Verification of a Quality Management Theory: Using a Delphi Study

PubMed Central

Mosadeghrad, Ali Mohammad

2013-01-01

Background: A model of quality management called Strategic Collaborative Quality Management (SCQM) model was developed based on the quality management literature review, the findings of a survey on quality management assessment in healthcare organisations, semi-structured interviews with healthcare stakeholders, and a Delphi study on healthcare quality management experts. The purpose of this study was to verify the SCQM model. Methods: The proposed model was further developed using feedback from thirty quality management experts using a Delphi method. Further, a guidebook for its implementation was prepared including a road map and performance measurement. Results: The research led to the development of a context-specific model of quality management for healthcare organisations and a series of guidelines for its implementation. Conclusion: A proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence. PMID:24596883

78 FR 53270 - Revision of Air Quality Implementation Plan; California; Sacramento Metropolitan Air Quality...

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2013-08-29

... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... to the Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the..., Sacramento Metropolitan Air Quality Management District, Rule 214 (Federal New Source Review), Rule 203...

75 FR 40762 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

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2010-07-14

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the...

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

DTIC Science & Technology

1989-07-01

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

77 FR 2469 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2012-01-18

... the California State Implementation Plan, Antelope Valley Air Quality Management District and Imperial... Quality Management District (AVAQMD) and Imperial County Air Pollution Control District (ICAPCD) portions... Technology (RACT),'' adopted on February 23, 2010. * * * * * (G) Antelope Valley Air Quality Management...

78 FR 45114 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2013-07-26

... the California State Implementation Plan, Antelope Valley Air Quality Management District AGENCY... the Antelope Valley Air Quality Management District (AVAQMD) portion of the California State... for the South Coast Air Quality Management District (SCAQMD). The Antelope Valley Air Pollution...

77 FR 12526 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2012-03-01

... the California State Implementation Plan, Antelope Valley Air Quality Management District and Mojave Desert Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District...

78 FR 21582 - Revisions to the California State Implementation Plan, Butte County Air Quality Management...

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2013-04-11

... the California State Implementation Plan, Butte County Air Quality Management District and Sacramento Metropolitan Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Butte County Air Quality Management...

78 FR 59840 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2013-09-30

...] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District... of plan. * * * * * (c) * * * (428) * * * (i) * * * (B) Antelope Valley Air Quality Management...) * * * (i) * * * (B) Antelope Valley Air Quality Management District. (1) Rule 431.1, ``Sulfur Content of...

76 FR 38572 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2011-07-01

... the California State Implementation Plan, Antelope Valley Air Quality Management District AGENCY... approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) portion of the... approving with the dates that they were adopted by the Antelope Valley Air Quality Management District...

76 FR 41717 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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2011-07-15

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California... Governor's Designee. (i) Incorporation by reference. (A) South Coast Air Quality Management District. (1...

78 FR 18853 - Revision to the California State Implementation Plan, South Coast Air Quality Management District

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2013-03-28

... California State Implementation Plan, South Coast Air Quality Management District AGENCY: Environmental... revision to the South Coast Air Quality Management District (SCAQMD) portion of the California State...) * * * (411) * * * (i) * * * (F) South Coast Air Quality Management District. (1) Rule 463, ``Organic Liquid...

77 FR 65133 - Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management District

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2012-10-25

... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... limited disapproval of revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of.... * * * * * (c) * * * (379) * * * (i) * * * (E) Mojave Desert Air Quality Management District. (1) Rule 1159...

75 FR 37308 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State...) * * * (i) * * * (C) Yolo Solano Air Quality Management District (1) Rule 3.21, ``Rice Straw Emission...

78 FR 59249 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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2013-09-26

...] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...'s Designee. (i) Incorporation by Reference. (A) South Coast Air Quality Management District. (1...

77 FR 12493 - Revisions to the California State Implementation Plan, Feather River Air Quality Management District

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2012-03-01

... the California State Implementation Plan, Feather River Air Quality Management District AGENCY... limited disapproval of revisions to the Feather River Air Quality Management District (FRAQMD) portion of.... * * * * * (c) * * * (378) * * * (i) * * * (E) Feather River Air Quality Management District. (1) Rule 3.22...

75 FR 25778 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

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2010-05-10

... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California... Identification of plan. * * * * * (c) * * * (377) * * * (i) * * * (B) Yolo Solano Air Quality Management District...

77 FR 23133 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

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2012-04-18

... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (Yolo-Solano AQMD) portion of the.... * * * * * (381) * * * (i) * * * (I) Yolo-Solano Air Quality Management District. (1) Rule 2.3, ``Ringelmann Chart...

