field water-quality properties (water temperature, pH, specific conductance, dissolved oxygen, oxidation potential); inorganic constituents including naturally occurring radioactive compounds (radon, radium-226 and radium-228); organic constituents; dissolved gasses; stable isotopes of methane, water, and dissolved inorganic carbon; and environmental tracers (carbon-14, chlorofluorocarbons, sulfur hexafluoride, tritium, helium, neon, argon, krypton, xenon, and the ratio of helium-3 to helium-4). Quality-control sample results associated with well MW01 were evaluated to determine the extent to which environmental sample analytical results were affected by bias and to evaluate the variability inherent to sample collection and laboratory analyses. Field documentation, environmental data, and quality-control data for activities that occurred at the two monitoring wells during April and May 2012 are presented.

Real-time simulation model of the HL-20 lifting body

NASA Technical Reports Server (NTRS)

Jackson, E. Bruce; Cruz, Christopher I.; Ragsdale, W. A.

1992-01-01

A proposed manned spacecraft design, designated the HL-20, has been under investigation at Langley Research Center. Included in that investigation are flight control design and flying qualities studies utilizing a man-in-the-loop real-time simulator. This report documents the current real-time simulation model of the HL-20 lifting body vehicle, known as version 2.0, presently in use at NASA Langley Research Center. Included are data on vehicle aerodynamics, inertias, geometries, guidance and control laws, and cockpit displays and controllers. In addition, trim case and dynamic check case data is provided. The intent of this document is to provide the reader with sufficient information to develop and validate an equivalent simulation of the HL-20 for use in real-time or analytical studies.

Space Transportation System Cargo projects: inertial stage/spacecraft integration plan. Volume 1: Management plan

NASA Technical Reports Server (NTRS)

1981-01-01

The Kennedy Space Center (KSC) Management System for the Inertial Upper Stage (IUS) - spacecraft processing from KSC arrival through launch is described. The roles and responsibilities of the agencies and test team organizations involved in IUS-S/C processing at KSC for non-Department of Defense missions are described. Working relationships are defined with respect to documentation preparation, coordination and approval, schedule development and maintenance, test conduct and control, configuration management, quality control and safety. The policy regarding the use of spacecraft contractor test procedures, IUS contractor detailed operating procedures and KSC operations and maintenance instructions is defined. Review and approval requirements for each documentation system are described.

Hanford Internal Dosimetry Project manual. Revision 1

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

Carbaugh, E.H.; Bihl, D.E.; MacLellan, J.A.

1994-07-01

This document describes the Hanford Internal Dosimetry Project, as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy and its Hanford contractors. Project services include administrating the bioassay monitoring program, evaluating and documenting assessment of potential intakes and internal dose, ensuring that analytical laboratories conform to requirements, selecting and applying appropriate models and procedures for evaluating radionuclide deposition and the resulting dose, and technically guiding and supporting Hanford contractors in matters regarding internal dosimetry. Specific chapters deal with the following subjects: practices of the project, including interpretation of applicable DOE Orders, regulations, andmore » guidance into criteria for assessment, documentation, and reporting of doses; assessment of internal dose, including summary explanations of when and how assessments are performed; recording and reporting practices for internal dose; selection of workers for bioassay monitoring and establishment of type and frequency of bioassay measurements; capability and scheduling of bioassay monitoring services; recommended dosimetry response to potential internal exposure incidents; quality control and quality assurance provisions of the program.« less

Impact of Quality Improvement Educational Interventions on Documented Adherence to Quality Measures for Adults with Crohn's Disease.

PubMed

Greene, Laurence; Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Patel, Barry; Higgins, Peter D R

2015-09-01

In recent years, leading organizations in inflammatory bowel disease (IBD) have developed quality measures for the care of adults with Crohn's disease or ulcerative colitis. We used chart audits to assess the impact of quality improvement educational activities on documented adherence to Physician Quality Reporting System measures for IBD. Twenty community-based gastroenterologists were recruited to participate in baseline chart audits (n = 200), a series of 4 accredited educational activities with feedback, and follow-up chart audits (n = 200). Trained abstractors reviewed randomly selected charts of adults with moderate or severe Crohn's disease. The charts were retrospectively abstracted for physicians' documented performance of the 2013 Physician Quality Reporting System IBD quality measures. We compared the physicians' baseline and posteducation rates of documented adherence with 10 of these measures. In a secondary analysis, we compared preeducation with posteducation difference scores of low-performing physicians, those whose baseline documentation rates were in the lowest quartile, and the rest of the cohort. At baseline, documentation of mean provider-level adherence to the 10 quality measures ranged from 3% to 98% (grand mean = 35.8%). In the overall analysis, baseline and posteducation rates of documented adherence did not differ significantly for any of the measures. However, for 4 measures, preeducation to posteducation difference scores were significantly greater among low performers than physicians in the highest 3 quartiles. The results of this preliminary pragmatic study indicate that quality improvement education affords the potential to improve adherence to Physician Quality Reporting System quality measures for IBD among low-performing gastroenterologists.

[Compatibility of different quality control systems].

PubMed

Invernizzi, Enrico

2002-01-01

Management of the good laboratory practice (GLP) quality system presupposes its linking to a basic recognized and approved quality system, from which it can draw on management procedures common to all quality systems, such as the ISO 9000 set of norms. A quality system organized in this way can also be integrated with other dedicated quality systems, or parts of them, to obtain principles or management procedures for specific topics. The aim of this organization is to set up a reliable, recognized quality system compatible with the principles of GLP and other quality management systems, which provides users with a simplified set of easily accessible management tools and answers. The organization of this quality system is set out in the quality assurance programme, which is actually the document in which the test facility incorporates the GLP principles into its own quality organization.

E-nursing documentation as a tool for quality assurance.

PubMed

Rajkovic, Vladislav; Sustersic, Olga; Rajkovic, Uros

2006-01-01

The article presents the results of a project with which we describe the reengineering of nursing documentation. Documentation in nursing is an efficient tool for ensuring quality health care and consequently quality patient treatment along the whole clinical path. We have taken into account the nursing process and patient treatment based on Henderson theoretical model of nursing that consists of 14 basic living activities. The model of new documentation enables tracing, transparency, selectivity, monitoring and analyses. All these factors lead to improvements of a health system as well as to improved safety of patients and members of nursing teams. Thus the documentation was developed for three health care segments: secondary and tertiary level, dispensaries and community health care. The new quality introduced to the documentation process by information and communication technology is presented by a database model and a software prototype for managing documentation.

National Functional Guidelines for Inorganic Superfund Methods Data Review (ISM02.4)

EPA Pesticide Factsheets

This document is designed to assist the reviewer in evaluating (a) whether the analytical data meet the technical and Quality Control (QC) criteria specified in the SOW, and (b) the usability and extent of bias of any data that do not meet these criteria.

The Lincoln Training System: A Summary Report.

ERIC Educational Resources Information Center

Butman, Robert C.; Frick, Frederick C.

The current status of the Lincoln Training System (LTS) is reported. This document describes LTS as a computer supported microfiche system which: 1) provides random access to voice quality audio and to graphics; 2) supports student-controlled interactive processes; and 3) functions in a variety of environments. The report offers a detailed…

7 CFR 981.442 - Quality control.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of this section, container means a box, bin, bag, carton, or any other type of receptacle used in the... container of such almonds with the term “unpasteurized.” Such lettering shall be on one outside principal... transaction, the handler must provide sufficient documentation to the Board to track the shipment from the...

34 CFR 200.89 - MEP allocations; Re-interviewing; Eligibility documentation; and Quality control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... determinations being tested) trained to conduct personal interviews and to understand and apply program... child eligibility determinations through the re-interview of a randomly selected sample of children previously identified as migratory. In conducting these re-interviews, an SEA must— (i) Use, at least once...

34 CFR 200.89 - MEP allocations; Re-interviewing; Eligibility documentation; and Quality control.

Code of Federal Regulations, 2010 CFR

2010-07-01

... determinations being tested) trained to conduct personal interviews and to understand and apply program... child eligibility determinations through the re-interview of a randomly selected sample of children previously identified as migratory. In conducting these re-interviews, an SEA must— (i) Use, at least once...

Off-Line Quality Control In Integrated Circuit Fabrication Using Experimental Design

NASA Astrophysics Data System (ADS)

Phadke, M. S.; Kackar, R. N.; Speeney, D. V.; Grieco, M. J.

1987-04-01

Off-line quality control is a systematic method of optimizing production processes and product designs. It is widely used in Japan to produce high quality products at low cost. The method was introduced to us by Professor Genichi Taguchi who is a Deming-award winner and a former Director of the Japanese Academy of Quality. In this paper we will i) describe the off-line quality control method, and ii) document our efforts to optimize the process for forming contact windows in 3.5 Aim CMOS circuits fabricated in the Murray Hill Integrated Circuit Design Capability Laboratory. In the fabrication of integrated circuits it is critically important to produce contact windows of size very near the target dimension. Windows which are too small or too large lead to loss of yield. The off-line quality control method has improved both the process quality and productivity. The variance of the window size has been reduced by a factor of four. Also, processing time for window photolithography has been substantially reduced. The key steps of off-line quality control are: i) Identify important manipulatable process factors and their potential working levels. ii) Perform fractional factorial experiments on the process using orthogonal array designs. iii) Analyze the resulting data to determine the optimum operating levels of the factors. Both the process mean and the process variance are considered in this analysis. iv) Conduct an additional experiment to verify that the new factor levels indeed give an improvement.

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

2010-01-01

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

Psychosocial impairment in DSM-5 intermittent explosive disorder.

PubMed

Rynar, Lauren; Coccaro, Emil F

2018-03-30

The purpose of this study was to document the functional severity of DSM-5 IED in a clinical research sample. IED and control groups were compared on psychosocial functioning, life satisfaction, and on a variety of cognitive and behavioral issues. IED study participants reported significantly worse psychosocial function, quality of life, and higher job dysfunction than both psychiatric and healthy control study participants. The presence of DSM-5 IED is associated with significant psychosocial and functional impairment. Early intervention may aid in minimizing the consequences of impulsive aggressive behavior, and improving psychosocial functioning and quality of life. Copyright © 2018 Elsevier B.V. All rights reserved.

A Pilot Randomized Trial of Text-Messaging for Symptom Awareness and Diabetes Knowledge in Adolescents With Type 1 Diabetes

PubMed Central

Han, Yi; Faulkner, Melissa Spezia; Fritz, Heather; Fadoju, Doris; Muir, Andrew; Abowd, Gregory D.; Head, Lauren; Arriaga, Rosa I.

2015-01-01

Adolescents with type 1 diabetes typically receive clinical care every 3 months. Between visits, diabetes-related issues may not be frequently reflected, learned, and documented by the patients, limiting their self-awareness and knowledge about their condition. We designed a text-messaging system to help resolve this problem. In a pilot, randomized controlled trial with 30 adolescents, we examined the effect of text messages about symptom awareness and diabetes knowledge on glucose control and quality of life. The intervention group that received more text messages between visits had significant improvements in quality of life. PMID:25720675

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

PubMed

Rousse, C; Chauvet, B

2015-10-01

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

Natural Language Processing–Enabled and Conventional Data Capture Methods for Input to Electronic Health Records: A Comparative Usability Study

PubMed Central

Sheehan, Barbara; Stetson, Peter; Bhatt, Ashish R; Field, Adele I; Patel, Chirag; Maisel, James Mark

2016-01-01

Background The process of documentation in electronic health records (EHRs) is known to be time consuming, inefficient, and cumbersome. The use of dictation coupled with manual transcription has become an increasingly common practice. In recent years, natural language processing (NLP)–enabled data capture has become a viable alternative for data entry. It enables the clinician to maintain control of the process and potentially reduce the documentation burden. The question remains how this NLP-enabled workflow will impact EHR usability and whether it can meet the structured data and other EHR requirements while enhancing the user’s experience. Objective The objective of this study is evaluate the comparative effectiveness of an NLP-enabled data capture method using dictation and data extraction from transcribed documents (NLP Entry) in terms of documentation time, documentation quality, and usability versus standard EHR keyboard-and-mouse data entry. Methods This formative study investigated the results of using 4 combinations of NLP Entry and Standard Entry methods (“protocols”) of EHR data capture. We compared a novel dictation-based protocol using MediSapien NLP (NLP-NLP) for structured data capture against a standard structured data capture protocol (Standard-Standard) as well as 2 novel hybrid protocols (NLP-Standard and Standard-NLP). The 31 participants included neurologists, cardiologists, and nephrologists. Participants generated 4 consultation or admission notes using 4 documentation protocols. We recorded the time on task, documentation quality (using the Physician Documentation Quality Instrument, PDQI-9), and usability of the documentation processes. Results A total of 118 notes were documented across the 3 subject areas. The NLP-NLP protocol required a median of 5.2 minutes per cardiology note, 7.3 minutes per nephrology note, and 8.5 minutes per neurology note compared with 16.9, 20.7, and 21.2 minutes, respectively, using the Standard-Standard protocol and 13.8, 21.3, and 18.7 minutes using the Standard-NLP protocol (1 of 2 hybrid methods). Using 8 out of 9 characteristics measured by the PDQI-9 instrument, the NLP-NLP protocol received a median quality score sum of 24.5; the Standard-Standard protocol received a median sum of 29; and the Standard-NLP protocol received a median sum of 29.5. The mean total score of the usability measure was 36.7 when the participants used the NLP-NLP protocol compared with 30.3 when they used the Standard-Standard protocol. Conclusions In this study, the feasibility of an approach to EHR data capture involving the application of NLP to transcribed dictation was demonstrated. This novel dictation-based approach has the potential to reduce the time required for documentation and improve usability while maintaining documentation quality. Future research will evaluate the NLP-based EHR data capture approach in a clinical setting. It is reasonable to assert that EHRs will increasingly use NLP-enabled data entry tools such as MediSapien NLP because they hold promise for enhancing the documentation process and end-user experience. PMID:27793791

Natural Language Processing-Enabled and Conventional Data Capture Methods for Input to Electronic Health Records: A Comparative Usability Study.

PubMed

Kaufman, David R; Sheehan, Barbara; Stetson, Peter; Bhatt, Ashish R; Field, Adele I; Patel, Chirag; Maisel, James Mark

2016-10-28

The process of documentation in electronic health records (EHRs) is known to be time consuming, inefficient, and cumbersome. The use of dictation coupled with manual transcription has become an increasingly common practice. In recent years, natural language processing (NLP)-enabled data capture has become a viable alternative for data entry. It enables the clinician to maintain control of the process and potentially reduce the documentation burden. The question remains how this NLP-enabled workflow will impact EHR usability and whether it can meet the structured data and other EHR requirements while enhancing the user's experience. The objective of this study is evaluate the comparative effectiveness of an NLP-enabled data capture method using dictation and data extraction from transcribed documents (NLP Entry) in terms of documentation time, documentation quality, and usability versus standard EHR keyboard-and-mouse data entry. This formative study investigated the results of using 4 combinations of NLP Entry and Standard Entry methods ("protocols") of EHR data capture. We compared a novel dictation-based protocol using MediSapien NLP (NLP-NLP) for structured data capture against a standard structured data capture protocol (Standard-Standard) as well as 2 novel hybrid protocols (NLP-Standard and Standard-NLP). The 31 participants included neurologists, cardiologists, and nephrologists. Participants generated 4 consultation or admission notes using 4 documentation protocols. We recorded the time on task, documentation quality (using the Physician Documentation Quality Instrument, PDQI-9), and usability of the documentation processes. A total of 118 notes were documented across the 3 subject areas. The NLP-NLP protocol required a median of 5.2 minutes per cardiology note, 7.3 minutes per nephrology note, and 8.5 minutes per neurology note compared with 16.9, 20.7, and 21.2 minutes, respectively, using the Standard-Standard protocol and 13.8, 21.3, and 18.7 minutes using the Standard-NLP protocol (1 of 2 hybrid methods). Using 8 out of 9 characteristics measured by the PDQI-9 instrument, the NLP-NLP protocol received a median quality score sum of 24.5; the Standard-Standard protocol received a median sum of 29; and the Standard-NLP protocol received a median sum of 29.5. The mean total score of the usability measure was 36.7 when the participants used the NLP-NLP protocol compared with 30.3 when they used the Standard-Standard protocol. In this study, the feasibility of an approach to EHR data capture involving the application of NLP to transcribed dictation was demonstrated. This novel dictation-based approach has the potential to reduce the time required for documentation and improve usability while maintaining documentation quality. Future research will evaluate the NLP-based EHR data capture approach in a clinical setting. It is reasonable to assert that EHRs will increasingly use NLP-enabled data entry tools such as MediSapien NLP because they hold promise for enhancing the documentation process and end-user experience. ©David R. Kaufman, Barbara Sheehan, Peter Stetson, Ashish R. Bhatt, Adele I. Field, Chirag Patel, James Mark Maisel. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 28.10.2016.

The Role of Documentation Quality in Anesthesia-Related Closed Claims: A Descriptive Qualitative Study.

PubMed

Wilbanks, Bryan A; Geisz-Everson, Marjorie; Boust, Rebecca R

2016-09-01

Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions.Through an examination of anesthesia-related closed claims, a descriptive qualitative study emerged, which explored the antecedents and consequences of documentation quality in the claims reviewed. A secondary data analysis utilized a database generated by the American Association of Nurse Anesthetists Foundation closed claim review team. Four major themes emerged from the analysis. Themes 1, 2, and 4 primarily describe how poor documentation quality can have negative consequences for clinicians. The third theme primarily describes how poor documentation quality that can negatively affect patient safety.

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

Design requirements for SRB production control system. Volume 3: Package evaluation, modification and hardware

NASA Technical Reports Server (NTRS)

1981-01-01

The software package evaluation was designed to analyze commercially available, field-proven, production control or manufacturing resource planning management technology and software package. The analysis was conducted by comparing SRB production control software requirements and conceptual system design to software package capabilities. The methodology of evaluation and the findings at each stage of evaluation are described. Topics covered include: vendor listing; request for information (RFI) document; RFI response rate and quality; RFI evaluation process; and capabilities versus requirements.

[Quality Management in Medicine: What the Surgeon Needs to Know].

PubMed

Holtel, M; Roßmüller, T; Frommhold, K

2016-10-01

Quality management (QM) is a method used in the field of economics that was adopted late by the medical sector. The coincidence of quality management and what is referred to as economisation in medicine frequently leads to QM being - incorrectly - perceived as part of the economisation problem rather than as part of its solution. Quality assurance defines and observes key performance indicators for the achievement of quality objectives. QM is a form of active management that intends to systematically exclude the effects of chance. It is supposed to enable those in charge of an institution to deal with complex processes, to influence them and achieve quality even under unfavourable circumstances. Clearly defined written standards are an important aspect of QM and allow for 80 % of patients to be treated faster and less labour-intensively and thus to create more capacity for the individual treatment of the 20 % of patients requiring other than routine care. Standards provide a framework to rely on for department heads and other staff alike. They reduce complexity, support processes in stress situations and prevent inconsistent decisions in the course of treatment. Document management ensures transparent and up-to-date in-house standards and creates continuity. Good documents are short, easy to use, and, at the same time, comply with requirements. Specifications describe in-house standards; validation documents provide a forensically sound documentation. Quality management has a broad impact on an institution. It helps staff reflect on their daily work, and it initiates a reporting and auditing system as well as the systematic management of responses to surveys and complaints. Risk management is another aspect of QM; it provides structures to identify, analyse, assess and modify risks and subject them to risk controlling. Quality management is not necessarily associated with certification. However, if certification is intended, it serves to define requirements, increase motivation for the implementation of measures to be taken, and provide long-term continuity in newly adopted processes. Specialist certificates issued by medical associations frequently emphasise an interdisciplinary treatment approach; however, their certification processes are often of poor quality. The effectiveness and efficiency is evident for individual QM instruments in medicine. It is very likely that quality management improves effectiveness in the whole field of medicine, but this has yet to be proved. Georg Thieme Verlag KG Stuttgart · New York.

Reliability and quality assurance on the MOD 2 wind system

NASA Technical Reports Server (NTRS)

Mason, W. E. B.; Jones, B. G.

1981-01-01

The Safety, Reliability, and Quality Assurance (R&QA) approach developed for the largest wind turbine generator, the Mod 2, is described. The R&QA approach assures that the machine is not hazardous to the public or to the operating personnel, is operated unattended on a utility grid, demonstrates reliable operation, and helps establish the quality assurance and maintainability requirements for future wind turbine projects. The significant guideline consisted of a failure modes and effects analysis (FMEA) during the design phase, hardware inspections during parts fabrication, and three simple documents to control activities during machine construction and operation.

ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

PubMed

Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

2015-12-01

The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included. © 2015 American Society for Veterinary Clinical Pathology.

[The dilemma of data flood - reducing costs and increasing quality control].

PubMed

Gassmann, B

2012-09-05

Digitization is found everywhere in sonography. Printing of ultrasound images using the videoprinter with special paper will be done in single cases. The documentation of sonography procedures is more and more done by saving image sequences instead of still frames. Echocardiography is routinely recorded in between with so called R-R-loops. Doing contrast enhanced ultrasound recording of sequences is necessary to get a deep impression of the vascular structure of interest. Working with this data flood in daily practice a specialized software is required. Comparison in follow up of stored and recent images/sequences is very helpful. Nevertheless quality control of the ultrasound system and the transducers is simple and safe - using a phantom for detail resolution and general image quality the stored images/sequences are comparable over the life cycle of the system. The comparison in follow up is showing decreased image quality and transducer defects immediately.

Quality of nursing diagnoses: evaluation of an educational intervention.

PubMed

Florin, Jan; Ehrenberg, Anna; Ehnfors, Margareta

2005-01-01

To investigate the effects on the quality of nursing diagnostic statements in patient records after education in the nursing process and implementation of new forms for recording. Quasi-experimental design. Randomly selected patient records reviewed before and after intervention from one experimental unit (n = 70) and three control units (n = 70). A scale with 14 characteristics pertaining to nursing diagnoses was developed and used together with the instrument (CAT-CH-ING) for record review. Quality of nursing diagnostic statements improved in the experimental unit, whereas no improvement was found in the control units. Serious flaws in the use of the etiology component were found. CONCLUSION. Nurses must be more concerned with the accuracy and quality of the nursing diagnoses and the etiology component needs to be given special attention. Education of RNs in nursing diagnostic statements and peer review using standardized evaluation instruments can be means to further enhance RNs' documentation practice.

jqcML: an open-source java API for mass spectrometry quality control data in the qcML format.

PubMed

Bittremieux, Wout; Kelchtermans, Pieter; Valkenborg, Dirk; Martens, Lennart; Laukens, Kris

2014-07-03

The awareness that systematic quality control is an essential factor to enable the growth of proteomics into a mature analytical discipline has increased over the past few years. To this aim, a controlled vocabulary and document structure have recently been proposed by Walzer et al. to store and disseminate quality-control metrics for mass-spectrometry-based proteomics experiments, called qcML. To facilitate the adoption of this standardized quality control routine, we introduce jqcML, a Java application programming interface (API) for the qcML data format. First, jqcML provides a complete object model to represent qcML data. Second, jqcML provides the ability to read, write, and work in a uniform manner with qcML data from different sources, including the XML-based qcML file format and the relational database qcDB. Interaction with the XML-based file format is obtained through the Java Architecture for XML Binding (JAXB), while generic database functionality is obtained by the Java Persistence API (JPA). jqcML is released as open-source software under the permissive Apache 2.0 license and can be downloaded from https://bitbucket.org/proteinspector/jqcml .

SUPERFUND INNOVATIVE TECHNOLOGIES EVALUATION ...

EPA Pesticide Factsheets

This task seeks to identify high priority needs of the Regions and Program Offices for innovative field sampling, characterization, monitoring, and measurement technologies. When an appropriate solution to a specific problem is identified, a field demonstration is conducted to document the performance and cost of the proposed technologies. The use of field analysis almost always provides a savings in time and cost over the usual sample and ship to a conventional laboratory for analysis approach to site characterization and monitoring. With improvements in technology and appropriate quality assurance/quality control, field analysis has been shown to provide high quality data, useful for most environmental monitoring or characterization projects. An emphasis of the program is to seek out innovative solutions to existing problems and to provide the cost and performance data a user would require to make an informed decision regarding the adequacy of a technology to address a specific environmental problem. The objective of this program is to promote the acceptance and use of innovative field technologies by providing well-documented performance and cost data obtained from field demonstrations.

Quality-Assurance/Quality-Control Manual for Collection and Analysis of Water-Quality Data in the Ohio District, US Geological Survey

USGS Publications Warehouse

Francy, D.S.; Jones, A.L.; Myers, Donna N.; Rowe, G.L.; Eberle, Michael; Sarver, K.M.

1998-01-01

The U.S. Geological Survey (USGS), Water Resources Division (WRD), requires that quality-assurance/quality-control (QA/QC) activities be included in any sampling and analysis program. Operational QA/QC procedures address local needs while incorporating national policies. Therefore, specific technical policies were established for all activities associated with water-quality project being done by the Ohio District. The policies described in this report provide Ohio District personnel, cooperating agencies, and others with a reference manual on QA/QC procedures that are followed in collecitng and analyzing water-quality samples and reporting water-quality information in the Ohio District. The project chief, project support staff, District Water-Quality Specialist, and District Laboratory Coordinator are all involved in planning and implementing QA/QC activities at the district level. The District Chief and other district-level managers provide oversight, and the Regional Water-Quality Specialist, Office of Water Quality (USGS headquarters), and the Branch of Quality Systems within the Office of Water Quality create national QA/QC polices and provide assistance to District personnel. In the literature, the quality of all measurement data is expressed in terms of precision, variability, bias, accuracy, completeness, representativeness, and comparability. In the Ohio District, bias and variability will be used to describe quality-control data generated from samples in the field and laboratory. Each project chief must plan for implementation and financing of QA/QC activities necessary to achieve data-quality objectives. At least 15 percent of the total project effort must be directed toward QA/QC activities. Of this total, 5-10 percent will be used for collection and analysis of quality-control samples. This is an absolute minimum, and more may be required based on project objectives. Proper techniques must be followed in the collection and processing of surface-water, ground-water, biological, precipitation, bed-sediment, bedload, suspended-sediment, and solid-phase samples. These techniques are briefly described in this report and are extensively documented. The reference documents listed in this report will be kept by the District librarian and District Water-Quality Specialist and updated regularly so that they are available to all District staff. Proper handling and documentation before, during, and after field activities are essential to ensure the integrity of the sample and to correct erroneous reporting of data results. Field sites are to be properly identified and entered into the data base before field data-collection activities begin. During field activities, field notes are to be completed and sample bottles appropriately labeled a nd stored. After field activities, all paperwork is to be completed promptly and samples transferred to the laboratory within allowable holding times. All equipment used by District personnel for the collection and processing of water-quality samples is to be properly operated, maintained, and calibrated by project personnel. This includes equipment for onsite measurement of water-quality characteristics (temperature, specific conductance, pH, dissolved oxygen, alkalinity, acidity, and turbidity) and equipment and instruments used for biological sampling. The District Water-Quality Specialist and District Laboratory Coordinator are responsible for preventive maintenance and calibration of equipment in the Ohio District laboratory. The USGS National Water Quality Laboratory in Arvada, Colo., is the primary source of analytical services for most project work done by the Ohio District. Analyses done at the Ohio District laboratory are usually those that must be completed within a few hours of sample collection. Contract laboratories or other USGS laboratories are sometimes used instead of the NWQL or the Ohio District laboratory. When a contract laboratory is used, the projec

Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

PubMed

Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S

2013-12-18

Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p = 0.001). However, the proportion receiving ≥80% of scheduled BPG did not change. Documentation in medical files improved: ARF episode documentation increased from 31/55 (56%) to 50/62 (81%) (p = 0.004), and RHD risk category documentation from 87/154 (56%) to 103/145 (76%) (p < 0.001). Large differences in performance were noted between health centres, reflected to some extent in SAT scores. A CQI process using a systems approach and participatory action research methodology can significantly improve delivery of ARF/RHD care.

Representations of a High-Quality System of Undergraduate Education in English Higher Education Policy Documents

ERIC Educational Resources Information Center

Ashwin, Paul; Abbas, Andrea; McLean, Monica

2015-01-01

This article examines the ways in which a high-quality system of undergraduate education is represented in recent policy documents from a range of actors interested in higher education. Drawing on Basil Bernstein's ideas, the authors conceptualise the policy documents as reflecting a struggle over competing views of quality that are expressed…

Evaluation of a mHealth Data Quality Intervention to Improve Documentation of Pregnancy Outcomes by Health Surveillance Assistants in Malawi: A Cluster Randomized Trial

PubMed Central

Joos, Olga; Silva, Romesh; Amouzou, Agbessi; Moulton, Lawrence H.; Perin, Jamie; Bryce, Jennifer; Mullany, Luke C.

2016-01-01

Background While community health workers are being recognized as an integral work force with growing responsibilities, increased demands can potentially affect motivation and performance. The ubiquity of mobile phones, even in hard-to-reach communities, has facilitated the pursuit of novel approaches to support community health workers beyond traditional modes of supervision, job aids, in-service training, and material compensation. We tested whether supportive short message services (SMS) could improve reporting of pregnancies and pregnancy outcomes among community health workers (Health Surveillance Assistants, or HSAs) in Malawi. Methods and Findings We designed a set of one-way SMS that were sent to HSAs on a regular basis during a 12-month period. We tested the effectiveness of the cluster-randomized intervention in improving the complete documentation of a pregnancy. We defined complete documentation as a pregnancy for which a specific outcome was recorded. HSAs in the treatment group received motivational and data quality SMS. HSAs in the control group received only motivational SMS. During baseline and intervention periods, we matched reported pregnancies to reported outcomes to determine if reporting of matched pregnancies differed between groups and by period. The trial is registered as ISCTRN24785657. Conclusions Study results show that the mHealth intervention improved the documentation of matched pregnancies in both the treatment (OR 1.31, 95% CI: 1.10–1.55, p<0.01) and control (OR 1.46, 95% CI: 1.11–1.91, p = 0.01) groups relative to the baseline period, despite differences in SMS content between groups. The results should be interpreted with caution given that the study was underpowered. We did not find a statistically significant difference in matched pregnancy documentation between groups during the intervention period (OR 0.94, 95% CI: 0.63–1.38, p = 0.74). mHealth applications have the potential to improve the tracking and data quality of pregnancies and pregnancy outcomes, particularly in low-resource settings. PMID:26731401

[Control of the legal practice of euthanasia in Belgium].

PubMed

Englert, M

2015-01-01

The Belgian law legalizing euthanasia under strict conditions came into effect September 22, 2002. Any physician performing euthanasia has to complete a registration document and to send it within four days to a federal commission whose mission is to verify that the legal conditions were fulfilled. From September 22, 2002 to December 31, 2013, 8.767 documents have been registered and analyzed by this commission. They are described in six reports referred to Parliament. The present paper analyzes the work of this commission and answers the criticisms concerning its quality and its efficiency. The allegations that clandestine euthanasia's escaping any control are performed are also discussed. In conclusion, it appears that the legal obligations concerning the practice of euthanasia in Belgium are fully effective.

Quality-assurance and data management plan for groundwater activities by the U.S. Geological Survey in Kansas, 2014

USGS Publications Warehouse

Putnam, James E.; Hansen, Cristi V.

2014-01-01

As the Nation’s principle earth-science information agency, the U.S. Geological Survey (USGS) is depended on to collect data of the highest quality. This document is a quality-assurance plan for groundwater activities (GWQAP) of the Kansas Water Science Center. The purpose of this GWQAP is to establish a minimum set of guidelines and practices to be used by the Kansas Water Science Center to ensure quality in groundwater activities. Included within these practices are the assignment of responsibilities for implementing quality-assurance activities in the Kansas Water Science Center and establishment of review procedures needed to ensure the technical quality and reliability of the groundwater products. In addition, this GWQAP is intended to complement quality-assurance plans for surface-water and water-quality activities and similar plans for the Kansas Water Science Center and general project activities throughout the USGS. This document provides the framework for collecting, analyzing, and reporting groundwater data that are quality assured and quality controlled. This GWQAP presents policies directing the collection, processing, analysis, storage, review, and publication of groundwater data. In addition, policies related to organizational responsibilities, training, project planning, and safety are presented. These policies and practices pertain to all groundwater activities conducted by the Kansas Water Science Center, including data-collection programs, interpretive and research projects. This report also includes the data management plan that describes the progression of data management from data collection to archiving and publication.

Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

PubMed Central

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-01-01

Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior. PMID:24762343

Development of evidence-based health policy documents in developing countries: a case of Iran.

PubMed

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-02-07

Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

Topographic and hydrographic survey data for the São Francisco River near Torrinha, Bahia, Brazil, 2014

USGS Publications Warehouse

Fosness, Ryan L.; Dietsch, Benjamin J.

2015-10-21

This report presents the surveying techniques and data-processing methods used to collect, process, and disseminate topographic and hydrographic data. All standard and non‑standard data-collection methods, techniques, and data process methods were documented. Additional discussion describes the quality-assurance and quality-control elements used in this study, along with the limitations for the Torrinha-Itacoatiara study reach data. The topographic and hydrographic geospatial data are published along with associated metadata.

Development of New Immunogens and a Controlled Release Delivery System for Oral Immunization Against Staphylococcal Enterotoxin B

DTIC Science & Technology

1991-12-06

DSN 343-7322. N fjGARX\\R. GILBERT COL, MS Deputy Chief of Staff for Information Management REPRODUCTION QUALITY NOTICE This document is the best quality...1976. 35. Ogre, P.L.: Karzon, D.T. Distribution of poliovirus antibody in serum, nasopharymrt and alimentary tract folloving segmental limunization...sysemst, In.- Hisholl, DAI. ; Advances in human fertility and reproductive endocrinology. NWe York, Raven Press Books. Ltd; Vol. 2. 1963: 175-199. 52. Tic

Computational strategy for the solution of large strain nonlinear problems using the Wilkins explicit finite-difference approach

NASA Technical Reports Server (NTRS)

Hofmann, R.

1980-01-01

The STEALTH code system, which solves large strain, nonlinear continuum mechanics problems, was rigorously structured in both overall design and programming standards. The design is based on the theoretical elements of analysis while the programming standards attempt to establish a parallelism between physical theory, programming structure, and documentation. These features have made it easy to maintain, modify, and transport the codes. It has also guaranteed users a high level of quality control and quality assurance.

User-friendly solutions for microarray quality control and pre-processing on ArrayAnalysis.org

PubMed Central

Eijssen, Lars M. T.; Jaillard, Magali; Adriaens, Michiel E.; Gaj, Stan; de Groot, Philip J.; Müller, Michael; Evelo, Chris T.

2013-01-01

Quality control (QC) is crucial for any scientific method producing data. Applying adequate QC introduces new challenges in the genomics field where large amounts of data are produced with complex technologies. For DNA microarrays, specific algorithms for QC and pre-processing including normalization have been developed by the scientific community, especially for expression chips of the Affymetrix platform. Many of these have been implemented in the statistical scripting language R and are available from the Bioconductor repository. However, application is hampered by lack of integrative tools that can be used by users of any experience level. To fill this gap, we developed a freely available tool for QC and pre-processing of Affymetrix gene expression results, extending, integrating and harmonizing functionality of Bioconductor packages. The tool can be easily accessed through a wizard-like web portal at http://www.arrayanalysis.org or downloaded for local use in R. The portal provides extensive documentation, including user guides, interpretation help with real output illustrations and detailed technical documentation. It assists newcomers to the field in performing state-of-the-art QC and pre-processing while offering data analysts an integral open-source package. Providing the scientific community with this easily accessible tool will allow improving data quality and reuse and adoption of standards. PMID:23620278

Using Inspections to Improve the Quality of Product Documentation and Code.

ERIC Educational Resources Information Center

Zuchero, John

1995-01-01

Describes how, by adapting software inspections to assess documentation and code, technical writers can collaborate with development personnel, editors, and customers to dramatically improve both the quality of documentation and the very process of inspecting that documentation. Notes that the five steps involved in the inspection process are:…

Controlled electrostatic methodology for imaging indentations in documents.

PubMed

Yaraskavitch, Luke; Graydon, Matthew; Tanaka, Tobin; Ng, Lay-Keow

2008-05-20

The electrostatic process for imaging indentations on documents using the ESDA device is investigated under controlled experimental settings. An in-house modified commercial xerographic developer housing is used to control the uniformity and volume of toner deposition, allowing for reproducible image development. Along with this novel development tool, an electrostatic voltmeter and fixed environmental conditions facilitate an optimization process. Sample documents are preconditioned in a humidity cabinet with microprocessor control, and the significant benefit of humidification above 70% RH on image quality is verified. Improving on the subjective methods of previous studies, image quality analysis is carried out in an objective and reproducible manner using the PIAS-II. For the seven commercial paper types tested, the optimum ESDA operating point is found to be at an electric potential near -400V at the Mylar surface; however, for most paper types, the optimum operating regime is found to be quite broad, spanning relatively small electric potentials between -200 and -550V. At -400V, the film right above an indented area generally carries a voltage which is 30-50V less negative than the non-indented background. In contrast with Seward's findings [G.H. Seward, Model for electrostatic imaging of forensic evidence via discharge through Mylar-paper path, J. Appl. Phys. 83 (3) (1998) 1450-1456; G.H. Seward, Practical implications of the charge transport model for electrostatic detection apparatus (ESDA), J. Forensic Sci. 44 (4) (1999) 832-836], a period of charge decay before image development is not required when operating in this optimal regime. A brief investigation of the role played by paper-to-paper friction during the indentation process is conducted using our optimized development method.

ISO 9000 and/or Systems Engineering Capability Maturity Model?

NASA Technical Reports Server (NTRS)

Gholston, Sampson E.

2002-01-01

For businesses and organizations to remain competitive today they must have processes and systems in place that will allow them to first identify customer needs and then develop products/processes that will meet or exceed the customers needs and expectations. Customer needs, once identified, are normally stated as requirements. Designers can then develop products/processes that will meet these requirements. Several functions, such as quality management and systems engineering management are used to assist product development teams in the development process. Both functions exist in all organizations and both have a similar objective, which is to ensure that developed processes will meet customer requirements. Are efforts in these organizations being duplicated? Are both functions needed by organizations? What are the similarities and differences between the functions listed above? ISO 9000 is an international standard of goods and services. It sets broad requirements for the assurance of quality and for management's involvement. It requires organizations to document the processes and to follow these documented processes. ISO 9000 gives customers assurance that the suppliers have control of the process for product development. Systems engineering can broadly be defined as a discipline that seeks to ensure that all requirements for a system are satisfied throughout the life of the system by preserving their interrelationship. The key activities of systems engineering include requirements analysis, functional analysis/allocation, design synthesis and verification, and system analysis and control. The systems engineering process, when followed properly, will lead to higher quality products, lower cost products, and shorter development cycles. The System Engineering Capability Maturity Model (SE-CMM) will allow companies to measure their system engineering capability and continuously improve those capabilities. ISO 9000 and SE-CMM seem to have a similar objective, which is to document the organization's processes and certify to potential customers the capability of a supplier to control the processes that determine the quality of the product or services being produced. The remaining sections of this report examine the differences and similarities between ISO 9000 and SE-CMM and make recommendations for implementation.

Saturn S-2 quality assurance techniques, critical process control. Volume 7: Metallic materials

NASA Technical Reports Server (NTRS)

Ross, W. D., Jr.

1970-01-01

The special skills developed during the Saturn S-2 Program are documented to enable qualified personnel to carry out efficient operations in future S-2 production. Skills covered include: acceptance testing of fusion-welding equipment, weld operators and inspector certification, machine certification, preweld operations, and repair weld certification.

Inorganic Analyses in Water Quality Control Programs. Training Manual.

ERIC Educational Resources Information Center

Office of Water Program Operations (EPA), Cincinnati, OH. National Training and Operational Technology Center.

This document is a lecture/laboratory manual dealing with the analysis of selected inorganic pollutants. The manual is an instructional aid for classroom presentations to those with little or no experience in the field, but having one year (or equivalent) of college level inorganic chemistry and having basic laboratory skills. Topics include:…

78 FR 38872 - Approval and Promulgation of Air Quality Implementation Plans; Idaho Amalgamated Sugar Company...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... form of encryption, and be free of any defects or viruses. Docket: All documents in the electronic... hard copy form. Publicly available docket materials are available either electronically in www... determination for TASCO's fossil fuel-fired Riley Boiler. This alternative control measure is also referred to...

Organic Analyses in Water Quality Control Programs. Training Manual.

ERIC Educational Resources Information Center

Office of Water Program Operations (EPA), Cincinnati, OH. National Training and Operational Technology Center.

This document is a lecture/laboratory manual dealing with the analysis of selected organic pollutants. It is intended for use by those having little or no experience in the field, but having one year (or equivalent) of college organic chemistry, and having basic laboratory skills (volumetric glassware, titration, analytical and trip balances).…

Attaining Visual Literacy Using Simplified Graphics in Industry.

ERIC Educational Resources Information Center

Burton, Terry

In the current milieu of ISO 9000 certification, just-in-time engineering (JIT), demand flow technology (DFT), and total quality management (TQM), industry is attempting to implement available technology for the creation, control, and delivery of documentation. In most cases, their efforts are in need of outside resources to analyze, develop,…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (SOPS) (UA-G-1.0)

EPA Science Inventory

The purpose of this SOP is to establish a uniform format for the preparation of SOPs. Use of these protocols ensures consistent implementation of project tasks, documents the preparation and implementation of the procedures used, describes quality control measures and the limits...

Surface electrical properties experiment study phase, volume 3

NASA Technical Reports Server (NTRS)

1973-01-01

The reliability and quality assurance system and procedures used in developing test equipment for the Lunar Experiment projects are described. The subjects discussed include the following: (1) documentation control, (2) design review, (3) parts and materials selection, (4) material procurement, (5) inspection procedures, (6) qualification and special testing, and failure modes and effects analysis.

An analysis of a candidate control algorithm for a ride quality augmentation system

NASA Technical Reports Server (NTRS)

Suikat, Reiner; Donaldson, Kent; Downing, David R.

1987-01-01

This paper presents a detailed analysis of a candidate algorithm for a ride quality augmentation system. The algorithm consists of a full-state feedback control law based on optimal control output weighting, estimators for angle of attack and sideslip, and a maneuvering algorithm. The control law is shown to perform well by both frequency and time domain analysis. The rms vertical acceleration is reduced by about 40 percent over the whole mission flight envelope. The estimators for the angle of attack and sideslip avoid the often inaccurate or costly direct measurement of those angles. The maneuvering algorithm will allow the augmented airplane to respond to pilot inputs. The design characteristics and performance are documented by the closed-loop eigenvalues; rms levels of vertical, lateral, and longitudinal acceleration; and representative time histories and frequency response.

Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.

PubMed

Newman, Eric D; Lerch, Virginia; Billet, Jon; Berger, Andrea; Kirchner, H Lester

2015-04-01

Electronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software. The software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatology-related demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception. Over 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P = 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted. We describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated. Copyright © 2015 by the American College of Rheumatology.

Optimal molecular profiling of tissue and tissue components: defining the best processing and microdissection methods for biomedical applications.

PubMed

Bova, G Steven; Eltoum, Isam A; Kiernan, John A; Siegal, Gene P; Frost, Andra R; Best, Carolyn J M; Gillespie, John W; Emmert-Buck, Michael R

2005-01-01

Isolation of well-preserved pure cell populations is a prerequisite for sound studies of the molecular basis of pancreatic malignancy and other biological phenomena. This chapter reviews current methods for obtaining anatomically specific signals from molecules isolated from tissues, a basic requirement for productive linking of phenotype and genotype. The quality of samples isolated from tissue and used for molecular analysis is often glossed-over or omitted from publications, making interpretation and replication of data difficult or impossible. Fortunately, recently developed techniques allow life scientists to better document and control the quality of samples used for a given assay, creating a foundation for improvement in this area. Tissue processing for molecular studies usually involves some or all of the following steps: tissue collection, gross dissection/identification, fixation, processing/embedding, storage/archiving, sectioning, staining, microdissection/annotation, and pure analyte labeling/identification. High-quality tissue microdissection does not necessarily mean high-quality samples to analyze. The quality of biomaterials obtained for analysis is highly dependent on steps upstream and downstream from tissue microdissection. We provide protocols for each of these steps, and encourage you to improve upon these. It is worth the effort of every laboratory to optimize and document its technique at each stage of the process, and we provide a starting point for those willing to spend the time to optimize. In our view, poor documentation of tissue and cell type of origin and the use of nonoptimized protocols is a source of inefficiency in current life science research. Even incremental improvement in this area will increase productivity significantly.

Gap Analysis for Chinese Drug Control Institutes to Achieve the Standards of World Health Organization Medicine Prequalification.

PubMed

Mao, Xin; Yang, Yue

2017-02-01

The study aims to explore the challenges and the gaps faced by Chinese Drug Control Institutes in achieving the standards of World Health Organization (WHO) Medicine Prequalification. The study was undertaken with 6 Provincial Drug Control Institutes in China from November 2012 to November 2013. The study assessed key elements required to comply with WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL). For GPPQCL, the study found gaps in quality management system, control of documentation, data-processing equipment, premises and equipment, contracts, reagents (water), reference substances and reference materials, calibration, verification of performance and qualification of equipment, instruments and other devices, analytical worksheet, evaluation of test results, personnel, and validation of analytical procedures. The study indicates that gaps are attributed to differences between the standards of Chinese Accreditation Standards and WHO-GPPQCL. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Position paper: recommendations for a digital mammography quality assurance program V4.0.

PubMed

Heggie, J C P; Barnes, P; Cartwright, L; Diffey, J; Tse, J; Herley, J; McLean, I D; Thomson, F J; Grewal, R K; Collins, L T

2017-09-01

In 2001 the ACPSEM published a position paper on quality assurance in screen film mammography which was subsequently adopted as a basis for the quality assurance programs of both the Royal Australian and New Zealand College of Radiologists (RANZCR) and of BreastScreen Australia. Since then the clinical implementation of digital mammography has been realised and it has become evident that existing screen-film protocols were not appropriate to assure the required image quality needed for reliable diagnosis or to address the new dose implications resulting from digital technology. In addition, the advantages and responsibilities inherent in teleradiology are most critical in mammography and also need to be addressed. The current document is the result of a review of current overseas practice and local experience in these areas. At this time the technology of digital imaging is undergoing significant development and there is still a lack of full international consensus about some of the detailed quality control (QC) tests that should be included in quality assurance (QA) programs. This document describes the current status in digital mammography QA and recommends test procedures that may be suitable in the Australasian environment. For completeness, this document also includes a review of the QA programs required for the various types of digital biopsy units used in mammography. In the future, international harmonisation of digital quality assurance in mammography and changes in the technology may require a review of this document. Version 2.0 represented the first of these updates and key changes related to image quality evaluation, ghost image evaluation and interpretation of signal to noise ratio measurements. In Version 3.0 some significant changes, made in light of further experience gained in testing digital mammography equipment were introduced. In Version 4.0, further changes have been made, most notably digital breast tomosynthesis (DBT) testing and QC have been addressed. Some additional testing for conventional projection imaging has been added in order that sites may have the capability to undertake dose surveys to confirm compliance with diagnostic reference levels (DRLs) that may be established at the National or State level. A key recommendation is that dosimetry calculations are now to be undertaken using the methodology of Dance et al. Some minor changes to existing facility QC tests have been made to ensure the suggested procedures align with those most recently adopted by the Royal Australian and New Zealand College of Radiologists and BreastScreen Australia. Future updates of this document may be provided as deemed necessary in electronic format on the ACPSEM's website ( https://www.acpsem.org.au/whatacpsemdoes/standards-position-papers and see also http://www.ranzcr.edu.au/quality-a-safety/radiology/practice-quality-activities/mqap ).

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.

Rubber stamp templates for improving clinical documentation: A paper-based, m-Health approach for quality improvement in low-resource settings.

PubMed

Kleczka, Bernadette; Musiega, Anita; Rabut, Grace; Wekesa, Phoebe; Mwaniki, Paul; Marx, Michael; Kumar, Pratap

2018-06-01

The United Nations' Sustainable Development Goal #3.8 targets 'access to quality essential healthcare services'. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use of guidelines relies on cumbersome clinical audits of paper records, and electronic systems face financial and other limitations. Here we describe a unique approach to generating digital data from paper using guideline-based templates, rubber stamps and mobile phones. The Guidelines Adherence in Slums Project targeted ten private sector primary healthcare clinics serving informal settlements in Nairobi, Kenya. Each clinic was provided with rubber stamp templates to support documentation and management of commonly encountered outpatient conditions. Participatory design methods were used to customize templates to the workflows and infrastructure of each clinic. Rubber stamps were used to print templates into paper charts, providing clinicians with checklists for use during consultations. Templates used bubble format data entry, which could be digitized from images taken on mobile phones. Besides rubber stamp templates, the intervention included booklets of guideline compilations, one Android phone for digitizing images of templates, and one data feedback/continuing medical education session per clinic each month. In this paper we focus on the effect of the intervention on documentation of three non-communicable diseases in one clinic. Seventy charts of patients enrolled in the chronic disease program (hypertension/diabetes, n=867; chronic respiratory diseases, n=223) at one of the ten intervention clinics were sampled. Documentation of each individual patient encounter in the pre-intervention (January-March 2016) and post-intervention period (May-July) was scored for information in four dimensions - general data, patient assessment, testing, and management. Control criteria included information with no counterparts in templates (e.g. notes on presenting complaints, vital signs). Documentation scores for each patient were compared between both pre- and post-intervention periods and between encounters documented with and without templates (post-intervention only). The total number of patient encounters in the pre-intervention (282) and post-intervention periods (264) did not differ. Mean documentation scores increased significantly in the post-intervention period on average by 21%, 24% and 17% for hypertension, diabetes and chronic respiratory diseases, respectively. Differences were greater (47%, 43% and 27%, respectively) when documentation with and without templates was compared. Changes between pre- vs.post-intervention, and with vs.without template, varied between individual dimensions of documentation. Overall, documentation improved more for general data and patient assessment than in testing or management. The use of templates improves paper-based documentation of patient care, a first step towards improving the quality of care. Rubber stamps provide a simple and low-cost method to print templates on demand. In combination with ubiquitously available mobile phones, information entered on paper can be easily and rapidly digitized. This 'frugal innovation' in m-Health can empower small, private sector facilities, where large numbers of urban patients seek healthcare, to generate digital data on routine outpatient care. These data can form the basis for evidence-based quality improvement efforts at large scale, and help deliver on the SDG promise of quality essential healthcare services for all. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of image quality of digital photo documentation of female genital injuries following sexual assault.