76 FR 30896 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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2011-05-27

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... overwhelmingly formed as a secondary pollutant. (South Coast 2007 Air Quality Management Plan, page ES-9...

78 FR 25011 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2013-04-29

... the California State Implementation Plan, Antelope Valley Air Quality Management District, Santa Barbara County Air Pollution Control District, South Coast Air Quality Management District and Ventura... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...

78 FR 58459 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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2013-09-24

... the California State Implementation Plan, Antelope Valley Air Quality Management District, Santa Barbara County Air Pollution Control District, South Coast Air Quality Management District and Ventura.... SUMMARY: EPA is finalizing approval of revisions to the Antelope Valley Air Quality Management District...

75 FR 25775 - Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District

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2010-05-10

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2009-0573; FRL-9146-5] Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District AGENCY: Environmental... South Coast Air Quality Management District (SCAQMD) portion of the California State Implementation Plan...

Nurse managers' work life quality and their participation in knowledge management: a correlational study.

PubMed

Hashemi Dehaghi, Zahra; Sheikhtaheri, Abbas; Dehnavi, Fariba

2015-01-01

The association between quality of work life and participation in knowledge management is unknown. This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management. This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach's alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson's correlation coefficient and linear regression. Nurse managers' performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P < 0.001). The strongest correlations were found between implementation of knowledge management and participation of nurse managers in decision making (r = 0.82; P < 0.001). Improvement of nurse managers' work life quality, especially in decision-making, may increase their participation in implementing knowledge management.

Total Quality Management Implementation Plan: Defense Depot, Ogden

DTIC Science & Technology

1989-07-01

NUMBERS Total Quality Management Implementation Plan Defense Depot Ogden 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...PAGES TQM (Total Quality Management ), Continuous Process Improvement, Depot Operations, Process Action Teams 16. PRICE CODE 17. SECURITY...034 A Message From The Commander On Total Quality Management i fully support the DLA aoproacii to Total Quality Management . As stated by General

Strengthening the regulatory system through the implementation and use of a quality management system.

PubMed

Eisner, Reinhold; Patel, Rakeshkumar

2017-04-20

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

Quality Management Systems Implementation Compared With Organizational Maturity in Hospital.

PubMed

Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiasvand, Hesam

2015-07-27

A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders' satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals should make changes in the quantity and quality of quality management systems in an effort to increase organizational maturity, whereby they improve the hospital efficiency and productivity.

Quality Management Systems Implementation Compared With Organizational Maturity in Hospital

PubMed Central

Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiyasvand, Hesam

2016-01-01

Background: A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders’ satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. Objectives: We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. Materials and Methods: This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. Results: According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Conclusions: Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals should make changes in the quantity and quality of quality management systems in an effort to increase organizational maturity, whereby they improve the hospital efficiency and productivity. PMID:26493411

76 FR 43183 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... Designee. (i) Incorporation by Reference. (A) Sacramento Metropolitan Air Quality Management District. (1...

75 FR 18068 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD...) * * * (362) * * * (i) * * * (C) Sacramento Metropolitan Air Quality Management District. (1) Rule 450...

Total Quality Management Office for Contracting Integrity Implementation Plan

DTIC Science & Technology

1989-07-01

REPORT______ANDDATESCOVERED 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Total Quality Management Office for Contracting Integrity Implementatiun Plan 6. AUTHOR(S) 7...01-280-5500 Standard Form 298 (Rev. 2-89) P’,croed 1:, ANSI Std 3J9-16 29d. 102 4 TOTAL QUALITY MANAGEMENT OFFICE FOR CONTRACTING INTEGRITY...IMPLEMENTATION PLAN According to the Total Quality Management (TQM) Master Plan, each PSE head, supported by Working Groups, will implement the HQ DLA Master

Total Quality Management Implementation Plan Defense Depot Memphis

DTIC Science & Technology

1989-07-01

W.ungilon. 0 t :0.O. )RT DATE 3. REPORT TYPE AND DATES COVERED I July 1989 _ 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Total Quality Management Implementation...improvement goals, implementation strategy and milestones. 6’ SEP 291989 /; ELECTE i= E 14. SUBJECT TERMS 15. NUMBER OF PAGES TQM (Total Quality Management ), Depot...changing work environment where change is the norm. We are talking about changes in attitudes and habits. Total Quality Management is not a panacea

76 FR 78829 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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2011-12-20

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... Reference (A) South Coast Air Quality Management District (1) Rule 2005, ``New Source Review for RECLAIM...

76 FR 29153 - Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... approve revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of the California... approving with the dates that they were adopted by the Mojave Desert Air Quality Management District (MDAQMD...