PubMed

Ernst, E J; Speck, Patricia M; Fitzpatrick, Joyce J

2011-12-01

With the patient's consent, physical injuries sustained in a sexual assault are evaluated and treated by the sexual assault nurse examiner (SANE) and documented on preprinted traumagrams and with photographs. Digital imaging is now available to the SANE for documentation of sexual assault injuries, but studies of the image quality of forensic digital imaging of female genital injuries after sexual assault were not found in the literature. The Photo Documentation Image Quality Scoring System (PDIQSS) was developed to rate the image quality of digital photo documentation of female genital injuries after sexual assault. Three expert observers performed evaluations on 30 separate images at two points in time. An image quality score, the sum of eight integral technical and anatomical attributes on the PDIQSS, was obtained for each image. Individual image quality ratings, defined by rating image quality for each of the data, were also determined. The results demonstrated a high level of image quality and agreement when measured in all dimensions. For the SANE in clinical practice, the results of this study indicate that a high degree of agreement exists between expert observers when using the PDIQSS to rate image quality of individual digital photographs of female genital injuries after sexual assault. © 2011 International Association of Forensic Nurses.

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.

EPA Guidance for Geospatially Related Quality Assurance Project Plans

EPA Pesticide Factsheets

This March 2003 document discusses EPA's Quality Assurance (QA) Project Plan as a tool for project managers and planners to document the type and quality of data and information needed for making environmental decisions

Associations between chronotype, sleep quality, suicidality, and depressive symptoms in patients with major depression and healthy controls.

PubMed

Selvi, Yavuz; Aydin, Adem; Boysan, Murat; Atli, Abdullah; Agargun, Mehmed Yucel; Besiroglu, Lutfullah

2010-10-01

Research interest concerning associations between sleep characteristics and suicidality in psychopathology has been growing. However, possible linkages of suicidality to sleep characteristics in terms of sleep quality and chronotypes among depressive patients have not been well documented. In the current study, the authors investigated the possible effects of sleep quality and chronotype on the severity of depressive symptoms and suicide risk in patients with depressive disorder and healthy controls. The study was conducted on 80 patients clinically diagnosed with major depression and 80 healthy subjects who were demographically matched with the patient group. All participants completed a questionnaire package containing self-report measures, including the Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), and Suicide Ideation Scale (SIS), and subjects were interviewed with the suicidality section of the Mini-International Neuropsychiatric Interview (MINI). Results are as follows: (a) logistic regression analyses revealed that poor sleep quality and depression symptom severity significantly predicted onset of major depression; (b) morningness-type circadian rhythm may play as a significant relief factor after onset of major depression; (c) sleep variables of chronotype and sleep quality did not significantly predict suicide ideation after controlling for depressive symptoms in the major depression group; and (d) suicide ideation and poor sleep quality were antecedents of depression symptom severity in patients with major depression, and in healthy controls. Findings are discussed under the theoretical assumptions concerning possible relations between chronotype, sleep quality, depression, and suicidality.

Piloted simulation study of two tilt-wing flap control concepts, phase 2

NASA Technical Reports Server (NTRS)

Birckelbaw, Lourdes G.; Corliss, Lloyd D.; Hindson, William S.; Churchill, Gary B.

1994-01-01

A two phase piloted simulation study has been conducted in the Ames Vertical Motion Simulator to investigate alternative wing and flap controls for tilt-wing aircraft. This report documents the flying qualities results and findings of the second phase of the piloted simulation study and describes the simulated tilt-wing aircraft, the flap control concepts, the experiment design and the evaluation tasks. The initial phase of the study compared the flying qualities of both a conventional programmed flap and an innovative geared flap. The second phase of the study introduced an alternate method of pilot control for the geared flap and further studied the flying qualities of the programmed flap and two geared flap configurations. In general, the pilot ratings showed little variation between the programmed flap and the geared flap control concepts. Some differences between the two control concepts were noticed and are discussed in this report. The geared flap configurations had very similar results. Although the geared flap concept has the potential to reduce or eliminate the pitch control power requirements from a tail rotor or a tail thruster at low speeds and in hover, the results did not show reduced tail thruster pitch control power usage with the geared flap configurations compared to the programmed flap configuration. The addition of pitch attitude stabilization in the second phase of simulation study greatly enhanced the aircraft flying qualities compared to the first phase.

[Multimodal document management in radiotherapy].

PubMed

Fahrner, H; Kirrmann, S; Röhner, F; Schmucker, M; Hall, M; Heinemann, F

2013-12-01

After incorporating treatment planning and the organisational model of treatment planning in the operating schedule system (BAS, "Betriebsablaufsystem"), complete document qualities were embedded in the digital environment. The aim of this project was to integrate all documents independent of their source (paper-bound or digital) and to make content from the BAS available in a structured manner. As many workflow steps as possible should be automated, e.g. assigning a document to a patient in the BAS. Additionally it must be guaranteed that at all times it could be traced who, when, how and from which source documents were imported into the departmental system. Furthermore work procedures should be changed that the documentation conducted either directly in the departmental system or from external systems can be incorporated digitally and paper document can be completely avoided (e.g. documents such as treatment certificate, treatment plans or documentation). It was a further aim, if possible, to automate the removal of paper documents from the departmental work flow, or even to make such paper documents superfluous. In this way patient letters for follow-up appointments should automatically generated from the BAS. Similarly patient record extracts in the form of PDF files should be enabled, e.g. for controlling purposes. The available document qualities were analysed in detail by a multidisciplinary working group (BAS-AG) and after this examination and assessment of the possibility of modelling in our departmental workflow (BAS) they were transcribed into a flow diagram. The gathered specifications were implemented in a test environment by the clinical and administrative IT group of the department of radiation oncology and subsequent to a detailed analysis introduced into clinical routine. The department has succeeded under the conditions of the aforementioned criteria to embed all relevant documents in the departmental workflow via continuous processes. Since the completion of the concepts and the implementation in our test environment 15,000 documents were introduced into the departmental workflow following routine approval. Furthermore approximately 5000 appointment letters for patient aftercare per year were automatically generated by the BAS. In addition patient record extracts in the form of PDF files for the medical services of the healthcare insurer can be generated.

AIR QUALITY CRITERIA DOCUMENT(S) FOR LEAD

EPA Science Inventory

This collection of documents intend to assess the latest scientific information on the health and environmental fate and effects of lead to provide scientific bases for periodic review and possible revision of the National Ambient Air Quality Standards (NAAQS) for lead.

The role of field auditing in environmental quality assurance management.

PubMed

Claycomb, D R

2000-01-01

Environmental data quality improvement continues to focus on analytical laboratoryperformance with little, if any, attention given to improving the performance of field consultants responsible for sample collection. Many environmental professionals often assume that the primary opportunity for data error lies within the activities conducted by the laboratory. Experience in the evaluation of environmental data and project-wide quality assurance programs indicates that an often-ignored factor affecting environmental data quality is the manner in which a sample is acquired and handled in the field. If a sample is not properly collected, preserved, stored, and transported in the field, even the best laboratory practices and analytical methods cannot deliver accurate and reliable data (i.e., bad data in equals bad data out). Poor quality environmental data may result in inappropriate decisions regarding site characterization and remedial action. Field auditing is becoming an often-employed technique for examining the performance of the environmental sampling field team and how their performance may affect data quality. The field audits typically focus on: (1) verifying that field consultants adhere to project control documents (e.g., Work Plans and Standard Operating Procedures [SOPs]) during field operations; (2) providing third-party independent assurance that field procedures, quality assurance/ quality control (QA/QC)protocol, and field documentation are sufficient to produce data of satisfactory quality; (3) providing a defense in the event that field procedures are called into question; and (4) identifying ways to reduce sampling costs. Field audits are typically most effective when performed on a surprise basis; that is, the sampling contractor may be aware that a field audit will be conducted during some phase of sampling activities but is not informed of the specific day(s) that the audit will be conducted. The audit also should be conducted early on in the sampling program such that deficiencies noted during the audit can be addressed before the majority of field activities have been completed. A second audit should be performed as a follow-up to confirm that the recommended changes have been implemented. A field auditor is assigned to the project by matching, as closely as possible, the auditor's experience with the type of field activities being conducted. The auditor uses a project-specific field audit checklist developed from key information contained in project control documents. Completion of the extensive audit checklist during the audit focuses the auditor on evaluating each aspect of field activities being performed. Rather than examine field team performance after sampling, a field auditor can do so while the samples are being collected and can apply real-time corrective action as appropriate. As a result of field audits, responsible parties often observe vast improvements in their consultant's field procedures and, consequently, receive more reliable and representative field data at a lower cost. The cost savings and improved data quality that result from properly completed field audits make the field auditing process both cost-effective and functional.

FDA 2011 process validation guidance: lifecycle compliance model.

PubMed

Campbell, Cliff

2014-01-01

This article has been written as a contribution to the industry's efforts in migrating from a document-driven to a data-driven compliance mindset. A combination of target product profile, control engineering, and general sum principle techniques is presented as the basis of a simple but scalable lifecycle compliance model in support of modernized process validation. Unit operations and significant variables occupy pole position within the model, documentation requirements being treated as a derivative or consequence of the modeling process. The quality system is repositioned as a subordinate of system quality, this being defined as the integral of related "system qualities". The article represents a structured interpretation of the U.S. Food and Drug Administration's 2011 Guidance for Industry on Process Validation and is based on the author's educational background and his manufacturing/consulting experience in the validation field. The U.S. Food and Drug Administration's Guidance for Industry on Process Validation (2011) provides a wide-ranging and rigorous outline of compliant drug manufacturing requirements relative to its 20(th) century predecessor (1987). Its declared focus is patient safety, and it identifies three inter-related (and obvious) stages of the compliance lifecycle. Firstly, processes must be designed, both from a technical and quality perspective. Secondly, processes must be qualified, providing evidence that the manufacturing facility is fully "roadworthy" and fit for its intended purpose. Thirdly, processes must be verified, meaning that commercial batches must be monitored to ensure that processes remain in a state of control throughout their lifetime.

Piloting Vertical Flight Aircraft: A Conference on Flying Qualities and Human Factors

NASA Technical Reports Server (NTRS)

Blanken, Christopher L. (Editor); Whalley, Matthew S. (Editor)

1993-01-01

This document contains papers from a specialists' meeting entitled 'Piloting Vertical Flight Aircraft: A Conference on Flying Qualities and Human Factors.' Vertical flight aircraft, including helicopters and a variety of Vertical Takeoff and Landing (VTOL) concepts, place unique requirements on human perception, control, and performance for the conduct of their design missions. The intent of this conference was to examine, for these vehicles, advances in: (1) design of flight control systems for ADS-33C standards; (2) assessment of human factors influences of cockpit displays and operational procedures; (3) development of VTOL design and operational criteria; and (4) development of theoretical methods or models for predicting pilot/vehicle performance and mission suitability. A secondary goal of the conference was to provide an initial venue for enhanced interaction between human factors and handling qualities specialists.

Investigation of Control System and Display Variations on Spacecraft Handling Qualities for Docking with Stationary and Rotating Targets

NASA Technical Reports Server (NTRS)

Jackson, E. Bruce; Goodrich, Kenneth H.; Bailey, Randall E.; Barnes, James R.; Ragsdale, William A.; Neuhaus, Jason R.

2010-01-01

This paper documents the investigation into the manual docking of a preliminary version of the Crew Exploration Vehicle with stationary and rotating targets in Low Earth Orbit. The investigation was conducted at NASA Langley Research Center in the summer of 2008 in a repurposed fixed-base transport aircraft cockpit and involved nine evaluation astronauts and research pilots. The investigation quantified the benefits of a feed-forward reaction control system thruster mixing scheme to reduce translation-into-rotation coupling, despite unmodeled variations in individual thruster force levels and off-axis center of mass locations up to 12 inches. A reduced rate dead-band in the phase-plane attitude controller also showed some promise. Candidate predictive symbology overlaid on a docking ring centerline camera image did not improve handling qualities, but an innovative attitude status indicator symbol was beneficial. The investigation also showed high workload and handling quality problems when manual dockings were performed with a rotating target. These concerns indicate achieving satisfactory handling quality ratings with a vehicle configuration similar to the nominal Crew Exploration Vehicle may require additional automation.

Metrology: Measurement Assurance Program Guidelines

NASA Technical Reports Server (NTRS)

Eicke, W. G.; Riley, J. P.; Riley, K. J.

1995-01-01

The 5300.4 series of NASA Handbooks for Reliability and Quality Assurance Programs have provisions for the establishment and utilization of a documented metrology system to control measurement processes and to provide objective evidence of quality conformance. The intent of these provisions is to assure consistency and conformance to specifications and tolerances of equipment, systems, materials, and processes procured and/or used by NASA, its international partners, contractors, subcontractors, and suppliers. This Measurement Assurance Program (MAP) guideline has the specific objectives to: (1) ensure the quality of measurements made within NASA programs; (2) establish realistic measurement process uncertainties; (3) maintain continuous control over the measurement processes; and (4) ensure measurement compatibility among NASA facilities. The publication addresses MAP methods as applied within and among NASA installations and serves as a guide to: control measurement processes at the local level (one facility); conduct measurement assurance programs in which a number of field installations are joint participants; and conduct measurement integrity (round robin) experiments in which a number of field installations participate to assess the overall quality of particular measurement processes at a point in time.

Quality and correlates of medical record documentation in the ambulatory care setting

PubMed Central

Soto, Carlos M; Kleinman, Kenneth P; Simon, Steven R

2002-01-01

Background Documentation in the medical record facilitates the diagnosis and treatment of patients. Few studies have assessed the quality of outpatient medical record documentation, and to the authors' knowledge, none has conclusively determined the correlates of chart documentation. We therefore undertook the present study to measure the rates of documentation of quality of care measures in an outpatient primary care practice setting that utilizes an electronic medical record. Methods We reviewed electronic medical records from 834 patients receiving care from 167 physicians (117 internists and 50 pediatricians) at 14 sites of a multi-specialty medical group in Massachusetts. We abstracted information for five measures of medical record documentation quality: smoking history, medications, drug allergies, compliance with screening guidelines, and immunizations. From other sources we determined physicians' specialty, gender, year of medical school graduation, and self-reported time spent teaching and in patient care. Results Among internists, unadjusted rates of documentation were 96.2% for immunizations, 91.6% for medications, 88% for compliance with screening guidelines, 61.6% for drug allergies, 37.8% for smoking history. Among pediatricians, rates were 100% for immunizations, 84.8% for medications, 90.8% for compliance with screening guidelines, 50.4% for drug allergies, and 20.4% for smoking history. While certain physician and patient characteristics correlated with some measures of documentation quality, documentation varied depending on the measure. For example, female internists were more likely than male internists to document smoking history (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.27 – 2.83) but were less likely to document drug allergies (OR, 0.51; 95% CI, 0.35 – 0.75). Conclusions Medical record documentation varied depending on the measure, with room for improvement in most domains. A variety of characteristics correlated with medical record documentation, but no pattern emerged. Further study could lead to targeted interventions to improve documentation. PMID:12473161

Development of An Intelligent Flight Propulsion Control System

NASA Technical Reports Server (NTRS)

Calise, A. J.; Rysdyk, R. T.; Leonhardt, B. K.

1999-01-01

The initial design and demonstration of an Intelligent Flight Propulsion and Control System (IFPCS) is documented. The design is based on the implementation of a nonlinear adaptive flight control architecture. This initial design of the IFPCS enhances flight safety by using propulsion sources to provide redundancy in flight control. The IFPCS enhances the conventional gain scheduled approach in significant ways: (1) The IFPCS provides a back up flight control system that results in consistent responses over a wide range of unanticipated failures. (2) The IFPCS is applicable to a variety of aircraft models without redesign and,(3) significantly reduces the laborious research and design necessary in a gain scheduled approach. The control augmentation is detailed within an approximate Input-Output Linearization setting. The availability of propulsion only provides two control inputs, symmetric and differential thrust. Earlier Propulsion Control Augmentation (PCA) work performed by NASA provided for a trajectory controller with pilot command input of glidepath and heading. This work is aimed at demonstrating the flexibility of the IFPCS in providing consistency in flying qualities under a variety of failure scenarios. This report documents the initial design phase where propulsion only is used. Results confirm that the engine dynamics and associated hard nonlineaaities result in poor handling qualities at best. However, as demonstrated in simulation, the IFPCS is capable of results similar to the gain scheduled designs of the NASA PCA work. The IFPCS design uses crude estimates of aircraft behaviour. The adaptive control architecture demonstrates robust stability and provides robust performance. In this work, robust stability means that all states, errors, and adaptive parameters remain bounded under a wide class of uncertainties and input and output disturbances. Robust performance is measured in the quality of the tracking. The results demonstrate the flexibility of the IFPCS architecture and the ability to provide robust performance under a broad range of uncertainty. Robust stability is proved using Lyapunov like analysis. Future development of the IFPCS will include integration of conventional control surfaces with the use of propulsion augmentation, and utilization of available lift and drag devices, to demonstrate adaptive control capability under a greater variety of failure scenarios. Further work will specifically address the effects of actuator saturation.

Section 3. The SPARROW Surface Water-Quality Model: Theory, Application and User Documentation

USGS Publications Warehouse

Schwarz, G.E.; Hoos, A.B.; Alexander, R.B.; Smith, R.A.

2006-01-01

SPARROW (SPAtially Referenced Regressions On Watershed attributes) is a watershed modeling technique for relating water-quality measurements made at a network of monitoring stations to attributes of the watersheds containing the stations. The core of the model consists of a nonlinear regression equation describing the non-conservative transport of contaminants from point and diffuse sources on land to rivers and through the stream and river network. The model predicts contaminant flux, concentration, and yield in streams and has been used to evaluate alternative hypotheses about the important contaminant sources and watershed properties that control transport over large spatial scales. This report provides documentation for the SPARROW modeling technique and computer software to guide users in constructing and applying basic SPARROW models. The documentation gives details of the SPARROW software, including the input data and installation requirements, and guidance in the specification, calibration, and application of basic SPARROW models, as well as descriptions of the model output and its interpretation. The documentation is intended for both researchers and water-resource managers with interest in using the results of existing models and developing and applying new SPARROW models. The documentation of the model is presented in two parts. Part 1 provides a theoretical and practical introduction to SPARROW modeling techniques, which includes a discussion of the objectives, conceptual attributes, and model infrastructure of SPARROW. Part 1 also includes background on the commonly used model specifications and the methods for estimating and evaluating parameters, evaluating model fit, and generating water-quality predictions and measures of uncertainty. Part 2 provides a user's guide to SPARROW, which includes a discussion of the software architecture and details of the model input requirements and output files, graphs, and maps. The text documentation and computer software are available on the Web at http://usgs.er.gov/sparrow/sparrow-mod/.

"A manager in the minds of doctors:" a comparison of new modes of control in European hospitals.

PubMed

Kuhlmann, Ellen; Burau, Viola; Correia, Tiago; Lewandowski, Roman; Lionis, Christos; Noordegraaf, Mirko; Repullo, Jose

2013-07-02

Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) 'integrated' control with high levels of coordination and coherent patterns for cost and quality controls; (2) 'partly integrated' control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) 'fragmented' control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Our comparison highlights how organisations matter and brings the crucial relevance of 'coordination' of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective.

Air Quality Criteria for Ozone and Related Photochemical Oxidants Volume I of III (Final Report, 1996)

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) promulgates the National Ambient Air Quality Standards (NAAQS) on the basis of scientific information contained in air quality criteria documents. The previous ozone (O3) criteria document, Air Quality Criteria for Ozone and Other Ph...

Understanding human quality judgment in assessing online forum contents for thread retrieval purpose

NASA Astrophysics Data System (ADS)

Ismail, Zuriati; Salim, Naomie; Huspi, Sharin Hazlin

2017-10-01

Compared to traditional materials or journals, user-generated contents are not peer-reviewed. Lack of quality control and the explosive growth of web contents make the task of finding quality information on the web especially critical. The existence of new facilities for producing web contents such as forum makes this issue more significant. This study focuses on online forums threads or discussion, where the forums contain valuable human-generated information in a form of discussions. Due to the unique structure of the online forum pages, special techniques are required to organize and search for information in these forums. Quality biased retrieval is a retrieval approach that search for relevant document and prioritized higher quality documents. Despite major concern of quality content and recent development of quality biased retrieval, there is an urgent need to understand how quality content is being judged, for retrieval and performance evaluation purposes. Furthermore, even though there are various studies on the quality of information, there is no standard framework that has been established. The primary aim of this paper is to contribute to the understanding of human quality judgment in assessing online forum contents. The foundation of this study is to compare and evaluate different frameworks (for quality biased retrieval and information quality). This led to the finding that many quality dimensions are redundant and some dimensions are understood differently between different studies. We conducted a survey on crowdsourcing community to measure the importance of each quality dimensions found in various frameworks. Accuracy and ease of understanding are among top important dimensions while threads popularity and contents manipulability are among least important dimensions. This finding is beneficial in evaluating contents of online forum.

Uas for Archaeology - New Perspectives on Aerial Documentation

NASA Astrophysics Data System (ADS)

Fallavollita, P.; Balsi, M.; Esposito, S.; Melis, M. G.; Milanese, M.; Zappino, L.

2013-08-01

In this work some Unmanned Aerial Systems applications are discussed and applied to archaeological sites survey and 3D model reconstructions. Interesting results are shown for three important and different aged sites on north Sardinia (Italy). An easy and simplified procedure has proposed permitting the adoption of multi-rotor aircrafts for daily archaeological survey during excavation and documentation, involving state of art in UAS design, flight control systems, high definition sensor cameras and innovative photogrammetric software tools. Very high quality 3D models results are shown and discussed and how they have been simplified the archaeologist work and decisions.

Management: A continuing literature survey with indexes, March 1976

NASA Technical Reports Server (NTRS)

1976-01-01

Management is a compilation of references to selected reports, journal articles, and other documents on the subject of management. This publication lists 368 documents originally announced in the 1975 issues of Scientific and Technical Aerospace Reports (STAR) or International Aerospace Abstracts (IAA). It includes references on the management of research and development, contracts, production, logistics, personnel, safety, reliability and quality control. It also includes references on: program, project and systems management; management policy, philosophy, tools, and techniques; decisionmaking processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting.

Trends in liability affecting technical writers

NASA Technical Reports Server (NTRS)

Driskill, L. P.

1981-01-01

Liability of technical writers for defective products is explored. Documents generated during a product's life cycle (including design memos, design tests, clinical trials, trial use reports, letters, and proposals) become relevant because they are likely to become the only available means of showing that the product was not defectively designed. These documents become the evidence that the product underwent balanced and well considered planning, development, testing, quality control, and field testing. The predicted increased involvement of technical writers in the prevention and defense of product liability claims is cited in view of a greater number of cases turning on "failure to warn".

Plan-provider integration, premiums, and quality in the Medicare Advantage market.

PubMed

Frakt, Austin B; Pizer, Steven D; Feldman, Roger

2013-12-01

To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. We used public data from the Centers for Medicare and Medicaid Services (CMS) and the Area Resource File and private data from one large insurer. Premiums and quality ratings are from 2009 CMS administrative files and some control variables are historical. We estimated ordinary least-squares models for premiums and plan quality ratings, with state fixed effects and firm random effects. The key independent variable was an indicator of plan-provider integration. With the exception of Medigap premium data, all data were publicly available. We ascertained plan-provider integration through examination of plans' websites and governance documents. We found that integrated plan-providers charge higher premiums, controlling for quality. Such plans also have higher quality ratings. We found no evidence that integration is associated with more generous benefits. Current policy encourages plan-provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur). © Health Research and Educational Trust.

Improving multiple sclerosis management and collecting safety information in the real world: the MSDS3D software approach.

PubMed

Haase, Rocco; Wunderlich, Maria; Dillenseger, Anja; Kern, Raimar; Akgün, Katja; Ziemssen, Tjalf

2018-04-01

For safety evaluation, randomized controlled trials (RCTs) are not fully able to identify rare adverse events. The richest source of safety data lies in the post-marketing phase. Real-world evidence (RWE) and observational studies are becoming increasingly popular because they reflect usefulness of drugs in real life and have the ability to discover uncommon or rare adverse drug reactions. Areas covered: Adding the documentation of psychological symptoms and other medical disciplines, the necessity for a complex documentation becomes apparent. The collection of high-quality data sets in clinical practice requires the use of special documentation software as the quality of data in RWE studies can be an issue in contrast to the data obtained from RCTs. The MSDS3D software combines documentation of patient data with patient management of patients with multiple sclerosis. Following a continuous development over several treatment-specific modules, we improved and expanded the realization of safety management in MSDS3D with regard to the characteristics of different treatments and populations. Expert opinion: eHealth-enhanced post-authorisation safety study may complete the fundamental quest of RWE for individually improved treatment decisions and balanced therapeutic risk assessment. MSDS3D is carefully designed to contribute to every single objective in this process.

Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization

DTIC Science & Technology

2014-12-01

Executive documented a threat to independence because they provided direction in a nonaudit service (IR End-to-End Assessment of DFAS Texarkana Operations...effect the lack of segregation of duties and system management controls has on the DFAS Texarkana Vendor Pay and Payroll functions.” Based on our...Infrastructure Management, February 10, 2014 Performance CO12PRC010TX Columbus Audit of DFAS Texarkana Vendor Pay and Payroll, November 19, 2013

[Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

2011-12-01

The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews). Copyright © 2011 Elsevier España S.L. All rights reserved.

Development of the Quality of Australian Nursing Documentation in Aged Care (QANDAC) instrument to assess paper-based and electronic resident records.

PubMed

Wang, Ning; Björvell, Catrin; Hailey, David; Yu, Ping

2014-12-01

To develop an Australian nursing documentation in aged care (Quality of Australian Nursing Documentation in Aged Care (QANDAC)) instrument to measure the quality of paper-based and electronic resident records. The instrument was based on the nursing process model and on three attributes of documentation quality identified in a systematic review. The development process involved five phases following approaches to designing criterion-referenced measures. The face and content validities and the inter-rater reliability of the instrument were estimated using a focus group approach and consensus model. The instrument contains 34 questions in three sections: completion of nursing history and assessment, description of care process and meeting the requirements of data entry. Estimates of the validity and inter-rater reliability of the instrument gave satisfactory results. The QANDAC instrument may be a useful audit tool for quality improvement and research in aged care documentation. © 2013 ACOTA.

[The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

PubMed

Men'shikov, V V

2013-08-01

The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

Antiretroviral therapy supply chain quality control and assurance in improving people living with HIV therapeutic outcomes in Cameroon.

PubMed

Djobet, M P Ngogang; Singhe, David; Lohoue, Julienne; Kuaban, Christopher; Ngogang, Jeanne; Tambo, Ernest

2017-04-04

Evaluation of medication efficacy and safety is an essential guarantee to successful therapeutic outcome in public health practices. However, larger distribution chain supply in developing countries such as Cameroon is often challenged by counterfeit drugs, poor manufacturing, storage and degradation leading to health and patient adverse consequences. Yet, access to supply chain management in strengthening ARVs quality assurance and outcomes remains poorly documented. More than 53,000 patients have been enrolled on free ARVs medications, but little is documented on quality assurance and validity of safety for affected populations along the supply chain management since 2008. The cross sectional study was conducted in ARVs distribution units and centers in central, littoral and south west regions of Cameroon. ARVs drugs samples included Nevirapine, Efavirenz, and fixed dose combinations of Zidovudine + Lamivudine, Lamivudine + Stavudine and Zidovudine + Lamivudine + Nevirapine. Drugs packaging and labeling was assessed and galenic assays were performed at National Laboratory of quality Control of Medications and Expertise (LANACOME), Yaoundé, Cameroon. The study covered 16 structures located in eight different towns including the central ARVs store, two regional pharmaceutical procurement centers and thirteen HIV approved treatment centers and management units. A total of 35 ARVs products were collected. Only eight ARVs drugs containing Lamivudine and Stavudine presented with white stains on tablets, however these drugs were standard for all other tests performed. The others 28 ARVs products were standards to all assays performed. We concluded that ARVs drugs freely accessible and distributed to PLWHA are of good quality in Cameroon. However, with the increase number of patients under HAART since 2013, adoption of "Test and Treat" approach to reach the 90-90-90 goals and with the implementation of new national antiretroviral regimen guidelines and molecules such as boosted protease inhibitors, continuous quality control and assurance surveillance, monitoring and evaluation is recommended. Assessment of quality of formulations that are more susceptible to degradation such as pediatric formulations for averting the rising multidrug resistance trend is also desired.

Air Quality Modeling Technical Support Document for the Final Cross State Air Pollution Rule Update

EPA Pesticide Factsheets

In this technical support document (TSD) we describe the air quality modeling performed to support the final Cross State Air Pollution Rule for the 2008 ozone National Ambient Air Quality Standards (NAAQS).

DEMONSTRATION AND QUALITY ASSURANCE PROJECT ...

EPA Pesticide Factsheets

The demonstration of technologies for determining the presence of dioxin in soil and sediment is being conducted under the U.S. Environmental Protection Agency Superfund Innovative Technology Evaluation Program in Saginaw, Michigan, at Green Point Environmental Learning Center from approximately April 26 to May 6, 2004. The primary purpose of the demonstration is to evaluate innovative monitoring technologies. The technologies listed below will be demonstrated. .AhRC PCRTM Kit, Hybrizyme Corporation .Ah-IMMUNOASSY@ Kit, Paralsian, Inc. .Coplanar PCB Immunoassay Kit, Abraxis LLC .DF-l Dioxin/Furan Immunoassay Kit, CAPE Technologies L.L.C. .CALUX@ by Xenobiotic Detection Systems, Inc- .Dioxin ELISA Kit, Wako Pure Chemical Industries LTD. This demonstration plan describes the procedures that will be used to verify the performance and cost of these technologies. The plan incorporates the quality assurance and quality control elements needed to generate data of sufficient quality to document each technology's performance and cost. A separate innovative technology verification report (ITVR) will.be prepared for each technology. The ITVRs will present the demonstration findings associated with the demonstration objectives. The objective of this program is to promote the acceptance and use of innovative field technologies by providing well-documented performance and cost data obtained from field demonstrations.

Institutional and economic influences on quality of nursing documentation.

PubMed

Parker, L E; Wells, K B; Buchanan, J L; Benjamin, B

1994-01-01

This study evaluates the quality of nursing documentation within the hospital record for a particularly vulnerable group of patients, the depressed aged. Specifically, the effects of prospective payment, unit type, hospital type, and nurse staffing levels on nursing documentation within hospital charts were assessed.

Goal-oriented evaluation of binarization algorithms for historical document images

NASA Astrophysics Data System (ADS)

Obafemi-Ajayi, Tayo; Agam, Gady

2013-01-01

Binarization is of significant importance in document analysis systems. It is an essential first step, prior to further stages such as Optical Character Recognition (OCR), document segmentation, or enhancement of readability of the document after some restoration stages. Hence, proper evaluation of binarization methods to verify their effectiveness is of great value to the document analysis community. In this work, we perform a detailed goal-oriented evaluation of image quality assessment of the 18 binarization methods that participated in the DIBCO 2011 competition using the 16 historical document test images used in the contest. We are interested in the image quality assessment of the outputs generated by the different binarization algorithms as well as the OCR performance, where possible. We compare our evaluation of the algorithms based on human perception of quality to the DIBCO evaluation metrics. The results obtained provide an insight into the effectiveness of these methods with respect to human perception of image quality as well as OCR performance.

Stop the pain! A nation-wide quality improvement programme in paediatric oncology pain control.

PubMed

Zernikow, Boris; Hasan, Carola; Hechler, Tanja; Huebner, Bettina; Gordon, Deb; Michel, Erik

2008-10-01

Little is known about the impact of translation of pain management clinical practice guidelines on pain control in paediatrics. In an effort to overcome this, a longitudinal, nation-wide, multi-centre paediatric quality improvement (QI) study was initiated by the German Society of Pediatric Haematology and Oncology (GPOH) entitled Schmerz-Therapie in der Onkologischen Paediatrie (STOP). The project's primary major aims were to improve paediatric oncology pain control in Germany, and to evaluate the project's impact on the pain management quality. To achieve these aims, STOP encompassed six sequential phases to evaluate present practice, develop recommendations for practical pain control, actively engage participants in improvement strategies, and assess change. The purpose of this paper is to briefly describe STOP in its entirety, report on comparisons between active quality management (QM) departments that actively participated in the project and non-active QM departments regarding differences in pain control, patients' and parents' perspectives on pain control and health professionals' knowledge, and to discuss the impact of STOP as a whole. Four hypotheses were examined: (1) changes in health care professionals' knowledge on pain in paediatric oncology and pain management after a three-year period (2) impact of active participation in the STOP-project; (3) differences in patients' and parents' perspective in active QM versus non-active QM departments; (4) impact of the STOP-project on the health care professionals' knowledge in active QM versus non-active QM departments. Data included surveys, interviews, and standardised pre-/post-intervention documentation of pain control. All German paediatric oncology departments were invited to participate. The prime means of intervention was education (printed material, passive participation; additional lectures and feed-back, active participation). Quality indicators were defined and compared with regards to the four hypotheses. Sixty-eight departments participated passively. Eight departments participated actively, enrolling 224 patients (median age, 9 years) and documenting a total of 2265 treatment days. In the areas addressed, all health professionals demonstrated increases in knowledge on pain and pain control after a three-year period. STOP objectively improved pain control in the actively participating departments. Painful modes of drug administration were used less frequently; the usage of mixed opioid agonists-antagonists was reduced; the physicians' knowledge of the treatment of neuropathic pain increased; pain ratings significantly decreased, and less episodes of strong pain were observed. There was a significant increase in the proportion of health-care professionals who post-interventionally judged that pain therapy had been initiated earlier and at exactly the right time. Neither patients nor parents felt, however, that there was any quality improvement. According to participants' self-assessment, STOP improved practical pain management in actively participating departments, while in passively participating departments the change to the better was negligible. STOP predominantly aimed at and succeeded in the improvement of structure, process and outcome quality. With regard to patients' and parents' opinions, the interview tools might have been unsuited to measure the quality of pain control, or STOP was insufficient to improve pain control to a magnitude significant to the patient.

[Quality assurance in ENT tumor surgery].

PubMed

Eckel, H E; Streppel, M; Schmalenbach, K; Volling, P; Schrappe, M; Dietz, A; Bootz, F

2000-12-01

Quality control is of special importance in head and neck oncology since the quality of medical care constitutes a vital parameter for the diseased patient. In contrast to other medical specialties, no quality assurance program for head and neck cancer patients has yet been established in Germany. Therefore, a survey was conducted to assess the quality assurance instruments that are in use today in otorhinolaryngology-head and neck (ORL-HNS) centers. In a nationwide survey, questionnaires were sent out to 146 German ORL-HNS departments (the return rate was 75%). 56% of all departments apply dedicated quality assurance processes, and 38% have appointed a formal quality assurance officer. Interdisciplinary oncological conferences are held in the vast majority of all departments with the participation of radiation oncologists in 86 (78%), medical oncologists in 84 (76%), diagnostic radiologists in 82 (74%), and pathologists in 73 (66%). Morbidity-mortality conferences are held in seven departments (6%). A standardized follow-up of oncological patients is carried out in 95 units (86%), and 53 departments use computer-assisted data bases to organize their follow-up data (48%). A wide variety of documentation systems is in use throughout the country: 78 units (71%) offer formal follow-up to their oncological patients. This survey documents a wide-spread interest in quality assurance procedures. Many individual efforts are being undertaken. However, no uniform quality assurance or auditing system is currently in use in Germany nor is a commonly accepted data base available. The ability to offer oncological follow-up within the national social security system is generally considered indispensable for the maintenance of high-quality oncological care in ORL-HNS departments.

Biological Water Quality Criteria

EPA Pesticide Factsheets

Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

Supplier Assessment System (SAS)

NASA Technical Reports Server (NTRS)

Dietrich, Kristen

2016-01-01

Background: Sponsored by NASA Headquarters; Charter - provide information to assist the quality assurance community in evaluating and determining supplier risk; Comprehensive on-line repository of supplier information; Available to approved civil service personnel from all NASA Centers, other U.S. Government Agencies, Prime Contractors, and NASA direct support contractors; User access to specific data types or documents is controlled as needed.

Biometrics Foundation Documents

DTIC Science & Technology

2009-01-01

a digital form. The quality of the sensor used has a significant impact on the recognition results. Example “sensors” could be digital cameras...Difficult to control sensor and channel variances that significantly impact capabilities Not sufficiently distinctive for identification over large...expressions, hairstyle, glasses, hats, makeup, etc. have on face recognition systems? Minor variances , such as those mentioned, will have a moderate

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (SOPS) (UA-G-1.0)

EPA Science Inventory

The purpose of this SOP is to establish a uniform format for the preparation of SOPs. Use of these protocols ensures consistent implementation of project tasks, documents the preparation and implementation of the procedures used, describes quality control measures and the limits...

Development and Exchange of Instructional Resources in Water Quality Control Programs, III: Selecting Audio-Visual Equipment.

ERIC Educational Resources Information Center

Moon, Donald K.

This document is one in a series of reports which reviews instructional materials and equipment and offers suggestions about how to select equipment. Topics discussed include: (1) the general criteria for audio-visual equipment selection such as performance, safety, comparability, sturdiness and repairability; and (2) specific equipment criteria…

The Troll HSE Risk Management System

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

Wiig, E.; Berthelsen, I.; Donovan, K.

1996-12-31

The Petroleum Act and Internal Control regulations in Norway lay down requirements for how HSE shall be Managed and documented. To comply with the Norwegian legislation the Troll Project has developed an HSE Risk Management System (RMS) structured around Hazards and Effects Management. The resulting quality, technical and operating integrity, and HSE performance are an endorsement of the power of RMS.

The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units.

PubMed

Li, Dan

2016-08-01

To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete picture of patients' care needs that require nursing interventions. The implication of this study involves pressure ulcer prevention and litigable risk of nursing documentation. © 2016 John Wiley & Sons Ltd.

Obstetric Safety and Quality.

PubMed

Pettker, Christian M; Grobman, William A

2015-07-01

Obstetric safety and quality is an emerging and important topic not only as a result of the pressures of patient and regulatory expectations, but also because of the genuine interest of caregivers to reduce harm, improve outcomes, and optimize care. Although each seeks to improve care by using scientific approaches beyond human physiology and pathophysiology, patient safety methodologies seek to avoid preventable adverse events, whereas health care quality projects aim to achieve the best possible outcomes. It is well-documented that an increasingly complex medical system controlled by human workers is a circumstance subject to recurrent failure. A safety culture encourages a proactive approach to mitigate failure before, during, and after it occurs. This article highlights the key concepts in health care safety and quality and reviews the background of the quality improvement sciences with particular emphasis on obstetric outcomes and quality measures.

HIS-based Kaplan-Meier plots--a single source approach for documenting and reusing routine survival information.

PubMed

Breil, Bernhard; Semjonow, Axel; Müller-Tidow, Carsten; Fritz, Fleur; Dugas, Martin

2011-02-16

Survival or outcome information is important for clinical routine as well as for clinical research and should be collected completely, timely and precisely. This information is relevant for multiple usages including quality control, clinical trials, observational studies and epidemiological registries. However, the local hospital information system (HIS) does not support this documentation and therefore this data has to generated by paper based or spreadsheet methods which can result in redundantly documented data. Therefore we investigated, whether integrating the follow-up documentation of different departments in the HIS and reusing it for survival analysis can enable the physician to obtain survival curves in a timely manner and to avoid redundant documentation. We analysed the current follow-up process of oncological patients in two departments (urology, haematology) with respect to different documentation forms. We developed a concept for comprehensive survival documentation based on a generic data model and implemented a follow-up form within the HIS of the University Hospital Muenster which is suitable for a secondary use of these data. We designed a query to extract the relevant data from the HIS and implemented Kaplan-Meier plots based on these data. To re-use this data sufficient data quality is needed. We measured completeness of forms with respect to all tumour cases in the clinic and completeness of documented items per form as incomplete information can bias results of the survival analysis. Based on the form analysis we discovered differences and concordances between both departments. We identified 52 attributes from which 13 were common (e.g. procedures and diagnosis dates) and were used for the generic data model. The electronic follow-up form was integrated in the clinical workflow. Survival data was also retrospectively entered in order to perform survival and quality analyses on a comprehensive data set. Physicians are now able to generate timely Kaplan-Meier plots on current data. We analysed 1029 follow-up forms of 965 patients with survival information between 1992 and 2010. Completeness of forms was 60.2%, completeness of items ranges between 94.3% and 98.5%. Median overall survival time was 16.4 years; median event-free survival time was 7.7 years. It is feasible to integrate survival information into routine HIS documentation such that Kaplan-Meier plots can be generated directly and in a timely manner.

Health on the Net Foundation: assessing the quality of health web pages all over the world.

PubMed

Boyer, Célia; Gaudinat, Arnaud; Baujard, Vincent; Geissbühler, Antoine

2007-01-01

The Internet provides a great amount of information and has become one of the communication media which is most widely used [1]. However, the problem is no longer finding information but assessing the credibility of the publishers as well as the relevance and accuracy of the documents retrieved from the web. This problem is particularly relevant in the medical area which has a direct impact on the well-being of citizens. In this paper, we assume that the quality of web pages can be controlled, even when a huge amount of documents has to be reviewed. But this must be supported by both specific automatic tools and human expertise. In this context, we present various initiatives of the Health on the Net Foundation informing the citizens about the reliability of the medical content on the web.

Air Quality Modeling Technical Support Document for the 2008 Ozone NAAQS Cross-State Air Pollution Rule Proposal

EPA Pesticide Factsheets

In this technical support document (TSD) we describe the air quality modeling performed to support the proposed Cross-State Air Pollution Rule for the 2008 ozone National Ambient Air Quality Standards (NAAQS)

Air Quality Modeling Technical Support Document for the 2015 Ozone NAAQS Preliminary Interstate Transport Assessment

EPA Pesticide Factsheets

In this technical support document (TSD) EPA describes the air quality modeling performed to support the 2015 ozone National Ambient Air Quality Standards (NAAQS) preliminary interstate transport assessment Notice of Data Availability (NODA).

Detailed design of a Ride Quality Augmentation System for commuter aircraft

NASA Technical Reports Server (NTRS)

Suikat, Reiner; Donaldson, Kent E.; Downing, David R.

1989-01-01

The design of a Ride Quality Augmentation System (RQAS) for commuter aircraft is documented. The RQAS is designed for a Cessna 402B, an 8 passenger prop twin representative to this class of aircraft. The purpose of the RQAS is the reduction of vertical and lateral accelerations of the aircraft due to atmospheric turbulence by the application of active control. The detailed design of the hardware (the aircraft modifications, the Ride Quality Instrumentation System (RQIS), and the required computer software) is examined. The aircraft modifications, consisting of the dedicated control surfaces and the hydraulic actuation system, were designed at Cessna Aircraft by Kansas University-Flight Research Laboratory. The instrumentation system, which consist of the sensor package, the flight computer, a Data Acquisition System, and the pilot and test engineer control panels, was designed by NASA-Langley. The overall system design and the design of the software, both for flight control algorithms and ground system checkout are detailed. The system performance is predicted from linear simulation results and from power spectral densities of the aircraft response to a Dryden gust. The results indicate that both accelerations are possible.

Improving documentation of a beta-blocker quality measure through an anesthesia information management system and real-time notification of documentation errors.

PubMed

Nair, Bala G; Peterson, Gene N; Newman, Shu-Fang; Wu, Wei-Ying; Kolios-Morris, Vickie; Schwid, Howard A

2012-06-01

Continuation of perioperative beta-blockers for surgical patients who are receiving beta-blockers prior to arrival for surgery is an important quality measure (SCIP-Card-2). For this measure to be considered successful, name, date, and time of the perioperative beta-blocker must be documented. Alternately, if the beta-blocker is not given, the medical reason for not administering must be documented. Before the study was conducted, the institution lacked a highly reliable process to document the date and time of self-administration of beta-blockers prior to hospital admission. Because of this, compliance with the beta-blocker quality measure was poor (-65%). To improve this measure, the anesthesia care team was made responsible for documenting perioperative beta-blockade. Clear documentation guidelines were outlined, and an electronic Anesthesia Information Management System (AIMS) was configured to facilitate complete documentation of the beta-blocker quality measure. In addition, real-time electronic alerts were generated using Smart Anesthesia Messenger (SAM), an internally developed decision-support system, to notify users concerning incomplete beta-blocker documentation. Weekly compliance for perioperative beta-blocker documentation before the study was 65.8 +/- 16.6%, which served as the baseline value. When the anesthesia care team started documenting perioperative beta-blocker in AIMS, compliance was 60.5 +/- 8.6% (p = .677 as compared with baseline). Electronic alerts with SAM improved documentation compliance to 94.6 +/- 3.5% (p < .001 as compared with baseline). To achieve high compliance for the beta-blocker measure, it is essential to (1) clearly assign a medical team to perform beta-blocker documentation and (2) enhance features in the electronic medical systems to alert the user concerning incomplete documentation.

AIR QUALITY CRITERIA CARBON MONOXIDE, EXTERNAL REVIEW DRAFT

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) promulgates the National Ambient Air Quality Standards (NAAQS) on the basis of scientific information contained in criteria documents. The last air quality criteria document for carbon monoxide (CO) was completed by EPA in 1991. This...

Quality Veneer and Lumber Company - Restart or New?

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Air Quality Analysis for PSD

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Factors in Software Quality. Volume I. Concepts and Definitions of Software Quality

DTIC Science & Technology

1977-11-01

FLEXIBILITY COMPLEXITY EXPANDABILITY PRECISION DOCUMENTATION TOLERANCE REPAIRABILITY COMPATABIL ITY SERVICEABILITY 2-4 AiI1I~3~I!-T A1 11 NI󈧥 AIiB 9l 0...applications. Several standard documents are required by DOD/AF’ regulations . The following references were used to compile the rFpnge of documents...documents are specified by the AF regulations or SPO-local regulations listed above. Each ot the document types for a long life/high cost software

Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

PubMed

Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

2016-01-01

Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

Improving Air Quality with Economic Incentive Programs

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

EPA Quality Assurance Policy Statement

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

UrQt: an efficient software for the Unsupervised Quality trimming of NGS data.

PubMed

Modolo, Laurent; Lerat, Emmanuelle

2015-04-29

Quality control is a necessary step of any Next Generation Sequencing analysis. Although customary, this step still requires manual interventions to empirically choose tuning parameters according to various quality statistics. Moreover, current quality control procedures that provide a "good quality" data set, are not optimal and discard many informative nucleotides. To address these drawbacks, we present a new quality control method, implemented in UrQt software, for Unsupervised Quality trimming of Next Generation Sequencing reads. Our trimming procedure relies on a well-defined probabilistic framework to detect the best segmentation between two segments of unreliable nucleotides, framing a segment of informative nucleotides. Our software only requires one user-friendly parameter to define the minimal quality threshold (phred score) to consider a nucleotide to be informative, which is independent of both the experiment and the quality of the data. This procedure is implemented in C++ in an efficient and parallelized software with a low memory footprint. We tested the performances of UrQt compared to the best-known trimming programs, on seven RNA and DNA sequencing experiments and demonstrated its optimality in the resulting tradeoff between the number of trimmed nucleotides and the quality objective. By finding the best segmentation to delimit a segment of good quality nucleotides, UrQt greatly increases the number of reads and of nucleotides that can be retained for a given quality objective. UrQt source files, binary executables for different operating systems and documentation are freely available (under the GPLv3) at the following address: https://lbbe.univ-lyon1.fr/-UrQt-.html .

Systematic Review of Plant-Based Homeopathic Basic Research: An Update.

PubMed

Ücker, Annekathrin; Baumgartner, Stephan; Sokol, Anezka; Huber, Roman; Doesburg, Paul; Jäger, Tim

2018-05-01

 Plant-based test systems have been described as a useful tool for investigating possible effects of homeopathic preparations. The last reviews of this research field were published in 2009/2011. Due to recent developments in the field, an update is warranted. Publications on plant-based test systems were analysed with regard to publication quality, reproducibility and potential for further research.  A literature search was conducted in online databases and specific journals, including publications from 2008 to 2017 dealing with plant-based test systems in homeopathic basic research. To be included, they had to contain statistical analysis and fulfil quality criteria according to a pre-defined manuscript information score (MIS). Publications scoring at least 5 points (maximum 10 points) were assumed to be adequate. They were analysed for the use of adequate controls, outcome and reproducibility.  Seventy-four publications on plant-based test systems were found. Thirty-nine publications were either abstracts or proceedings of conferences and were excluded. From the remaining 35 publications, 26 reached a score of 5 or higher in the MIS. Adequate controls were used in 13 of these publications. All of them described specific effects of homeopathic preparations. The publication quality still varied: a substantial number of publications (23%) did not adequately document the methods used. Four reported on replication trials. One replication trial found effects of homeopathic preparations comparable to the original study. Three replication trials failed to confirm the original study but identified possible external influencing factors. Five publications described novel plant-based test systems. Eight trials used systematic negative control experiments to document test system stability.  Regarding research design, future trials should implement adequate controls to identify specific effects of homeopathic preparations and include systematic negative control experiments. Further external and internal replication trials, and control of influencing factors, are needed to verify results. Standardised test systems should be developed. The Faculty of Homeopathy.

A critical appraisal of probiotics (as drugs or food supplements) in gastrointestinal diseases.

PubMed

Passariello, Annalisa; Agricole, Pascal; Malfertheiner, Peter

2014-06-01

Probiotics may be registered as food supplements or drugs. This article summarizes differences in European regulations of probiotics registered as food supplements and drugs, as well as issues related to the quality of probiotic products. For registration as a drug, the European Medicines Agency demands extensive and detailed quality, efficacy and safety evidence; whereas compulsory analyses requested for food supplements consist only in a nutritional analysis. As a result, the quality of those probiotics registered as drugs, compared to food supplements, is in general controlled with higher standards. Despite these differences and whatever the status of the probiotic product, its efficacy and safety has to be documented in well conducted randomized controlled trials (RCTs). Furthermore, this paper reviews recent evidence on the use of probiotics for gastrointestinal diseases, evaluating all the existing information up to January 2014. In all eligible published studies in which use of probiotics for gastrointestinal diseases were investigated and reported, no language limitations were applied. Special focus is placed on RCTs (or their meta-analyses) showing positive results, so that the findings may be applicable to everyday clinical practice. Currently, the best documented clinical areas appear to be probiotics efficacy for the treatment of acute gastroenteritis in children and for the prevention of antibiotic-associated diarrhea both in children and in adults. In other gastrointestinal conditions, some promising observations are emerging, but no definitive conclusions can be reached at present.

Quality expectations and tolerance limits of trial master files (TMF) – Developing a risk-based approach for quality assessments of TMFs

PubMed Central

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B.

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs. PMID:26693218

Quality expectations and tolerance limits of trial master files (TMF) - Developing a risk-based approach for quality assessments of TMFs.

PubMed

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs.

Quality improvement in breast cancer project: compliance with antiresorptive agents and changing patterns of drug use.

PubMed

Borden, Charles P; Shapiro, Charles L; Ramirez, Maria Teresa; Kotur, Linda; Farrar, William

2014-02-01

The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute participated in NCCN's Quality Improvement in Breast Cancer initiative. The Opportunities for Improvement (OFI) team elected to improve concordance with the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. Assembling a multidisciplinary team of clinicians, researchers, and administrative stakeholders, the OFI team followed Six Sigma's approach to problem-solving known as DMAIC (define, measure, analyze, improve, and control). Baseline concordance was 79%, which was below the recommended target range. Initial analysis quickly revealed that 5 cases were concordant, resulting in a new baseline of 89%. The key root cause identified for the remaining gap was lack of documentation. The solution included education regarding documentation for existing staff, in addition to hard-wiring the material into new physician orientation, discussion of all patients with bone disease at tumor board meetings, and improved consistency with use of the new electronic medical record system. After implementation, the reported concordance was 92%, and the lack of documentation problem decreased from 11% in the baseline study to 6%. The team concluded that use of the NCCN Oncology Outcomes Database as an opportunity for clinical quality improvement initiatives not only is possible but also should be an essential element of any clinical program looking to continuously improve.

Design and development of a structural mode control system

NASA Technical Reports Server (NTRS)

1977-01-01

A program was conducted to compile and document some of the existing information about the conceptual design, development, and tests of the B-1 structural mode control system (SMCS) and its impact on ride quality. This report covers the following topics: (1) Rationale of selection of SMCS to meet ride quality criteria versus basic aircraft stiffening. (2) Key considerations in designing an SMCS, including vane geometry, rate and deflection requirements, power required, compensation network design, and fail-safe requirements. (3) Summary of key results of SMCS vane wind tunnel tests. (4) SMCS performance. (5) SMCS design details, including materials, bearings, and actuators. (6) Results of qualification testing of SMCS on the "Iron Bird" flight control simulator, and lab qualification testing of the actuators. (7) Impact of SMCS vanes on engine inlet characteristics from wind tunnel tests.

The Baldrige Award for Education: How To Measure and Document Quality Improvement.

ERIC Educational Resources Information Center

Arcaro, Jerome S.

This volume describes in practical terms how schools and colleges can use the Malcolm Baldrige National Quality Award assessment as a tool to document and measure areas of existing quality and to identify areas for improvement. This Award is currently given annually to recognize quality in business companies with plans to expand it to include…

Examining Changes to Michigan's Early Childhood Quality Rating and Improvement System (QRIS). REL 2015-029

ERIC Educational Resources Information Center

Faria, Ann-Marie; Hawkinson, Laura E.; Greenberg, Ariela C.; Howard, Eboni C.; Brown, Leah

2015-01-01

Documenting and improving early childhood program quality is a national priority, leading to a rapid expansion of Quality Rating and Improvement Systems (QRISs). QRISs document and improve the quality of early childhood education programs and provide clear information to families about their child care choices. The current study described how…

Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach

PubMed Central

2013-01-01

Background Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. Methods We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008–2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Results Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p = 0.001). However, the proportion receiving ≥80% of scheduled BPG did not change. Documentation in medical files improved: ARF episode documentation increased from 31/55 (56%) to 50/62 (81%) (p = 0.004), and RHD risk category documentation from 87/154 (56%) to 103/145 (76%) (p < 0.001). Large differences in performance were noted between health centres, reflected to some extent in SAT scores. Conclusions A CQI process using a systems approach and participatory action research methodology can significantly improve delivery of ARF/RHD care. PMID:24350582

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

PubMed

Hanna, Timothy P; Kangolle, Alfred C T

2010-10-13

Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

Benefits of physical exercise training on cognition and quality of life in frail older adults.

PubMed

Langlois, Francis; Vu, Thien Tuong Minh; Chassé, Kathleen; Dupuis, Gilles; Kergoat, Marie-Jeanne; Bherer, Louis

2013-05-01

Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life. Whether frail older adults can show such benefits remains to be documented. A total of 83 participants aged 61-89 years were assigned to an exercise-training group (3 times a week for 12 weeks) or a control group (waiting list). Frailty was determined by a complete geriatric examination using specific criteria. Pre- and post-test measures assessed physical capacity, cognitive performance, and quality of life. Compared with controls, the intervention group showed significant improvement in physical capacity (functional capacities and physical endurance), cognitive performance (executive functions, processing speed, and working memory), and quality of life (global quality of life, leisure activities, physical capacity, social/family relationships, and physical health). Benefits were overall equivalent between frail and nonfrail participants. Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.

Air Quality Operating Permits Programs Which Apply to Tribal Lands

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

[Differentiation of coding quality in orthopaedics by special, illustration-oriented case group analysis in the G-DRG System 2005].

PubMed

Schütz, U; Reichel, H; Dreinhöfer, K

2007-01-01

We introduce a grouping system for clinical practice which allows the separation of DRG coding in specific orthopaedic groups based on anatomic regions, operative procedures, therapeutic interventions and morbidity equivalent diagnosis groups. With this, a differentiated aim-oriented analysis of illustrated internal DRG data becomes possible. The group-specific difference of the coding quality between the DRG groups following primary coding by the orthopaedic surgeon and final coding by the medical controlling is analysed. In a consecutive series of 1600 patients parallel documentation and group-specific comparison of the relevant DRG parameters were carried out in every case after primary and final coding. Analysing the group-specific share in the additional CaseMix coding, the group "spine surgery" dominated, closely followed by the groups "arthroplasty" and "surgery due to infection, tumours, diabetes". Altogether, additional cost-weight-relevant coding was necessary most frequently in the latter group (84%), followed by group "spine surgery" (65%). In DRGs representing conservative orthopaedic treatment documented procedures had nearly no influence on the cost weight. The introduced system of case group analysis in internal DRG documentation can lead to the detection of specific problems in primary coding and cost-weight relevant changes of the case mix. As an instrument for internal process control in the orthopaedic field, it can serve as a communicative interface between an economically oriented classification of the hospital performance and a specific problem solution of the medical staff involved in the department management.

Microbial (Pathogen)/Recreational Water Quality Criteria

EPA Pesticide Factsheets

Documents pertaining to Recreational Human Health Ambient Water Quality Criteria for Microbial Organisms (Pathogens). These documents include safe levels for cyanotoxins microcystin and cylindrospermopsin, and Coliphage to protect human health.

40 CFR 132.1 - Scope, purpose, and availability of documents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...

40 CFR 132.1 - Scope, purpose, and availability of documents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...

40 CFR 132.1 - Scope, purpose, and availability of documents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...

40 CFR 132.1 - Scope, purpose, and availability of documents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...

Three Quality Professional Documents to Guide Teachers for Puberty, Relationships and Sexuality Education

ERIC Educational Resources Information Center

Goldman, Juliette D. G.; Collier-Harris, Christine A.

2017-01-01

Quality school-based sexuality education is important for all children and adolescents. The global trend towards students' earlier, longer, and technologically connected pubertal experience makes the timely provision of such education particularly significant. Quality international sexuality education documents are available for teachers…

Qualification Procedures for VHSIC/VLSI

DTIC Science & Technology

1990-12-01

alternative approach for qualification of complex microcircuits. To address the technical issues related to a process oriented qualification approach, the...methodology of microcircuit process control to promote the United States to a position of supplying the nighest quality and most reliable...available resources . o Coordinate document reviews with weekly and monthly status reviews on progress. o Summarize results and collate into four basic

Controls on mass loss and nitrogen dynamics of oak leaf litter along an urban-rural land-use gradient

Treesearch

Richard V. Pouyat; Margaret M. Carreiro

2003-01-01

Using reciprocal leaf litter transplants, we investigated the effects of contrasting environments (urban vs. rural) and intraspecific variations in oak leaf litter quality on mass loss rates and nitrogen (N) dynamics along an urban-rural gradient in the New York City metropolitan area. Differences in earthworm abundances and temperature had previously been documented...

User's Guide for ERB 7 SEFDT. Volume 1: User's Guide. Volume 2: Quality Control Report, Year 1

NASA Technical Reports Server (NTRS)

Ray, S. N.; Tighe, R. J.; Scherrer, S. A.

1984-01-01

The Nimbus-7 ERB SEFDT Data User's Guide is presented. The guide consists of four subsections which describe: (1) the scope of the data User's Guide; (2) the background on Nimbus-7 Spacecraft and the ERB experiment; (3) the SEFDT data product and processing scenario; and (4) other related products and documents.

[Computerized system validation of clinical researches].

PubMed

Yan, Charles; Chen, Feng; Xia, Jia-lai; Zheng, Qing-shan; Liu, Daniel

2015-11-01

Validation is a documented process that provides a high degree of assurance. The computer system does exactly and consistently what it is designed to do in a controlled manner throughout the life. The validation process begins with the system proposal/requirements definition, and continues application and maintenance until system retirement and retention of the e-records based on regulatory rules. The objective to do so is to clearly specify that each application of information technology fulfills its purpose. The computer system validation (CSV) is essential in clinical studies according to the GCP standard, meeting product's pre-determined attributes of the specifications, quality, safety and traceability. This paper describes how to perform the validation process and determine relevant stakeholders within an organization in the light of validation SOPs. Although a specific accountability in the implementation of the validation process might be outsourced, the ultimate responsibility of the CSV remains on the shoulder of the business process owner-sponsor. In order to show that the compliance of the system validation has been properly attained, it is essential to set up comprehensive validation procedures and maintain adequate documentations as well as training records. Quality of the system validation should be controlled using both QC and QA means.

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

PubMed

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

2014-01-01

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

[Efficient document management by introduction of a new, dynamic quality manual application according to DIN EN ISO 9001:2000].

PubMed

Pache, G; Saueressig, U; Baumann, T; Dürselen, L; Langer, M; Kotter, E

2008-06-01

Evaluation of the impact of a new, dynamic computer-aided quality manual application (QMA) regarding the acceptance and efficiency of a quality management system (QMS) according to DIN EN ISO 9001:2000. The QMA combines static pages of HTML with active content generated from an underlying database. Through user access rights, a hierarchy is defined to create and administer quality documents. Document workflow, feedback management and employee survey were analyzed to compare the performance of the new QMH with the formerly used static version. Integration of a document editor and automated document re-approval accelerated the document process by an average of 10 min. In spite of an increase of the yearly document changes of 60%, the administration effort was reduced by approximately 160 h. Integration of the feedback management system into the QMA decreased handling time from an average of 16.5 to 3.4 days. Simultaneously the number of feedback messages increased from 160 in 2005 to 306 in 2006. Employee satisfaction was raised (old: 3.19+/-1.02, new: 1.91+/-0.8). The number of users who partook in the QMA more than once a week also increased from 29.5% to 60%. The computer-aided quality manual application constitutes the basis for the success of our QMS. The possibility to actively participate in the quality management process has led to broad acceptance and usage by the employees. The administration effort was able to be tremendously decreased as compared to conventional QMS.

WHO Expert Committee on Biological Standardization.

PubMed

2002-01-01

This report presents the recommendations of a WHO Expert Committee commissioned to coordinate activities leading to the adoption of international recommendations for the production and quality control of vaccines and other biologicals and the establishment of international biological reference materials. The report starts with a discussion of general issues brought to the attention of the Committee and provides information on issues relevant to international guidelines, recommendations and other matters related to the manufacture and quality control of biologicals. This is followed by information on the status and development of reference materials for bovine spongiform encephalopathy, various antigens, blood products, cytokines, growth factors and endocrinological substances. The second part of the report, of particular interest to manufacturers and national control authorities, contains sets of recommendations for the production and control of poliomyelitis vaccine (oral) and poliomyelitis vaccine (inactivated) and guidelines for the production and control of live attenuated Japanese encephalitis vaccine. Also included are lists of recommendations and guidelines for biological substances used in medicine, and other relevant documents.

Improving program documentation quality through the application of continuous improvement processes.

PubMed

Lovlien, Cheryl A; Johansen, Martha; Timm, Sandra; Eversman, Shari; Gusa, Dorothy; Twedell, Diane

2007-01-01

Maintaining the integrity of record keeping and retrievable information related to the provision of continuing education credit creates challenges for a large organization. Accurate educational program documentation is vital to support the knowledge and professional development of nursing staff. Quality review and accurate documentation of programs for nursing staff development occurred at one institution through the use of continuous improvement principles. Integration of the new process into the current system maintains the process of providing quality record keeping.

Uniform Federal Policy for Quality Assurance Project Plans: Evaluating, Assessing, and Documenting Environmental Data Collection and Use Programs. Part 1. UFP-QAPP Manual

DTIC Science & Technology

2004-07-01

sampler, project manager, data reviewer, statistician , risk assessor, assessment personnel, and laboratory QC manager. In addition, a complete copy of...sample • Corrective actions to be taken if the QC sample fails these criteria • A description of how the QC data and results are to be documented and...Intergovernmental Data Quality Task Force Uniform Federal Policy for Quality Assurance Project Plans Evaluating, Assessing, and Documenting

Document segmentation for high-quality printing

NASA Astrophysics Data System (ADS)

Ancin, Hakan

1997-04-01

A technique to segment dark texts on light background of mixed mode color documents is presented. This process does not perceptually change graphics and photo regions. Color documents are scanned and printed from various media which usually do not have clean background. This is especially the case for the printouts generated from thin magazine samples, these printouts usually include text and figures form the back of the page, which is called bleeding. Removal of bleeding artifacts improves the perceptual quality of the printed document and reduces the color ink usage. By detecting the light background of the document, these artifacts are removed from background regions. Also detection of dark text regions enables the halftoning algorithms to use true black ink for the black text pixels instead of composite black. The processed document contains sharp black text on white background, resulting improved perceptual quality and better ink utilization. The described method is memory efficient and requires a small number of scan lines of high resolution color documents during processing.

Quality of cancer family history and referral for genetic counseling and testing among oncology practices: a pilot test of quality measures as part of the American Society of Clinical Oncology Quality Oncology Practice Initiative.

PubMed

Wood, Marie E; Kadlubek, Pamela; Pham, Trang H; Wollins, Dana S; Lu, Karen H; Weitzel, Jeffrey N; Neuss, Michael N; Hughes, Kevin S

2014-03-10

Family history of cancer (CFH) is important for identifying individuals to receive genetic counseling/testing (GC/GT). Prior studies have demonstrated low rates of family history documentation and referral for GC/GT. CFH quality and GC/GT practices for patients with breast (BC) or colon cancer (CRC) were assessed in 271 practices participating in the American Society of Clinical Oncology Quality Oncology Practice Initiative in fall 2011. A total of 212 practices completed measures regarding CFH and GC/GT practices for 10,466 patients; 77.4% of all medical records reviewed documented presence or absence of CFH in first-degree relatives, and 61.5% of medical records documented presence or absence of CFH in second-degree relatives, with significantly higher documentation for patients with BC compared with CRC. Age at diagnosis was documented for all relatives with cancer in 30.7% of medical records (BC, 45.2%; CRC, 35.4%; P ≤ .001). Referall for GC/GT occurred in 22.1% of all patients with BC or CRC. Of patients with increased risk for hereditary cancer, 52.2% of patients with BC and 26.4% of those with CRC were referred for GC/GT. When genetic testing was performed, consent was documented 77.7% of the time, and discussion of results was documented 78.8% of the time. We identified low rates of complete CFH documentation and low rates of referral for those with BC or CRC meeting guidelines for referral among US oncologists. Documentation and referral were greater for patients with BC compared with CRC. Education and support regarding the importance of accurate CFH and the benefits of proactive high-risk patient management are clearly needed.

Measuring the quality of therapeutic apheresis care in the pediatric intensive care unit.

PubMed

Sussmane, Jeffrey B; Torbati, Dan; Gitlow, Howard S

2012-01-01

Our goal was to measure the quality of care provided in the Pediatric Intensive Care Unit (PICU) during Therapeutic Apheresis (TA). We described the care as a step by step process. We designed a flow chart to carefully document each step of the process. We then defined each step with a unique clinical indictor (CI) that represented the exact task we felt provided quality care. These CIs were studied and modified for 1 year. We measured our performance in this process by the number of times we accomplished the CI vs. the total number of CIs that were to be performed. The degree of compliance, with these clinical indicators, was analyzed and used as a metric for quality by calculating how close the process is running exactly as planned or "in control." The Apheresis Process was in control (compliance) for 47% of the indicators, as measured in the aggregate for the first observational year. We then applied the theory of Total Quality Management (TQM) through our Design, Measure, Analyze, Improve, and Control (DMAIC) model. We were able to improve the process and bring it into control by increasing the compliance to > 99.74%, in the aggregate, for the third and fourth quarter of the second year. We have implemented TQM to increase compliance, thus control, of a highly complex and multidisciplinary Pediatric Intensive Care therapy. We have shown a reproducible and scalable measure of quality for a complex clinical process in the PICU, without additional capital expenditure. Copyright © 2011 Wiley-Liss, Inc.

38 CFR 17.508 - Access to quality assurance records and documents within the agency.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review...

38 CFR 17.508 - Access to quality assurance records and documents within the agency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review...

38 CFR 17.508 - Access to quality assurance records and documents within the agency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review...

38 CFR 17.508 - Access to quality assurance records and documents within the agency.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review...

38 CFR 17.508 - Access to quality assurance records and documents within the agency.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review...

Visualizing Topic Flow in Students' Essays

ERIC Educational Resources Information Center

O'Rourke, Stephen T.; Calvo, Rafael A.; McNamara, Danielle S.

2011-01-01

Visualizing how the parts of a document relate to each other and producing automatically generated quality measures that people can understand are means that writers can use to improve the quality of their compositions. This paper presents a novel document visualization technique and a measure of quality based on the average semantic distance…

Contemporaneous Emissions Determination for PSD Netting from Region 5 to Michigan Department of Environmental Quality

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Response to Follow-up Questions From the Hearing on Air Quality Issues Affecting Our Forests and Public Lands.

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Southern LNG, Inc., Elba Island Terminal, Savannah Georgia Draft Air Quality Permit and PSD Preliminary Determination

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Cumulative Impacts on the Air Quality Related Values (AQRVs) of Shenandoah National Park

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

EPA, FWS, NPS Coordination Procedures for Determining Air Quality Impact in Region IV Class I Areas

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Citizen's Petition for Administrator's objection to the issuance of ADEQ Air Quality Permit # 1000383

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

PubMed

Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

2018-06-14

Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

The element of naturalness when evaluating image quality of digital photo documentation after sexual assault.

PubMed

Ernst, E J; Speck, P M; Fitzpatrick, J J

2012-01-01

Digital photography is a valuable adjunct to document physical injuries after sexual assault. In order for a digital photograph to have high image quality, there must exist a high level of naturalness. Digital photo documentation has varying degrees of naturalness; however, for a photograph to be natural, specific technical elements for the viewer must be satisfied. No tool was available to rate the naturalness of digital photo documentation of female genital injuries after sexual assault. The Photo Documentation Image Quality Scoring System (PDIQSS) tool was developed to rate technical elements for naturalness. Using this tool, experts evaluated randomly selected digital photographs of female genital injuries captured following sexual assault. Naturalness of female genital injuries following sexual assault was demonstrated when measured in all dimensions.

Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

PubMed

López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

2015-11-01

Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Plan–Provider Integration, Premiums, and Quality in the Medicare Advantage Market

PubMed Central

Frakt, Austin B; Pizer, Steven D; Feldman, Roger

2013-01-01

Objective. To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. Data Source. We used public data from the Centers for Medicare and Medicaid Services (CMS) and the Area Resource File and private data from one large insurer. Premiums and quality ratings are from 2009 CMS administrative files and some control variables are historical. Study Design. We estimated ordinary least-squares models for premiums and plan quality ratings, with state fixed effects and firm random effects. The key independent variable was an indicator of plan–provider integration. Data Collection. With the exception of Medigap premium data, all data were publicly available. We ascertained plan–provider integration through examination of plans’ websites and governance documents. Principal Findings. We found that integrated plan–providers charge higher premiums, controlling for quality. Such plans also have higher quality ratings. We found no evidence that integration is associated with more generous benefits. Conclusions. Current policy encourages plan–provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur). PMID:23800017

CCHDO: Data Management for US and International GO-SHIP and Related Programs

NASA Astrophysics Data System (ADS)

Diggs, S. C.

2016-02-01

An ever-expanding universe of oceanographic data that includes ship-based measurements (CTD, Nutrients, CFCs, etc.) - as well as the data collected from floats, drifters, gliders and moorings - are continuously gathered, scrutinized, documented and disseminated by the CLIVAR and Carbon Hydrographic Data Office (CCHDO) at Scripps Institution of Oceanography. As the official data assembly center for US GO-SHIP (a decadal global hydrography program) the CCHDO is involved in setting and promoting standards of modern data exchange - from observations at sea to final archive. Established in 1996, the CCHDO has a solid history of curating the highest quality full-depth hydrographic data and associated documentation, metadata and DOIs on an API-based web site that provides data in multiple formats and platforms that have been specifically requested by the hydrographic research community. The CCHDO's website, programming platforms, and documentation standards constantly evolve, based on the feedback we receive from the hydrographic community. Technical convergence and collaboration with organizations that include CDIAC, Princeton, NOAA/NCEI, Argo, OceanSITES, BCO-DMO and GO-SHIP is central to our success. We were early adopters of small crowd-sourcing for quality control, and by being involved in all aspects of data use we reintegrate suggested changes to the data, flags and documentation supplied by the most highly recognized and regarded hydrography researchers and institutions in the world.

Implementation of Quality Management in Core Service Laboratories

PubMed Central

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

2010-01-01

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

BACT Simulation User Guide (Version 7.0)

NASA Technical Reports Server (NTRS)

Waszak, Martin R.

1997-01-01

This report documents the structure and operation of a simulation model of the Benchmark Active Control Technology (BACT) Wind-Tunnel Model. The BACT system was designed, built, and tested at NASA Langley Research Center as part of the Benchmark Models Program and was developed to perform wind-tunnel experiments to obtain benchmark quality data to validate computational fluid dynamics and computational aeroelasticity codes, to verify the accuracy of current aeroservoelasticity design and analysis tools, and to provide an active controls testbed for evaluating new and innovative control algorithms for flutter suppression and gust load alleviation. The BACT system has been especially valuable as a control system testbed.

Agency-wide Quality System Documents

EPA Pesticide Factsheets

Quality specifications for EPA organizations as defined by EPA Directives are internal policy documents that apply only to EPA organizations. The Code of Federal Regulations defines specifications for extramural agreements with non-EPA organizations.

Flight-testing and frequency-domain analysis for rotorcraft handling qualities

NASA Technical Reports Server (NTRS)

Ham, Johnnie A.; Gardner, Charles K.; Tischler, Mark B.

1995-01-01

A demonstration of frequency-domain flight-testing techniques and analysis was performed on a U.S. Army OH-58D helicopter in support of the OH-58D Airworthiness and Flight Characteristics Evaluation and of the Army's development and ongoing review of Aeronautical Design Standard 33C, Handling Qualities Requirements for Military Rotorcraft. Hover and forward flight (60 kn) tests were conducted in 1 flight hour by Army experimental test pilots. Further processing of the hover data generated a complete database of velocity, angular-rate, and acceleration-frequency responses to control inputs. A joint effort was then undertaken by the Airworthiness Qualification Test Dirtectorate and the U.S. Army Aeroflightdynamics Directorate to derive handling-quality information from the frequency-domain database using a variety of approaches. This report documents numerous results that have been obtained from the simple frequency-domain tests; in many areas, these results provide more insight into the aircraft dynmamics that affect handling qualities than do traditional flight tests. The handling-quality results include ADS-33C bandwidth and phase-delay calculations, vibration spectral determinations, transfer-function models to examine single-axis results, and a six-degree-of-freedom fully coupled state-space model. The ability of this model to accurately predict responses was verified using data from pulse inputs. This report also documents the frequency-sweep flight-test technique and data analysis used to support the tests.

[Techniques of iconographic documentation].

PubMed

Motta, G; Valentino, G; Di Lorenzo, G

1996-04-01

The Authors describe modalities of photography and videorecording that should be used in stapes surgery and report the solutions they adopted to get iconographic documentation of high quality standard. As regards videorecording systems, the authors used both S-VHS and U-Matic equipment; with both types high fidelity shootings are obtained in the active documentation of each phase of the operation. Moreover, U-Matic master copying guarantees a final copy of higher quality. Technical difficulties that the authors met in videorecording are connected to the restricted field of view, limited by the speculum, which may itself cause dazzling phenomena or light refraction. A 2/3 inch CCD Sony camera, with a modified ELC(Electronic Light Control), was used to get round these problems, so as to eliminate the reflection of surgical instruments. In order to build up a photographic archive, it is also possible to get slides from single pictures of the recorded tapes, although their definition quality is lower than the one obtained foff photos; these, however, must be taken with reference to precise optical parameters and in particular: for shooting view pictures low enlargements (1,6x) were used with an intermediate aperture (f44), while, to better visualize details(footplate hole, stapedial tendon), it was considered right to u se restricted frames (2,5x) and a low aperture (f22). Such a technical solution, in fact, gives a better relation between depth of field and brightness. Finally the Authors underline that the constant use of the intraoperative videorecording system allows: greater participation of every member of the team in the operation; a delayed critical revision of th e operation; medico-legal documentation of possible intraoperative complications; iconographic material available both for scientific and didactic purposes.

Quality of outpatient clinical notes: a stakeholder definition derived through qualitative research.

PubMed

Hanson, Janice L; Stephens, Mark B; Pangaro, Louis N; Gimbel, Ronald W

2012-11-19

There are no empirically-grounded criteria or tools to define or benchmark the quality of outpatient clinical documentation. Outpatient clinical notes document care, communicate treatment plans and support patient safety, medical education, medico-legal investigations and reimbursement. Accurately describing and assessing quality of clinical documentation is a necessary improvement in an increasingly team-based healthcare delivery system. In this paper we describe the quality of outpatient clinical notes from the perspective of multiple stakeholders. Using purposeful sampling for maximum diversity, we conducted focus groups and individual interviews with clinicians, nursing and ancillary staff, patients, and healthcare administrators at six federal health care facilities between 2009 and 2011. All sessions were audio-recorded, transcribed and qualitatively analyzed using open, axial and selective coding. The 163 participants included 61 clinicians, 52 nurse/ancillary staff, 31 patients and 19 administrative staff. Three organizing themes emerged: 1) characteristics of quality in clinical notes, 2) desired elements within the clinical notes and 3) system supports to improve the quality of clinical notes. We identified 11 codes to describe characteristics of clinical notes, 20 codes to describe desired elements in quality clinical notes and 11 codes to describe clinical system elements that support quality when writing clinical notes. While there was substantial overlap between the aspects of quality described by the four stakeholder groups, only clinicians and administrators identified ease of translation into billing codes as an important characteristic of a quality note. Only patients rated prioritization of their medical problems as an aspect of quality. Nurses included care and education delivered to the patient, information added by the patient, interdisciplinary information, and infection alerts as important content. Perspectives of these four stakeholder groups provide a comprehensive description of quality in outpatient clinical documentation. The resulting description of characteristics and content necessary for quality notes provides a research-based foundation for assessing the quality of clinical documentation in outpatient health care settings.

The application of quality risk management to the bacterial endotoxins test: use of hazard analysis and critical control points.

PubMed

Annalaura, Carducci; Giulia, Davini; Stefano, Ceccanti

2013-01-01

Risk analysis is widely used in the pharmaceutical industry to manage production processes, validation activities, training, and other activities. Several methods of risk analysis are available (for example, failure mode and effects analysis, fault tree analysis), and one or more should be chosen and adapted to the specific field where they will be applied. Among the methods available, hazard analysis and critical control points (HACCP) is a methodology that has been applied since the 1960s, and whose areas of application have expanded over time from food to the pharmaceutical industry. It can be easily and successfully applied to several processes because its main feature is the identification, assessment, and control of hazards. It can be also integrated with other tools, such as fishbone diagram and flowcharting. The aim of this article is to show how HACCP can be used to manage an analytical process, propose how to conduct the necessary steps, and provide data templates necessary to document and useful to follow current good manufacturing practices. In the quality control process, risk analysis is a useful tool for enhancing the uniformity of technical choices and their documented rationale. Accordingly, it allows for more effective and economical laboratory management, is capable of increasing the reliability of analytical results, and enables auditors and authorities to better understand choices that have been made. The aim of this article is to show how hazard analysis and critical control points can be used to manage bacterial endotoxins testing and other analytical processes in a formal, clear, and detailed manner.

A quality control circle process to improve implementation effect of prevention measures for high-risk patients.

PubMed

Feng, Haixia; Li, Guohong; Xu, Cuirong; Ju, Changping; Suo, Peiheng

2017-12-01

The aim of the study was to analyse the influence of prevention measures on pressure injuries for high-risk patients and to establish the most appropriate methods of implementation. Nurses assessed patients using a checklist and factors influencing the prevention of a pressure injury determined by brain storming. A specific series of measures was drawn up and an estimate of risk of pressure injury determined using the Braden Scale, analysis of nursing documents, implementation of prevention measures for pressure sores and awareness of the system both before and after carrying out a quality control circle (QCC) process. The overall scores of implementation of prevention measures ranged from 74.86 ± 14.24 to 87.06 ± 17.04, a result that was statistically significant (P < 0.0025). The Braden Scale scores ranged from 8.53 ± 3.21 to 13.48 ± 3.57. The nursing document scores ranged from 7.67 ± 3.98 to 10.12 ± 1.63; prevention measure scores ranged from 11.48 ± 4.18 to 13.96 ± 3.92. Differences in all of the above results are statistically significant (P < 0.05). Implementation of a QCC can standardise and improve the prevention measures for patients who are vulnerable to pressure sores and is of practical importance to their prevention and control. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Development of Methodology and Technology for Identifying and Quantifying Emission Products from Open Burning and Open Detonation Thermal Treatment Methods. BangBox Test Series. Volume 3. Quality Assurance and Quality Control

DTIC Science & Technology

1992-01-01

software. This document may not be cited for purposes of advertisement. I I I I I I I’ I , , I SECURITY CLASSIF!CATION 0a . T - S PAGE Form Aoprovea...8217, 3 DISTRIBUTION 1AVAILABSLITY OF REPORT N/A 2b DECLASSIFICATION/DOWNGRADING SCHEDULE Unlimited N/A 4 PERFORMING ORGANIZATION REPORT NUMBER( S ) S ...MONITORING ORGANIZATION REPORT NUMBER( S , 6a NAME OF PERFORMING ORGANIZATION 6b. OFFICE SYMBOL 7a NAME OF MONITORING ORGANIZATION Andrulis Research

Experience with modified aerospace reliability and quality assurance method for wind turbines

NASA Technical Reports Server (NTRS)

Klein, W. E.

1982-01-01

The SR&QA approach assures that the machine is not hazardous to the public or operating personnel, can operate unattended on a utility grid, demonstrates reliability operation, and helps establish the quality assurance and maintainability requirements for future wind turbine projects. The approach consisted of modified failure modes and effects analysis (FMEA) during the design phase, minimal hardware inspection during parts fabrication, and three simple documents to control activities during machine construction and operation. Five years experience shows that this low cost approach works well enough that it should be considered by others for similar projects.

2016 Draft Estuarine/Marine Copper Aquatic Life Ambient Water Quality Criteria

EPA Pesticide Factsheets

Documents pertain to Aquatic Life Ambient Water Quality criteria for Copper (2016 Estuarine/marine). These documents contain the safe levels of Copper in water that should protect to the majority of species.

The Empirical Investigation of Perspective-Based Reading

NASA Technical Reports Server (NTRS)

Basili, Victor R.; Green, Scott; Laitenberger, Oliver; Shull, Forrest; Sorumgard, Sivert; Zelkowitz, Marvin V.

1995-01-01

We consider reading techniques a fundamental means of achieving high quality software. Due to lack of research in this area, we are experimenting with the application and comparison of various reading techniques. This paper deals with our experiences with Perspective Based Reading (PBR) a particular reading technique for requirement documents. The goal of PBR is to provide operation scenarios where members of a review team read a document from a particular perspective (eg., tester, developer, user). Our assumption is that the combination of different perspective provides better coverage of the document than the same number of readers using their usual technique. To test the efficacy of PBR, we conducted two runs of a controlled experiment in the environment of NASA GSFC Software Engineering Laboratory (SEL), using developers from the environment. The subjects read two types of documents, one generic in nature and the other from the NASA Domain, using two reading techniques, PBR and their usual technique. The results from these experiment as well as the experimental design, are presented and analyzed. When there is a statistically significant distinction, PBR performs better than the subjects' usual technique. However, PBR appears to be more effective on the generic documents than on the NASA documents.

“A manager in the minds of doctors:” a comparison of new modes of control in European hospitals

PubMed Central

2013-01-01

Background Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. Methods The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. Results The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) ‘integrated’ control with high levels of coordination and coherent patterns for cost and quality controls; (2) ‘partly integrated’ control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) ‘fragmented’ control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Conclusions Our comparison highlights how organisations matter and brings the crucial relevance of ‘coordination’ of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective. PMID:23819578

Analysis of Documentation Speed Using Web-Based Medical Speech Recognition Technology: Randomized Controlled Trial.

PubMed

Vogel, Markus; Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan

2015-11-03

Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted by ASR. Participants' average mood rating was 1.3 (SD 0.6) using ASR assistance compared to 1.6 (SD 0.7) without ASR assistance (P<.001). We conclude that medical documentation with the assistance of Web-based speech recognition leads to an increase in documentation speed, document length, and participant mood when compared to self-typing. Speech recognition is a meaningful and effective tool for the clinical documentation process.

Making Work Pay: Changes in Effective Tax Rates and Guarantees in U.S. Transfer Programs, 1983-2002

ERIC Educational Resources Information Center

Ziliak, James P.

2007-01-01

In the 1990s, many states liberalized statutory rules regarding the tax treatment of earned and unearned income for welfare program eligibility and benefit levels. I use quality control data from the AFDC/TANF program over 1983-2002 to document changes in the corresponding effective tax rates and benefit guarantees. After welfare reform I find…

The Interchangeability of Viscoelastographic Instruments and Reagents

DTIC Science & Technology

2014-01-01

policy or decision, unless so designated by other documentation. 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office...range designated by the manufac- turer. During the period during which the experiments were conducted, a total of 18 quality control tests were run on...instruments and reagents BACKGROUND: Viscoelastic measurements are frequently being used in clinical and research settings for a rapid assessment of

A framework for developing research protocols for evaluation of microbial hazards and controls during production that pertain to the quality of agricultural water contacting fresh produce that may be consumed raw

USDA-ARS?s Scientific Manuscript database

Agricultural water may contact fresh produce during irrigation and/or when crop protection sprays (e.g., cooling to prevent sunburn, frost protection, and agrochemical mixtures) are applied. This document provides a framework for designing research studies that would add to our understanding of preh...

GCE Data Toolbox for MATLAB - a software framework for automating environmental data processing, quality control and documentation

NASA Astrophysics Data System (ADS)

Sheldon, W.; Chamblee, J.; Cary, R. H.

2013-12-01

Environmental scientists are under increasing pressure from funding agencies and journal publishers to release quality-controlled data in a timely manner, as well as to produce comprehensive metadata for submitting data to long-term archives (e.g. DataONE, Dryad and BCO-DMO). At the same time, the volume of digital data that researchers collect and manage is increasing rapidly due to advances in high frequency electronic data collection from flux towers, instrumented moorings and sensor networks. However, few pre-built software tools are available to meet these data management needs, and those tools that do exist typically focus on part of the data management lifecycle or one class of data. The GCE Data Toolbox has proven to be both a generalized and effective software solution for environmental data management in the Long Term Ecological Research Network (LTER). This open source MATLAB software library, developed by the Georgia Coastal Ecosystems LTER program, integrates metadata capture, creation and management with data processing, quality control and analysis to support the entire data lifecycle. Raw data can be imported directly from common data logger formats (e.g. SeaBird, Campbell Scientific, YSI, Hobo), as well as delimited text files, MATLAB files and relational database queries. Basic metadata are derived from the data source itself (e.g. parsed from file headers) and by value inspection, and then augmented using editable metadata templates containing boilerplate documentation, attribute descriptors, code definitions and quality control rules. Data and metadata content, quality control rules and qualifier flags are then managed together in a robust data structure that supports database functionality and ensures data validity throughout processing. A growing suite of metadata-aware editing, quality control, analysis and synthesis tools are provided with the software to support managing data using graphical forms and command-line functions, as well as developing automated workflows for unattended processing. Finalized data and structured metadata can be exported in a wide variety of text and MATLAB formats or uploaded to a relational database for long-term archiving and distribution. The GCE Data Toolbox can be used as a complete, light-weight solution for environmental data and metadata management, but it can also be used in conjunction with other cyber infrastructure to provide a more comprehensive solution. For example, newly acquired data can be retrieved from a Data Turbine or Campbell LoggerNet Database server for quality control and processing, then transformed to CUAHSI Observations Data Model format and uploaded to a HydroServer for distribution through the CUAHSI Hydrologic Information System. The GCE Data Toolbox can also be leveraged in analytical workflows developed using Kepler or other systems that support MATLAB integration or tool chaining. This software can therefore be leveraged in many ways to help researchers manage, analyze and distribute the data they collect.

St. Bernard Citizens for Environmental Quality (et al.) Petition to Object to Chalmette Refinery Wastewater Treatment and Coker Title V Permits

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Review of maintenance, start-up, shutdown activities by Region 6 of the Texas Commission on Environmental Quality draft model permit

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Response to a Question Concerning the Use of the Significant Levels for Air Quality Impact as Outlined in Section III.A. of 40 CFR 51, Appendix S.

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

St. Bernard Citizens for Environmental Quality (et al.) Petition to Object to Chalmette Refinery Utilities Title V Permit

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

U.S. District Court, District of Oregon, Order, Oregon Environmental Council and the Sierra Club v. Oregon Department on Environmental Quality

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Improving Quality of Seal Leak Test Product using Six Sigma

NASA Astrophysics Data System (ADS)

Luthfi Malik, Abdullah; Akbar, Muhammad; Irianto, Dradjad

2016-02-01

Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure.

Early Childhood Education and Care (ECEC) Quality Standards in the Republic of Ireland and the Republic of Serbia: Two Discourses of Quality

ERIC Educational Resources Information Center

Breneselovic, Dragana Pavlovic

2015-01-01

The paper provides a comparative analysis of establishing quality in early childhood education and care (ECEC) in the Republic of Ireland and the Republic of Serbia. The analysis is done through desk research of documents dealing with the standards of quality. The following dimensions were compared: 1) The way of preparing and adopting documents;…

ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

PubMed

Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

2010-09-01

Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.

Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores.

PubMed

Skyttberg, Niclas; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2017-08-30

Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories - plausibility and concordance - were used. The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely electronic.

U.S. Geological Survey quality-assurance plan for continuous water-quality monitoring in Kansas, 2014

USGS Publications Warehouse

Bennett, Trudy J.; Graham, Jennifer L.; Foster, Guy M.; Stone, Mandy L.; Juracek, Kyle E.; Rasmussen, Teresa J.; Putnam, James E.

2014-01-01

A quality-assurance plan for use in conducting continuous water-quality monitoring activities has been developed for the Kansas Water Science Center in accordance with guidelines set forth by the U.S. Geological Survey. This quality-assurance plan documents the standards, policies, and procedures used by the U.S. Geological Survey in Kansas for activities related to the collection, processing, storage, analysis, and release of continuous water-quality monitoring data. The policies and procedures that are documented in this quality-assurance plan for continuous water-quality monitoring activities complement quality-assurance plans for surface-water and groundwater activities in Kansas.

Quality-assurance plan for water-quality activities in the U.S. Geological Survey Washington Water Science Center

USGS Publications Warehouse

Conn, Kathleen E.; Huffman, Raegan L.; Barton, Cynthia

2017-05-08

In accordance with guidelines set forth by the Office of Water Quality in the Water Mission Area of the U.S. Geological Survey, a quality-assurance plan has been created for use by the Washington Water Science Center (WAWSC) in conducting water-quality activities. This qualityassurance plan documents the standards, policies, and procedures used by the WAWSC for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures documented in this quality-assurance plan for water-quality activities complement the quality-assurance plans for surface-water and groundwater activities at the WAWSC.

Spouses' involvement in their partners' diabetes management: associations with spouse stress and perceived marital quality.

PubMed

August, Kristin J; Rook, Karen S; Franks, Melissa M; Parris Stephens, Mary Ann

2013-10-01

Spouses frequently attempt to influence (control) or support their chronically ill partners' adherence behaviors. Studies have documented effects of spousal control and support on chronically ill individuals, but little is known about how these two forms of involvement in a partner's disease management may be associated with spouses' stress or the quality of their interactions with their ill partners. The current study sought to address this gap by examining spouses' day-to-day involvement in their marital partner's management of type 2 diabetes (n = 129). Multilevel analyses of daily diary data revealed that on days when spouses exerted control, they reported more stress and more tense marital interactions, although these associations were more pronounced when patients exhibited poor adherence, had been ill for a longer period of time, and had more comorbid health conditions. On days when spouses provided support, in contrast, they reported less stress and more enjoyable marital interactions. The findings from the current study suggest that spouses' day-to-day stress and quality of interactions with their partners are associated with spouses' involvement in their partners' disease management, with health-related social control and support exhibiting distinctive associations.

Interim Basis for PCB Sampling and Analyses

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

BANNING, D.L.

2001-01-18

This document was developed as an interim basis for sampling and analysis of polychlorinated biphenyls (PCBs) and will be used until a formal data quality objective (DQO) document is prepared and approved. On August 31, 2000, the Framework Agreement for Management of Polychlorinated Biphenyls (PCBs) in Hanford Tank Waste was signed by the US. Department of Energy (DOE), the Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) (Ecology et al. 2000). This agreement outlines the management of double shell tank (DST) waste as Toxic Substance Control Act (TSCA) PCB remediation waste based on a risk-based disposalmore » approval option per Title 40 of the Code of Federal Regulations 761.61 (c). The agreement calls for ''Quantification of PCBs in DSTs, single shell tanks (SSTs), and incoming waste to ensure that the vitrification plant and other ancillary facilities PCB waste acceptance limits and the requirements of the anticipated risk-based disposal approval are met.'' Waste samples will be analyzed for PCBs to satisfy this requirement. This document describes the DQO process undertaken to assure appropriate data will be collected to support management of PCBs and is presented in a DQO format. The DQO process was implemented in accordance with the U.S. Environmental Protection Agency EPA QAlG4, Guidance for the Data Quality Objectives Process (EPA 1994) and the Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. 1 A, Vol. IV, Section 4.16 (Banning 1999).« less

Interim Basis for PCB Sampling and Analyses

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

BANNING, D.L.

2001-03-20

This document was developed as an interim basis for sampling and analysis of polychlorinated biphenyls (PCBs) and will be used until a formal data quality objective (DQO) document is prepared and approved. On August 31, 2000, the Framework Agreement for Management of Polychlorinated Biphenyls (PCBs) in Hanford Tank Waste was signed by the U.S. Department of Energy (DOE), the Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) (Ecology et al. 2000). This agreement outlines the management of double shell tank (DST) waste as Toxic Substance Control Act (TSCA) PCB remediation waste based on a risk-based disposalmore » approval option per Title 40 of the Code of Federal Regulations 761.61 (c). The agreement calls for ''Quantification of PCBs in DSTs, single shell tanks (SSTs), and incoming waste to ensure that the vitrification plant and other ancillary facilities PCB waste acceptance limits and the requirements of the anticipated risk-based disposal approval are met.'' Waste samples will be analyzed for PCBs to satisfy this requirement. This document describes the DQO process undertaken to assure appropriate data will be collected to support management of PCBs and is presented in a DQO format. The DQO process was implemented in accordance with the U.S. Environmental Protection Agency EPA QA/G4, Guidance for the Data Quality Objectives Process (EPA 1994) and the Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. 1A, Vol. IV, Section 4.16 (Banning 1999).« less

78 FR 4151 - Medicare Program; Request for Information on Hospital and Vendor Readiness for Electronic Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-18

...) Program using the Quality Reporting Document Architecture (QRDA) Category I. The comment period for the... Reporting (IQR) Program using the Quality Reporting Document Architecture (QRDA) Category I beginning with...

7 CFR 62.206 - Access to program documents and activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) LIVESTOCK, MEAT, AND OTHER AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.206 Access to program documents and... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

EMC and power quality standards for 20-kHz power distribution

NASA Technical Reports Server (NTRS)

Hansen, Irving G.

1987-01-01

The Space Station Power Distribution System has been baselined as a sinusoidal single phase, 440 VRMS system. This system has certain unique characteristics directly affecting its application. In particular, existing systematic description and control documents were modified to reflect the high operating frequency. This paper will discuss amendments made on Mil STD 704 (Electrical Power Characteristics), and Mil STD 461-B (Electromagnetic Emission and Susceptibility Requirements for the Control of Electromagnetic Interference). In some cases these amendments reflect changes of several orders of magnitude. Implications and impacts of these changes are discussed.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

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

Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert

2005-01-01

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 DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management andmore » software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.« less

The standard calibration instrument automation system for the atomic absorption spectrophotometer. Part 3: Program documentation

NASA Astrophysics Data System (ADS)

Ryan, D. P.; Roth, G. S.

1982-04-01

Complete documentation of the 15 programs and 11 data files of the EPA Atomic Absorption Instrument Automation System is presented. The system incorporates the following major features: (1) multipoint calibration using first, second, or third degree regression or linear interpolation, (2) timely quality control assessments for spiked samples, duplicates, laboratory control standards, reagent blanks, and instrument check standards, (3) reagent blank subtraction, and (4) plotting of calibration curves and raw data peaks. The programs of this system are written in Data General Extended BASIC, Revision 4.3, as enhanced for multi-user, real-time data acquisition. They run in a Data General Nova 840 minicomputer under the operating system RDOS, Revision 6.2. There is a functional description, a symbol definitions table, a functional flowchart, a program listing, and a symbol cross reference table for each program. The structure of every data file is also detailed.

Low bandwidth robust controllers for flight

NASA Technical Reports Server (NTRS)

Biezad, Daniel J.; Chou, Hwei-Lan

1992-01-01

During the final reporting period (Jun. - Dec. 1992), analyses of the longitudinal and lateral flying qualities were made for propulsive-only flight control (POFC) of a Boeing 720 aircraft model. Performance resulting from compensators developed using Quantitative Feedback Theory (QFT) is documented and analyzed. This report is a first draft of a thesis to be presented by graduate student Hwei-Lan Chou. The final thesis will be presented to NASA when it is completed later this year. The latest landing metrics related to bandwidth criteria and based on the Neal-Smith approach to flying qualities prediction were used in developing performance criteria for the controllers. The compensator designs were tested on the NASA simulator and exhibited adequate performance for piloted flight. There was no significant impact of QFT on performance of the propulsive-only flight controllers in either the longitudinal or lateral modes of flight. This was attributed to the physical limits of thrust available and the engine rate of response, both of whiih severely limited the available bandwidth of the closed-loop system.

Shoulder dystocia documentation: an evaluation of a documentation training intervention.

PubMed

LeRiche, Tammy; Oppenheimer, Lawrence; Caughey, Sharon; Fell, Deshayne; Walker, Mark

2015-03-01

To evaluate the quality and content of nurse and physician shoulder dystocia delivery documentation before and after MORE training in shoulder dystocia management skills and documentation. Approximately 384 charts at the Ottawa Hospital General Campus involving a diagnosis of shoulder dystocia between the years of 2000 and 2006 excluding the training year of 2003 were identified. The charts were evaluated for 14 key components derived from a validated instrument. The delivery notes were then scored based on these components by 2 separate investigators who were blinded to delivery note author, date, and patient identification to further quantify delivery record quality. Approximately 346 charts were reviewed for physician and nurse delivery documentation. The average score for physician notes was 6 (maximum possible score of 14) both before and after the training intervention. The nurses' average score was 5 before and after the training intervention. Negligible improvement was observed in the content and quality of shoulder dystocia documentation before and after nurse and physician training.

76 FR 22665 - Release of Final Document Related to the Review of the National Ambient Air Quality Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... ``cause or contribute to air pollution which may reasonably be anticipated to endanger public health or... Document Related to the Review of the National Ambient Air Quality Standards for Particulate Matter AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of availability. SUMMARY: The Office of Air Quality...

Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

PubMed

Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

2018-02-09

Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P < 0.01). Chart design did support neither clinical authorization of individual insulin prescription (10%), nor insulin administration confirmed by nurses' signature (25%), nor treatment of hypoglycemia (0%), which resulted in a reduced documentation and treatment quality in clinical practice 7%, 30%, 25%, respectively. A multitude of charts with variable design characteristics and structural deficits were in use across the inpatient wards. More than half of the inpatients had a chart displaying a medication error. Lack of structure quality features of the charts had an impact on documentation and treatment quality. Based on identified deficits and international standards, a new insulin chart was developed to overcome these quality hurdles.

The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration

PubMed Central

Ogrinc, G; Mooney, S E; Estrada, C; Foster, T; Goldmann, D; Hall, L W; Huizinga, M M; Liu, S K; Mills, P; Neily, J; Nelson, W; Pronovost, P J; Provost, L; Rubenstein, L V; Speroff, T; Splaine, M; Thomson, R; Tomolo, A M; Watts, B

2008-01-01

As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This “Explanation and Elaboration” document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org. PMID:18836062

Motivation for documentation.

PubMed

Graham, Denise H

2004-11-01

The quality improvement plan relies on controlling quality of care through improving the process or system as a whole. Your ongoing data collection is paramount to the process of system-wide improvement and performance, enhancement of financial performance, operational performance and overall service performance and satisfaction. The threat of litigation and having to defend yourself from a claim of wrongdoing still looms every time your wheels turn. Your runsheet must serve and protect you. Look at the NFPA 1710 standard, which was enacted to serve and protect firefighters. This standard was enacted with their personal safety and well-being as the principle behind staffing requirements. At what stage of draft do you suppose the NFPA 1710 standard would be today if the relative data were collected sporadically or were not tracked for each service-related death? It may have taken many more service-related deaths to effect change for a system-wide improvement in operational performance. Every call merits documentation and data collection. Your data are catalysts for change.

Preliminary remediation goals for use at the US Department of Energy Oak Ridge Operations Office. Revision 1

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

NONE

1996-05-01

This technical memorandum presents Preliminary Remediation Goals (PRGs) for use in human health risk assessment efforts under the United States Department of Energy, Oak Ridge Operations Office Environmental Restoration (ER) Division. This document provides the ER Division with standardized PRGs which are integral to the Remedial Investigation/Feasibility Study process. They are used during project scooping (Data Quality Objectives development), in screening level risk assessments to support early action or No Further Investigation decisions, and in the baselines risk assessment where they are employed in the selection of chemicals of potential concern. The primary objective of this document is to standardizemore » these values and eliminate any duplication of effort by providing PRGs to all contractors involved in risk activities. In addition, by managing the assumptions and systems used in PRG derivation, the ER Risk Assessment Program will be able to control the level of quality assurance associated with these risk-based guideline values.« less

Tactical Approaches for Making a Successful Satellite Passive Microwave ESDR

NASA Astrophysics Data System (ADS)

Hardman, M.; Brodzik, M. J.; Gotberg, J.; Long, D. G.; Paget, A. C.

2014-12-01

Our NASA MEaSUREs project is producing a new, enhanced resolution gridded Earth System Data Record for the entire satellite passive microwave (SMMR, SSM/I-SSMIS and AMSR-E) time series. Our project goals are twofold: to produce a well-documented, consistently processed, high-quality historical record at higher spatial resolutions than have previously been available, and to transition the production software to the NSIDC DAAC for ongoing processing after our project completion. In support of these goals, our distributed team at BYU and NSIDC faces project coordination challenges to produce a high-quality data set that our user community will accept as a replacement for the currently available historical versions of these data. We work closely with our DAAC liaison on format specifications, data and metadata plans, and project progress. In order for the user community to understand and support our project, we have solicited a team of Early Adopters who are reviewing and evaluating a prototype version of the data. Early Adopter feedback will be critical input to our final data content and format decisions. For algorithm transparency and accountability, we have released an Algorithm Theoretical Basis Document (ATBD) and detailed supporting technical documentation, with rationale for all algorithm implementation decisions. For distributed team management, we are using collaborative tools for software revision control and issue tracking. For reliably transitioning a research-quality image reconstruction software system to production-quality software suitable for use at the DAAC, we have adopted continuous integration methods for running automated regression testing. Our presentation will summarize bothadvantages and challenges of each of these tactics in ensuring production of a successful ESDR and an enduring production software system.

Efficacy testing of cosmetic products. A proposal to the European Community by the Danish Environmental Protection Agency, Ministry of Environment and Energy.

PubMed

Serup, J

2001-08-01

Regulations for cosmetic products primarily address safety of the products that may be used by large populations of healthy consumers. Requirements for documentation of efficacy claims are only fragmentary. This synopsis aims to review and conclude a set of standards that may be acceptable to the European Community, and the cosmetic industry, as a legal standard for efficacy documentation in Europe in the future. Ethical, formal, experimental, statistical and other aspects of efficacy testing are described, including validation, quality control and assurance. The importance of user relevant clinical end points, a controlled randomized trial design and evidence-based cosmetic product documentation, validation of methods, statistical power estimation and proper data handling, reporting and archiving is emphasized. The main principles of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) good clinical practice (GCP) should be followed by the cosmetics industry in a spirit of good documentation standard and scientific soundness, but full GCP is not considered mandatory in the field of cosmetics. Documentation by validated bio-instrumental methods may be acceptable, but efficacy documentation based on information about raw materials, reference to literature and laboratory experiments are only acceptable in exceptional cases. Principles for efficacy substantiation of cosmetic products in Europe, as described in this synopsis, are officially proposed by the Danish Ministry of Environment and Energy to the European Community as a basis for an amendment to the Cosmetics Directive or otherwise implemented as a European Community regulation.

Discharge documentation of patients discharged to subacute facilities: a three-year quality improvement process across an integrated health care system.

PubMed

Gandara, Esteban; Ungar, Jonathan; Lee, Jason; Chan-Macrae, Myrna; O'Malley, Terrence; Schnipper, Jeffrey L

2010-06-01

Effective communication among physicians during hospital discharge is critical to patient care. Partners Healthcare (Boston) has been engaged in a multi-year process to measure and improve the quality of documentation of all patients discharged from its five acute care hospitals to subacute facilities. Partners first engaged stakeholders to develop a consensus set of 12 required data elements for all discharges to subacute facilities. A measurement process was established and later refined. Quality improvement interventions were then initiated to address measured deficiencies and included education of physicians and nurses, improvements in information technology, creation of or improvements in discharge documentation templates, training of hospitalists to serve as role models, feedback to physicians and their service chiefs regarding reviewed cases, and case manager review of documentation before discharge. To measure improvement in quality as a result of these efforts, rates of simultaneous inclusion of all 12 applicable data elements ("defect-free rate") were analyzed over time. Some 3,101 discharge documentation packets of patients discharged to subacute facilities from January 1, 2006, through September 2008 were retrospectively studied. During the 11 monitored quarters, the defect-free rate increased from 65% to 96% (p < .001 for trend). The largest improvements were seen in documentation of preadmission medication lists, allergies, follow-up, and warfarin information. Institution of rigorous measurement, feedback, and multidisciplinary, multimodal quality improvement processes improved the inclusion of data elements in discharge documentation required for safe hospital discharge across a large integrated health care system.

Assessment Report Sandia National Laboratories Fuel Cycle Technologies Quality Assurance Evaluation of FY15 SNL FCT M2 Milestone Deliverables

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

Appel, Gordon John

Sandia National Laboratories (SNL) Fuel Cycle Technologies (FCT) program activities are conducted in accordance with FCT Quality Assurance Program Document (FCT-QAPD) requirements. The FCT-QAPD interfaces with SNL approved Quality Assurance Program Description (SNL-QAPD) as explained in the Sandia National Laboratories QA Program Interface Document for FCT Activities (Interface Document). This plan describes SNL's FY16 assessment of SNL's FY15 FCT M2 milestone deliverable's compliance with program QA requirements, including SNL R&A requirements. The assessment is intended to confirm that SNL's FY15 milestone deliverables contain the appropriate authenticated review documentation and that there is a copy marked with SNL R&A numbers.

Quality assurance and quality control for thermal/optical analysis of aerosol samples for organic and elemental carbon.

PubMed

Chow, Judith C; Watson, John G; Robles, Jerome; Wang, Xiaoliang; Chen, L-W Antony; Trimble, Dana L; Kohl, Steven D; Tropp, Richard J; Fung, Kochy K

2011-12-01

Accurate, precise, and valid organic and elemental carbon (OC and EC, respectively) measurements require more effort than the routine analysis of ambient aerosol and source samples. This paper documents the quality assurance (QA) and quality control (QC) procedures that should be implemented to ensure consistency of OC and EC measurements. Prior to field sampling, the appropriate filter substrate must be selected and tested for sampling effectiveness. Unexposed filters are pre-fired to remove contaminants and acceptance tested. After sampling, filters must be stored in the laboratory in clean, labeled containers under refrigeration (<4 °C) to minimize loss of semi-volatile OC. QA activities include participation in laboratory accreditation programs, external system audits, and interlaboratory comparisons. For thermal/optical carbon analyses, periodic QC tests include calibration of the flame ionization detector with different types of carbon standards, thermogram inspection, replicate analyses, quantification of trace oxygen concentrations (<100 ppmv) in the helium atmosphere, and calibration of the sample temperature sensor. These established QA/QC procedures are applicable to aerosol sampling and analysis for carbon and other chemical components.

Microbiological methods for the water recovery systems test, revision 1.1

NASA Technical Reports Server (NTRS)

Rhoads, Tim; Kilgore, M. V., Jr.; Mikell, A. T., Jr.

1990-01-01

Current microbiological parameters specified to verify microbiological quality of Space Station Freedom water quality include the enumeration of total bacteria, anaerobes, aerobes, yeasts and molds, enteric bacteria, gram positives, gram negatives, and E. coli. In addition, other parameters have been identified as necessary to support the Water Recovery Test activities to be conducted at the NASA/MSFC later this year. These other parameters include aerotolerant eutrophic mesophiles, legionellae, and an additional method for heterotrophic bacteria. If inter-laboratory data are to be compared to evaluate quality, analytical methods must be eliminated as a variable. Therefore, each participating laboratory must utilize the same analytical methods and procedures. Without this standardization, data can be neither compared nor validated between laboratories. Multiple laboratory participation represents a conservative approach to insure quality and completeness of data. Invariably, sample loss will occur in transport and analyses. Natural variance is a reality on any test of this magnitude and is further enhanced because biological entities, capable of growth and death, are specific parameters of interest. The large variation due to the participation of human test subjects has been noted with previous testing. The resultant data might be dismissed as 'out of control' unless intra-laboratory control is included as part of the method or if participating laboratories are not available for verification. The purpose of this document is to provide standardized laboratory procedures for the enumeration of certain microorganisms in water and wastewater specific to the water recovery systems test. The document consists of ten separate cultural methods and one direct count procedure. It is not intended nor is it implied to be a complete microbiological methods manual.

Industry guidelines, laws and regulations ignored: quality of drug advertising in medical journals.

PubMed

Lankinen, Kari S; Levola, Tero; Marttinen, Kati; Puumalainen, Inka; Helin-Salmivaara, Arja

2004-11-01

To document the quality of evidence base for marketing claims in prescription drug advertisements, to facilitate identification of potential targets for quality improvement. A sample of 1036 advertisements from four major Finnish medical journals published in 2002. Marketing claims were classified in four groups: unambiguous clinical outcome, vague clinical outcome, emotive or immeasurable outcome and non-clinical outcome. Medline references were traced and classified according to the level of evidence available. The statistical variables used in the advertisements were also documented. The sample included 245 distinct advertisements with 883 marketing claims, 1-10 claims per advertisement. Three hundred thirty seven (38%) of the claims were referenced. Each claim could be supported by one reference or more, so the number of references analysed totalled 381, 1-9 references per advertisement. Nine percent of the claims implied unambiguous clinical outcomes, 68% included vague or emotive statements. Twenty one percent of the references were irrelevant to the claim. There was a fair amount of non-scientific and scientific support for the 73 unambiguous claims, but not a single claim was supported by strong scientific evidence. Vague, emotive and non-clinical claims were significantly more often supported by non-Medline or irrelevant references than unambiguous claims. Statistical parameters were stated only 34 times. Referenced marketing claims may appear more scientific, but the use of references does not guarantee the quality of the claims. For the benefit of all stakeholders, both the regulatory control and industry's self-control of drug marketing should adopt more active monitoring roles, and apply sanctions when appropriate. Concerted efforts by several stakeholders might be more effective. Copyright 2004 John Wiley & Sons, Ltd.

A Community Standard Format for the Representation of Protein Affinity Reagents*

PubMed Central

Gloriam, David E.; Orchard, Sandra; Bertinetti, Daniela; Björling, Erik; Bongcam-Rudloff, Erik; Borrebaeck, Carl A. K.; Bourbeillon, Julie; Bradbury, Andrew R. M.; de Daruvar, Antoine; Dübel, Stefan; Frank, Ronald; Gibson, Toby J.; Gold, Larry; Haslam, Niall; Herberg, Friedrich W.; Hiltke, Tara; Hoheisel, Jörg D.; Kerrien, Samuel; Koegl, Manfred; Konthur, Zoltán; Korn, Bernhard; Landegren, Ulf; Montecchi-Palazzi, Luisa; Palcy, Sandrine; Rodriguez, Henry; Schweinsberg, Sonja; Sievert, Volker; Stoevesandt, Oda; Taussig, Michael J.; Ueffing, Marius; Uhlén, Mathias; van der Maarel, Silvère; Wingren, Christer; Woollard, Peter; Sherman, David J.; Hermjakob, Henning

2010-01-01

Protein affinity reagents (PARs), most commonly antibodies, are essential reagents for protein characterization in basic research, biotechnology, and diagnostics as well as the fastest growing class of therapeutics. Large numbers of PARs are available commercially; however, their quality is often uncertain. In addition, currently available PARs cover only a fraction of the human proteome, and their cost is prohibitive for proteome scale applications. This situation has triggered several initiatives involving large scale generation and validation of antibodies, for example the Swedish Human Protein Atlas and the German Antibody Factory. Antibodies targeting specific subproteomes are being pursued by members of Human Proteome Organisation (plasma and liver proteome projects) and the United States National Cancer Institute (cancer-associated antigens). ProteomeBinders, a European consortium, aims to set up a resource of consistently quality-controlled protein-binding reagents for the whole human proteome. An ultimate PAR database resource would allow consumers to visit one on-line warehouse and find all available affinity reagents from different providers together with documentation that facilitates easy comparison of their cost and quality. However, in contrast to, for example, nucleotide databases among which data are synchronized between the major data providers, current PAR producers, quality control centers, and commercial companies all use incompatible formats, hindering data exchange. Here we propose Proteomics Standards Initiative (PSI)-PAR as a global community standard format for the representation and exchange of protein affinity reagent data. The PSI-PAR format is maintained by the Human Proteome Organisation PSI and was developed within the context of ProteomeBinders by building on a mature proteomics standard format, PSI-molecular interaction, which is a widely accepted and established community standard for molecular interaction data. Further information and documentation are available on the PSI-PAR web site. PMID:19674966

Fact Sheet: Revised Draft Ambient Water Quality Criteria Document for Atrazine and Request for Scientific Views

EPA Pesticide Factsheets

Documents pertaining to Acute and Chronic Ambient Water Quality Aquatic Life Criteria for Atrazine (Freshwater and Salt Water) and revised Ecological Fate and Effects Risk Assessment for Atrazine. (Fact Sheet)

Fisher Sand & Gravel New Mexico, Inc. General Air Quality Permit: Related Documents

EPA Pesticide Factsheets

Documents related to the Fisher Sand & Gravel – New Mexico, Inc., Grey Mesa Gravel Pit General Air Quality Permit for New or Modified Minor Source Stone Quarrying, Crushing, and Screening Facilities in Indian Country.

Air Quality Criteria for Ozone and Related Photochemical ...

EPA Pesticide Factsheets

In February 2006, EPA released the final document, Air Quality Criteria for Ozone and Other Photochemical Oxidants. Tropospheric or surface-level ozone (O3) is one of six major air pollutants regulated by National Ambient Air Quality Standards (NAAQS) under the U.S. Clean Air Act. As mandated by the Clean Air Act, the U.S. Environmental Protection Agency (EPA) must periodically review the scientific bases (or criteria) for the various NAAQS by assessing newly available scientific information on a given criteria air pollutant. This document, Air Quality Criteria for Ozone and Other Photochemical Oxidants, is an updated revision of the 1996 Ozone Air Quality Criteria Document (O3 AQCD) that provided scientific bases for the current O3 NAAQS set in 1997. The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including ozone.

Quality-assurance and data-management plan for water-quality activities in the Kansas Water Science Center, 2014

USGS Publications Warehouse

Rasmussen, Teresa J.; Bennett, Trudy J.; Foster, Guy M.; Graham, Jennifer L.; Putnam, James E.

2014-01-01

As the Nation’s largest water, earth, and biological science and civilian mapping information agency, the U.S. Geological Survey is relied on to collect high-quality data, and produce factual and impartial interpretive reports. This quality-assurance and data-management plan provides guidance for water-quality activities conducted by the Kansas Water Science Center. Policies and procedures are documented for activities related to planning, collecting, storing, documenting, tracking, verifying, approving, archiving, and disseminating water-quality data. The policies and procedures described in this plan complement quality-assurance plans for continuous water-quality monitoring, surface-water, and groundwater activities in Kansas.

The changes in caregivers' perceptions about the quality of information and benefits of nursing documentation associated with the introduction of an electronic documentation system in a nursing home.

PubMed

Munyisia, Esther N; Yu, Ping; Hailey, David

2011-02-01

To date few studies have compared nursing home caregivers' perceptions about the quality of information and benefits of nursing documentation in paper and electronic formats. With the increased interest in the use of information technology in nursing homes, it is important to obtain information on the benefits of newer approaches to nursing documentation so as to inform investment, organisational and care service decisions in the aged care sector. This study aims to investigate caregivers' perceptions about the quality of information and benefits of nursing documentation before and after the introduction of an electronic documentation system in a nursing home. A self-administered questionnaire survey was conducted three months before, and then six, 18 and 31 months after the introduction of an electronic documentation system. Further evidence was obtained through informal discussions with caregivers. Scores for questionnaire responses showed that the benefits of the electronic documentation system were perceived by the caregivers as provision of more accurate, legible and complete information, and reduction of repetition in data entry, with consequential managerial benefits. However, caregivers' perceptions of relevance and reliability of information, and of their communication and decision-making abilities were perceived to be similar either using an electronic or a paper-based documentation system. Improvement in some perceptions about the quality of information and benefits of nursing documentation was evident in the measurement conducted six months after the introduction of the electronic system, but were not maintained 18 or 31 months later. The electronic documentation system was perceived to perform better than the paper-based system in some aspects, with subsequent benefits to management of aged care services. In other areas, perceptions of additional benefits from the electronic documentation system were not maintained. In a number of attributes, there were similar perceptions on the two types of systems. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Archive data base and handling system for the Orbiter flying qualities experiment program

NASA Technical Reports Server (NTRS)

Myers, T. T.; Dimarco, R.; Magdaleno, R. E.; Aponso, B. L.

1986-01-01

The OFQ archives data base and handling system assembled as part of the Orbiter Flying Qualities (OFQ) research of the Orbiter Experiments Program (EOX) are described. The purpose of the OFQ archives is to preserve and document shuttle flight data relevant to vehicle dynamics, flight control, and flying qualities in a form that permits maximum use for qualified users. In their complete form, the OFQ archives contain descriptive text (general information about the flight, signal descriptions and units) as well as numerical time history data. Since the shuttle program is so complex, the official data base contains thousands of signals and very complex entries are required to obtain data. The OFQ archives are intended to provide flight phase oriented data subsets with relevant signals which are easily identified for flying qualities research.

Ethnographic Exploration of Empowerment to Improve Elderly Residents' Quality of Life.

PubMed

Tabatabaei, Seyed Zia; Ebrahimi, Fatemeh; Hamzah, Azimi Bin Hj; Rezaeian, Mohsen; Kamrani, Mahnaz Akbari

2017-01-01

Evidence underscores that empowerment is central to improve the elderly residents' quality of life. In truth, empowerment is a process through which individuals gain better control over their life. The aim of this study was to explore how perceived empowerment influence on the quality of life among elderly Malay residents. A focus ethnographic approach was employed in a Malaysian residential home between May 2011 and January 2012. Data were gathered from participant observations, field notes, in-depth interviews, and exploring related documents. The analysis of the data gathered in the current study resulted in the development of three themes - social life and its requirements, caregivers' skills empowerment, and listening and supporting. Findings of the study provide new insights that are useful in charting new guideline for care providers and policy makers to improve the elderly residents' quality of life.

40 CFR 1508.10 - Environmental document.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Environmental document. 1508.10 Section 1508.10 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY TERMINOLOGY AND INDEX § 1508.10 Environmental document. Environmental document includes the documents specified in § 1508.9 (environmental...

40 CFR 1508.10 - Environmental document.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Environmental document. 1508.10 Section 1508.10 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY TERMINOLOGY AND INDEX § 1508.10 Environmental document. Environmental document includes the documents specified in § 1508.9 (environmental...

An electronic registry for physiotherapists in Belgium.

PubMed

Buyl, Ronald; Nyssen, Marc

2008-01-01

This paper describes the results of the KINELECTRICS project. Since more and more clinical documents are stored and transmitted in an electronic way, the aim of this project was to design an electronic version of the registry that contains all acts of physiotherapists. The solution we present here, not only meets all legal constraints, but also enables to verify the traceability and inalterability of the generated documents, by means of SHA-256 codes. The proposed structure, using XML technology can also form a basis for the development of tools that can be used by the controlling authorities. By means of a certification procedure for software systems, we succeeded in developing a user friendly system that enables end-users that use a quality labeled software package, to automatically produce all the legally necessary documents concerning the registry. Moreover, we hope that this development will be an incentive for non-users to start working in an electronic way.

Treatment of type 2 diabetes mellitus in elderly patients.

PubMed

Gómez-Huelgas, R; Gómez Peralta, F; Rodríguez Mañas, L; Formiga, F; Puig Domingo, M; Mediavilla Bravo, J J; Miranda, C; Ena, J

2018-03-01

The prevalence of type 2 diabetes mellitus (DM2) increases markedly with age. Antidiabetic treatment and the objectives of glycaemic control in elderly patients with DM2 should be individualised according to their biopsychosocial characteristics. In elderly patients for whom the benefits of intensive antidiabetic treatment are limited, the basic objectives should be to improve the quality of life, preserve functionality and avoid adverse effects, especially hypoglycaemia. Treatment of DM2 in the elderly was the subject of a consensus document published in 2012 and endorsed by several Spanish scientific societies. Since then, new therapeutic groups and evidence have emerged that warrant an update to this consensus document. The present document focuses on the therapeutic aspects of DM2 in elderly patients, understood as being older than 75 years or frail. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

[Treatment of type 2 diabetes mellitus in elderly patients].

PubMed

Gómez-Huelgas, R; Gómez Peralta, F; Rodríguez Mañas, L; Formiga, F; Puig Domingo, M; Mediavilla Bravo, J J; Miranda, C; Ena, J

The prevalence of type 2 diabetes mellitus (DM2) increases markedly with age. Antidiabetic treatment and the objectives of glycaemic control in elderly patients with DM2 should be individualised according to their biopsychosocial characteristics. In elderly patients for whom the benefits of intensive antidiabetic treatment are limited, the basic objectives should be to improve the quality of life, preserve functionality and avoid adverse effects, especially hypoglycaemia. Treatment of DM2 in the elderly was the subject of a consensus document published in 2012 and endorsed by several Spanish scientific societies. Since then, new therapeutic groups and evidence have emerged that warrant an update to this consensus document. The present document focuses on the therapeutic aspects of DM2 in elderly patients, understood as being older than 75 years or frail. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Persistent atrial fibrillation vs paroxysmal atrial fibrillation: differences in management.

PubMed

Margulescu, Andrei D; Mont, Lluis

2017-08-01

Atrial fibrillation (AF) is the most common human arrhythmia. AF is a progressive disease, initially being nonsustained and induced by trigger activity, and progressing towards persistent AF through alteration of the atrial myocardial substrate. Treatment of AF aims to decrease the risk of stroke and improve the quality of life, by preventing recurrences (rhythm control) or controlling the heart rate during AF (rate control). In the last 20 years, catheter-based and, less frequently, surgical and hybrid ablation techniques have proven more successful compared with drug therapy in achieving rhythm control in patients with AF. However, the efficiency of ablation techniques varies greatly, being highest in paroxysmal and lowest in long-term persistent AF. Areas covered: In this review, we discuss the fundamental differences between paroxysmal and persistent AF and the potential impact of those differences on patient management, emphasizing the available therapeutic strategies to achieve rhythm control. Expert commentary: Treatment to prevent AF recurrences is suboptimal, particularly in patients with persistent AF. Emerging technologies, such as documentation of atrial fibrosis using magnetic resonance imaging and documentation of electrical substrate using advanced electrocardiographic imaging techniques are likely to provide valuable insights about patient-specific tailoring of treatments.

Quality-Assurance Plan for Water-Quality Activities in the USGS Ohio Water Science Center

USGS Publications Warehouse

Francy, Donna S.; Shaffer, Kimberly H.

2008-01-01

In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Discipline of the U.S. Geological Survey, a quality-assurance plan has been written for use by the Ohio Water Science Center in conducting water-quality activities. This quality-assurance plan documents the standards, policies, and procedures used by the Ohio Water Science Center for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures documented in this quality-assurance plan for water-quality activities are meant to complement the Ohio Water Science Center quality-assurance plans for water-quality monitors, the microbiology laboratory, and surface-water and ground-water activities.

Standard classification of software documentation

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

General conceptual requirements for standard levels of documentation and for application of these requirements to intended usages. These standards encourage the policy to produce only those forms of documentation that are needed and adequate for the purpose. Documentation standards are defined with respect to detail and format quality. Classes A through D range, in order, from the most definitive down to the least definitive, and categories 1 through 4 range, in order, from high-quality typeset down to handwritten material. Criteria for each of the classes and categories, as well as suggested selection guidelines for each are given.

Physical Property Analysis and Report for Sediments at 100-BC-5 Operable Unit, Boreholes C7505, C7506, C7507, and C7665

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

Lindberg, Michael J.

2010-09-28

Between October 14, 2009 and February 22, 2010 sediment samples were received from 100-BC Decision Unit for geochemical studies. This is an analytical data report for sediments received from CHPRC at the 100 BC 5 OU. The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site. The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures and/or nationally recognized test procedures. The data sets include the sample identification numbers, analytical results, estimated quantification limits (EQL), and quality control data. The preparatory and analytical quality control requirements, calibrationmore » requirements, acceptance criteria, and failure actions are defined in the on-line QA plan 'Conducting Analytical Work in Support of Regulatory Programs' (CAW). This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL.« less

XAL Application Framework and Bricks GUI Builder

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

Pelaia II, Tom

2007-01-01

The XAL [1] Application Framework is a framework for rapidly developing document based Java applications with a common look and feel along with many built-in user interface behaviors. The Bricks GUI builder consists of a modern application and framework for rapidly building user interfaces in support of true Model-View-Controller (MVC) compliant Java applications. Bricks and the XAL Application Framework allow developers to rapidly create quality applications.

Earth Observatory Satellite system definition study. Report no. 4: Management approach recommendations

NASA Technical Reports Server (NTRS)

1974-01-01

A management approach for the Earth Observatory Satellite (EOS) which will meet the challenge of a constrained cost environment is presented. Areas of consideration are contracting techniques, test philosophy, reliability and quality assurance requirements, commonality options, and documentation and control requirements. The various functional areas which were examined for cost reduction possibilities are identified. The recommended management approach is developed to show the primary and alternative methods.

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

[Testing of medicinal products produced from pooled plasma].

PubMed

Unkelbach, U; Hunfeld, A; Breitner-Ruddock, S

2014-10-01

Medicinal products produced from human plasma fall under the administrative batch release procedure of the competent authority. In Germany, this has been carried out since 1995 by the Paul Ehrlich Institute (PEI), the responsible state control agency for blood products. Medicinal products released for the European and national market are tested for quality, efficacy and safety. Experimental testing of the final product and the starting materials, the plasma pools, as well as control of the production documentation guarantee a constantly high product safety. In the 28,000 batches tested since the beginning of the state controlled batch release testing of these blood products at the PEI, there has been no transmission of infectious viruses (HIV, HBV and HCV) to any patient. The batch release has made a contribution to the improvement of product quality. This procedure is still an important tool to ensure safety of blood products. The PEI is integrated in the batch release network of the European Directorate for the Quality of Medicines & Health Care (EDQM) in Strasbourg. Regulations and guidelines for official control authority batch release (OCABR) ensure harmonized procedures for mutual recognition of batch release on the European level. The EU certificates and German national certificates are requested and accepted in over 70 countries worldwide. Experimental testing in the EU and the requisite certificates have developed into a seal of quality for the world market.

Reference H Cycle 3 Stability, Control, and Flying Qualities Batch Assessments

NASA Technical Reports Server (NTRS)

Henderson, Dennis K.

1999-01-01

This work is an update of the assessment completed in February of 1996, when a preliminary assessment report was issued for the Cycle 2B simulation model. The primary purpose of the final assessment was to re-evaluate each assessment against the flight control system (FCS) requirements document using the updated model. Only a limited number of final assessments were completed due to the close proximity of the release of the Langley model and the assessment deliverable date. The assessment used the nonlinear Cycle 3 simulation model because it combines nonlinear aeroelastic (quasi-static) aerodynamic with hinge moment and rate limited control surface deflections. Both Configuration Aerodynamics (Task 32) and Flight Controls (Task 36) were funded in 1996 to conduct the final stability and control assessments of the unaugmented Reference H configuration in FY96. Because the two tasks had similar output requirements, the work was divided such that Flight Controls would be responsible for the implementation and checkout of the simulation model and Configuration Aerodynamics for writing Madab "script' files, conducting the batch assessments and writing the assessment report. Additionally, Flight Controls was to investigate control surface allocations schemes different from the baseline Reference H in an effort to fulfill flying qualities criteria.

[Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

PubMed

Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

2015-05-26

The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for the clinical laboratories launched via the Hospital Group platform can promote the joint development of the pediatric clinical laboratory discipline of all the member hospitals with remarkable improvement results, and the experience is recommendable for further rollout.

ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories.

PubMed

Gunn-Christie, Rebekah G; Flatland, Bente; Friedrichs, Kristen R; Szladovits, Balazs; Harr, Kendal E; Ruotsalo, Kristiina; Knoll, Joyce S; Wamsley, Heather L; Freeman, Kathy P

2012-03-01

In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and documents recommendations for control of preanalytical, analytical, and postanalytical factors related to urinalysis, cytology, and clinical chemistry in veterinary laboratories and is adapted from sections 1.1 and 2.2 (clinical chemistry), 1.3 and 2.5 (urinalysis), 1.4 and 2.6 (cytology), and 3 (postanalytical factors important in veterinary clinical pathology) of these guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

An International Coordinated Effort to Further the Documentation & Development of Quality Assurance, Quality Control, and Best Practices for Oceanographic Observations

NASA Astrophysics Data System (ADS)

Bushnell, M.; Waldmann, C.; Hermes, J.; Tamburri, M.

2017-12-01

Many oceanographic observation groups create and maintain QA, QC, and best practices (BP) to ensure efficient and accurate data collection and quantify quality. Several entities - IOOS® QARTOD, AtlantOS, ACT, WMO/IOC JCOMM OCG - have joined forces to document existing practices, identify gaps, and support development of emerging techniques. While each group has a slightly different focus, many underlying QA/QC/BP needs can be quite common. QARTOD focuses upon real-time data QC, and has produced manuals that address QC tests for eleven ocean variables. AtlantOS is a research and innovation project working towards the integration of ocean-observing activities across all disciplines in the Atlantic Basin. ACT brings together research institutions, resource managers, and private companies to foster the development and adoption of effective and reliable sensors for coastal, freshwater, and ocean environments. JCOMM promotes broad international coordination of oceanographic and marine meteorological observations and data management and services. Leveraging existing efforts of these organizations is an efficient way to consolidate available information, develop new practices, and evaluate the use of ISO standards to judge the quality of measurements. ISO standards may offer accepted support for a framework for an ocean data quality management system, similar to the meteorological standards defined by WMO (https://www.wmo.int/pages/prog/arep/gaw/qassurance.html). We will first cooperatively develop a plan to create a QA/QC/BP manual. The resulting plan will describe the need for such a manual, the extent of the manual, the process used to engage the community in creating it, the maintenance of the resultant document, and how these things will be done. It will also investigate standards for metadata. The plan will subsequently be used to develop the QA/QC/BP manual, providing guidance which advances the standards adopted by IOOS, AtlantOS, JCOMM, and others.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

PubMed Central

2010-01-01

Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important. PMID:20942937

Flight testing and frequency domain analysis for rotorcraft handling qualities characteristics

NASA Technical Reports Server (NTRS)

Ham, Johnnie A.; Gardner, Charles K.; Tischler, Mark B.

1993-01-01

A demonstration of frequency domain flight testing techniques and analyses was performed on a U.S. Army OH-58D helicopter in support of the OH-58D Airworthiness and Flight Characteristics Evaluation and the Army's development and ongoing review of Aeronautical Design Standard 33C, Handling Qualities Requirements for Military Rotorcraft. Hover and forward flight (60 knots) tests were conducted in 1 flight hour by Army experimental test pilots. Further processing of the hover data generated a complete database of velocity, angular rate, and acceleration frequency responses to control inputs. A joint effort was then undertaken by the Airworthiness Qualification Test Directorate (AQTD) and the U.S. Army Aeroflightdynamics Directorate (AFDD) to derive handling qualities information from the frequency response database. A significant amount of information could be extracted from the frequency domain database using a variety of approaches. This report documents numerous results that have been obtained from the simple frequency domain tests; in many areas, these results provide more insight into the aircraft dynamics that affect handling qualities than to traditional flight tests. The handling qualities results include ADS-33C bandwidth and phase delay calculations, vibration spectral determinations, transfer function models to examine single axis results, and a six degree of freedom fully coupled state space model. The ability of this model to accurately predict aircraft responses was verified using data from pulse inputs. This report also documents the frequency-sweep flight test technique and data analysis used to support the tests.

Quality of Life. Interpretive Series No. 8.

ERIC Educational Resources Information Center

Senesh, Lawrence

Two government documents, "Goals for Americans" and "Toward Balanced Growth: Quantity with Quality" (ED 055 009), together with previous documents, serve as the information source and basis of this guide. The "Goals for Americans" report, initiated by President Eisenhower's Commission in 1960, identified social…

[Quality control an assessment system. Its location within a program for food, nutrition and metabolic intervention].

PubMed

Santana Porbén, S

2012-01-01

A design proposal for a HQCAS Hospital Quality Control and Assessment System of the nutritional and feeding care processes conducted in a hospital environment is presented in this article. The design proposal is accompanied of the results of inspections conducted by the hospital NST Nutritional Support Group between 2005-2010. The system design includes quality policies that should rule the useful and safe conduction of such processes, the recording and documentary foundations of the System, and the quality control and assessment exercises for the continuous verification of such established policies. The current state of the conduction of these processes was documented from secondary records opened by the NST after satisfying consultation requests from the medical care teams of the institution. Inspections conducted by the NST revealed that less than half of clinical charts contained information minimally enough for elaborating nutritional judgments, almost one-fifth of the assisted patients were on Nils Per Oris, for whom no nutritional support schemes were prescribed, and a low prescription and usage of artificial nutrition schemes. Corrective measures adopted by the NST served to significantly increase the rates of successful completion of inspected processes. Quality assurance of feeding and nutritional care processes is a practical as well as an intellectual activity subjected to constant remodeling, in order to always warrant the fulfillment of quality policies advanced by the NST, and thus, that the patient benefits from the prescribed nutritional intervention strategy.

[Implementation of a web based software for documentation and control of quality of an acute pain service].

PubMed

Pawlik, Michael T; Abel, Reinhard; Abt, Gregor; Kieninger, Martin; Graf, Bernhard Martin; Taeger, Kai; Ittner, Karl Peter

2009-07-01

Providing an acute pain service means accumulation of a large amount of data. The alleviation of data collection, improvement of data quality and data analysis plays a pivotal role. The electronic medical record (EMR) is gaining more and more importance in this context and is continuously spreading in clinical practice. Up to now only a few commercial softwares are available that specifically fit to the needs of an acute pain service. Here we report the development and implementation of such a program (Schmerzvisite, Medlinq, Hamburg, Germany) in the acute pain service of a University Hospital.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

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

Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise

2006-09-01

The purpose of the Sandia National Laboratories 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. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

Environmental effects of dredging. Documentation of the efqual module for ADDAMS: Comparison of predicted effluent water quality with standards. Technical notes

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

Palermo, M.R.; Schroeder, P.R.

This technical note describes a technique for comparison of the predicted quality of effluent discharged from confined dredged material disposal areas with applicable water quality standards. This note also serves as documentation of a computer program called EFQUAL written for that purpose as part of the Automated Dredging and Disposal Alternatives Management System (ADDAMS).

Tobacco control advocates must demand high-quality media campaigns: the California experience.

PubMed

Balbach, E D; Glantz, S A

1998-01-01

To document efforts on the part of public officials in California to soften the media campaign's attack on the tobacco industry and to analyse strategies to counter those efforts on the part of tobacco control advocates. Data were gathered from interviews with programme participants, direct observation, written materials, and media stories. In addition, internal documents were released by the state's Department of Health Services in response to requests made under the California Public Records Act by Americans for Nonsmokers' Rights. Finally, a draft of the paper was circulated to 11 key players for their comments. In 1988 california voters enacted Proposition 99, an initiative that raised the tobacco tax by $0.25 and allocated 20% of the revenues to anti-tobacco education. A media campaign, which was part of the education programme, directly attacked the tobacco industry, exposing the media campaign to politically based efforts to shut it down or soften it. Through use of outsider strategies such as advertising, press conferences, and public meetings, programme advocates were able to counter the efforts to soften the campaign. Anti-tobacco media campaigns that expose industry manipulation are a key component of an effective tobacco control programme. The effectiveness of these campaigns, however, makes them a target for elimination by the tobacco industry. The experience from California demonstrates the need for continuing, aggressive intervention by nongovernmental organisations in order to maintain the quality of anti-tobacco media campaigns.

Data Quality Objectives for Tank Farms Waste Compatibility Program

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

BANNING, D.L.

1999-07-02

There are 177 waste storage tanks containing over 210,000 m{sup 3} (55 million gal) of mixed waste at the Hanford Site. The River Protection Project (RPP) has adopted the data quality objective (DQO) process used by the U.S. Environmental Protection Agency (EPA) (EPA 1994a) and implemented by RPP internal procedure (Banning 1999a) to identify the information and data needed to address safety issues. This DQO document is based on several documents that provide the technical basis for inputs and decision/action levels used to develop the decision rules that evaluate the transfer of wastes. A number of these documents are presentlymore » in the process of being revised. This document will need to be revised if there are changes to the technical criteria in these supporting documents. This DQO process supports various documents, such as sampling and analysis plans and double-shell tank (DST) waste analysis plans. This document identifies the type, quality, and quantity of data needed to determine whether transfer of supernatant can be performed safely. The requirements in this document are designed to prevent the mixing of incompatible waste as defined in Washington Administrative Code (WAC) 173-303-040. Waste transfers which meet the requirements contained in this document and the Double-Shell Tank Waste Analysis Plan (Mulkey 1998) are considered to be compatible, and prevent the mixing of incompatible waste.« less

The Effect of an Electronic SBAR Communication Tool on Documentation of Acute Events in the Pediatric Intensive Care Unit.

PubMed

Panesar, Rahul S; Albert, Ben; Messina, Catherine; Parker, Margaret

2016-01-01

The Situation, Background, Assessment, Recommendation (SBAR) handoff tool is designed to improve communication. The effects of integrating an electronic medical record (EMR) with a SBAR template are unclear. The research team hypothesizes that an electronic SBAR template improves documentation and communication between nurses and physicians. In all, 84 patient events were recorded from 542 admissions to the pediatric intensive care unit. Three time periods were studied: (a) paper documentation only, (b) electronic documentation, and (c) electronic documentation with an SBAR template. Documentation quality was assessed using a 4-point scoring system. The frequency of event notes increased progressively during the 3 study periods. Mean quality scores improved significantly from paper documentation to EMR free-text notes and to electronic SBAR-template notes, as did nurse and attending physician notification. The implementation of an electronic SBAR note is associated with more complete documentation and increased frequency of documentation of communication among nurses and physicians. © The Author(s) 2014.

The Environmental Data Initiative: A broad-use data repository for environmental and ecological data that strives to balance data quality and ease of submission

NASA Astrophysics Data System (ADS)

Servilla, M. S.; Brunt, J.; Costa, D.; Gries, C.; Grossman-Clarke, S.; Hanson, P. C.; O'Brien, M.; Smith, C.; Vanderbilt, K.; Waide, R.

2017-12-01

In the world of data repositories, there seems to be a never ending struggle between the generation of high-quality data documentation and the ease of archiving a data product in a repository - the higher the documentation standards, the greater effort required by the scientist, and the less likely the data will be archived. The Environmental Data Initiative (EDI) attempts to balance the rigor of data documentation to the amount of effort required by a scientist to upload and archive data. As an outgrowth of the LTER Network Information System, the EDI is funded by the US NSF Division of Environmental Biology, to support the LTER, LTREB, OBFS, and MSB programs, in addition to providing an open data archive for environmental scientists without a viable archive. EDI uses the PASTA repository software, developed originally by the LTER. PASTA is metadata driven and documents data with the Ecological Metadata Language (EML), a high-fidelity standard that can describe all types of data in great detail. PASTA incorporates a series of data quality tests to ensure that data are correctly documented with EML in a process that is termed "metadata and data congruence", and incongruent data packages are forbidden in the repository. EDI reduces the burden of data documentation on scientists in two ways: first, EDI provides hands-on assistance in data documentation best practices using R and being developed in Python, for generating EML. These tools obscure the details of EML generation and syntax by providing a more natural and contextual setting for describing data. Second, EDI works closely with community information managers in defining rules used in PASTA quality tests. Rules deemed too strict can be turned off completely or just issue a warning, while the community learns to best handle the situation and improve their documentation practices. Rules can also be added or refined over time to improve overall quality of archived data. The outcome of quality tests are stored as part of the data archive in PASTA and are accessible to all users of the EDI data repository. In summary, EDI's metadata support to scientists and the comprehensive set of data quality tests for metadata and data congruency provide an ideal archive for environmental and ecological data.

[Handbook for the preparation of evidence-based documents. Tools derived from scientific knowledge].

PubMed

Carrión-Camacho, M R; Martínez-Brocca, M A; Paneque-Sánchez-Toscano, I; Valencia-Martín, R; Palomino-García, A; Muñoz-Durán, C; Tamayo-López, M J; González-Eiris-Delgado, C; Otero-Candelera, R; Ortega-Ruiz, F; Sobrino-Márquez, J M; Jiménez-García-Bóveda, R; Fernández-Quero, M; Campos-Pareja, A M

2013-01-01

This handbook is intended to be an accessible, easy-to-consult guide to help professionals produce or adapt Evidence-Based Documents. Such documents will help standardize both clinical practice and decision-making, the quality always being monitored in such a way that established references are complied with. Evidence-Based Health Care Committee, a member of "Virgen del Rocío" University Hospital quality structure, proposed the preparation of a handbook to produce Evidence-Based Documents including: a description of products, characteristics, qualities, uses, methodology of production, and application scope of every one of them. The handbook consists of seven Evidence-Based tools, one chapter on critical analysis methodology of scientific literature, one chapter with internet resources, and some appendices with different assessment tools. This Handbook provides general practitioners with a great opportunity to improve quality and as a guideline to standardize clinical healthcare, and managers with a strategy to promote and encourage the development of documents in an effort to reduce clinical practice variability, as well as giving patients the opportunity of taking part in planning their own care. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Triangle area water supply monitoring project, October 1988 through September 2001, North Carolina -- description of the water-quality network, sampling and analysis methods, and quality-assurance practices

USGS Publications Warehouse

Oblinger, Carolyn J.

2004-01-01

The Triangle Area Water Supply Monitoring Project was initiated in October 1988 to provide long-term water-quality data for six area water-supply reservoirs and their tributaries. In addition, the project provides data that can be used to determine the effectiveness of large-scale changes in water-resource management practices, document differences in water quality among water-supply types (large multiuse reservoir, small reservoir, run-of-river), and tributary-loading and in-lake data for water-quality modeling of Falls and Jordan Lakes. By September 2001, the project had progressed in four phases and included as many as 34 sites (in 1991). Most sites were sampled and analyzed by the U.S. Geological Survey. Some sites were already a part of the North Carolina Division of Water Quality statewide ambient water-quality monitoring network and were sampled by the Division of Water Quality. The network has provided data on streamflow, physical properties, and concentrations of nutrients, major ions, metals, trace elements, chlorophyll, total organic carbon, suspended sediment, and selected synthetic organic compounds. Project quality-assurance activities include written procedures for sample collection, record management and archive, collection of field quality-control samples (blank samples and replicate samples), and monitoring the quality of field supplies. In addition to project quality-assurance activities, the quality of laboratory analyses was assessed through laboratory quality-assurance practices and an independent laboratory quality-control assessment provided by the U.S. Geological Survey Branch of Quality Systems through the Blind Inorganic Sample Project and the Organic Blind Sample Project.

Document control and Conduct of Operations

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

Collins, S.K.; Meltzer, F.L.

1993-01-01

Department of Energy (DOE) Order 5480.19, Conduct of operations, places stringent requirements on a wide range of activities at DOE facilities. These requirements directly affect personnel at the Advanced Test Reactor (ATR), which is located in the Test Reactor Area of the Idaho National Engineering Laboratory and operated for DOE by EG G Idaho, Inc. In order for the ATR to comply with 5480.19, the very personality of the reactor facility's document control unit has had to undergo a major change. The Facility and Administrative Support Unit (FAS) is charged with nudntenance of ATR's controlled ddcuments-diousands of operating and administrativemore » procedures. Prior to the imposition of 5480.19, FAS was content to operate in a clerical support mode, seldom questioning or seeking to improve. This numer of doing business is inappropriate within the framework of DOE 5480.19 and is also at odds with the approach to Total Quality Management (TQM) promulgated by EG G Idaho.To comply with the requirements of 5480.19, FAS has Actively applied TQM principles. Empowered personnel to unprove operations through the establishment of a teatn approach. Begun an automation process that is already paying large dividends in terms of improved procedure accuracy and compliance. A state-of-the-art text retrival system is already in place. We are vigorously pursuing fully automated document tmcidng and document management. This paper describes in detail the steps taken to date, the improvements and the lessons learned. It aLw discusses plans for the future that will enable FAS to support the ATR in inccreasing its responsiveness to the Conduct of Operations Order.« less

Trigram-based algorithms for OCR result correction

NASA Astrophysics Data System (ADS)

Bulatov, Konstantin; Manzhikov, Temudzhin; Slavin, Oleg; Faradjev, Igor; Janiszewski, Igor

2017-03-01

In this paper we consider a task of improving optical character recognition (OCR) results of document fields on low-quality and average-quality images using N-gram models. Cyrillic fields of Russian Federation internal passport are analyzed as an example. Two approaches are presented: the first one is based on hypothesis of dependence of a symbol from two adjacent symbols and the second is based on calculation of marginal distributions and Bayesian networks computation. A comparison of the algorithms and experimental results within a real document OCR system are presented, it's showed that the document field OCR accuracy can be improved by more than 6% for low-quality images.

An Evaluation of Automatic Control System Concepts for General Aviation Airplanes

NASA Technical Reports Server (NTRS)

Stewart, E. C.

1990-01-01

A piloted simulation study of automatic longitudinal control systems for general aviation airplanes has been conducted. These automatic control systems were designed to make the simulated airplane easy to fly for a beginning or infrequent pilot. Different control systems are presented and their characteristics are documented. In a conventional airplane control system each cockpit controller commands combinations of both the airspeed and the vertical speed. The best system in the present study decoupled the airspeed and vertical speed responses to cockpit controller inputs. An important feature of the automatic system was that neither changing flap position nor maneuvering in steeply banked turns affected either the airspeed or the vertical speed. All the pilots who flew the control system simulation were favorably impressed with the very low workload and the excellent handling qualities of the simulated airplane.

EPA's Quality Policy and Procedure CIO Policy Transmittal 09-001

EPA Pesticide Factsheets

The purpose of this memo is to (1) issue the final versions of the Quality Policy and Procedure documents (with a Q&A document for your reference as well) and (2) call for members of a new advisory group to guide Policy implementation activities.

Integrating Quality Concepts into TAFE Courses.

ERIC Educational Resources Information Center

Hayton, Geoff; And Others

This document contains the written outcomes from a 1988 project designed to result in the development and integration of instruction on quality into existing Australia's technical and further education (TAFE) courses. The document is intended for TAFE senior staff, staff developers, teaching staff, and curriculum developers; and senior management…