Is having quality as an item on the executive board agenda associated with the implementation of quality management systems in European hospitals: a quantitative analysis

PubMed Central

Botje, Daan; Klazinga, N.S.; Suñol, R.; Groene, O.; Pfaff, H.; Mannion, R.; Depaigne-Loth, A.; Arah, O.A.; Dersarkissian, M.; Wagner, C.; Klazinga, N.; Kringos, D.S.; Lombarts, M.J.M.H.; Plochg, T.; Lopez, M.A.; Vallejo, P.; Saillour-Glenisson, F.; Car, M.; Jones, S.; Klaus, E.; Bottaro, S.; Garel, P.; Saluvan, M.; Bruneau, C.; Depaigne-Loth, A.; Hammer, A.; Ommen, O.; Pfaff, H.; Botje, D.; Escoval, A.; Lívio, A.; Eiras, M.; Franca, M.; Leite, I.; Almeman, F.; Kus, H.; Ozturk, K.; Mannion, R.; Wang, A.; Thompson, A.

2014-01-01

Objective To assess whether there is a relationship between having quality as an item on the board's agenda, perceived external pressure (PEP) and the implementation of quality management in European hospitals. Design A quantitative, mixed method, cross-sectional study in seven European countries in 2011 surveying CEOs and quality managers and data from onsite audits. Participants One hundred and fifty-five CEOs and 155 quality managers. Setting One hundred and fifty-five randomly selected acute care hospitals in seven European countries (Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey). Main outcome measure(s) Three constructs reflecting quality management based on questionnaire and audit data: (i) Quality Management System Index, (ii) Quality Management Compliance Index and (iii) Clinical Quality Implementation Index. The main predictor was whether quality performance was on the executive board's agenda. Results Discussing quality performance at executive board meetings more often was associated with a higher quality management system score (regression coefficient b = 2.53; SE = 1.16; P = 0.030). We found a trend in the associations of discussing quality performance with quality compliance and clinical quality implementation. PEP did not modify these relationships. Conclusions Having quality as an item on the executive board's agenda allows them to review and discuss quality performance more often in order to improve their hospital's quality management. Generally, and as this study found, having quality on the executive board's agenda matters. PMID:24550260

Is having quality as an item on the executive board agenda associated with the implementation of quality management systems in European hospitals: a quantitative analysis.

PubMed

Botje, Daan; Klazinga, N S; Suñol, R; Groene, O; Pfaff, H; Mannion, R; Depaigne-Loth, A; Arah, O A; Dersarkissian, M; Wagner, C

2014-04-01

To assess whether there is a relationship between having quality as an item on the board's agenda, perceived external pressure (PEP) and the implementation of quality management in European hospitals. A quantitative, mixed method, cross-sectional study in seven European countries in 2011 surveying CEOs and quality managers and data from onsite audits. One hundred and fifty-five CEOs and 155 quality managers. One hundred and fifty-five randomly selected acute care hospitals in seven European countries (Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey). Main outcome measure(s) Three constructs reflecting quality management based on questionnaire and audit data: (i) Quality Management System Index, (ii) Quality Management Compliance Index and (iii) Clinical Quality Implementation Index. The main predictor was whether quality performance was on the executive board's agenda. Discussing quality performance at executive board meetings more often was associated with a higher quality management system score (regression coefficient b = 2.53; SE = 1.16; P = 0.030). We found a trend in the associations of discussing quality performance with quality compliance and clinical quality implementation. PEP did not modify these relationships. Having quality as an item on the executive board's agenda allows them to review and discuss quality performance more often in order to improve their hospital's quality management. Generally, and as this study found, having quality on the executive board's agenda matters.

77 FR 23193 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0180; FRL-9652-3] Revisions to the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District portion of the California State Implementation Plan...

77 FR 32483 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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2012-06-01

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9670-9] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...

75 FR 32353 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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2010-06-08

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0276; FRL-9139-8] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...

76 FR 54384 - California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0537; FRL-9457-6] California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of Direct Final Rule... Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District (SCAQMD) Rule 1143...

Leadership: The Key to Successful Implementation of Total Quality Management

DTIC Science & Technology

1990-05-01

the implementation of the initiative called Total Quality Management as the philosophy and guiding principles to improve organizational efficiency...where and how to start. This paper presents the critical elements, their interrelationships, and how they can be used to achieve the cultural change necessary for successful implementation of Total Quality Management .

76 FR 20242 - Revisions to the California State Implementation Plan; Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... the California State Implementation Plan; Sacramento Metropolitan Air Quality Management District... a revision to the Sacramento Metropolitan Air Quality Management District's portion of the... (Permit No. 17359), which was issued by the Sacramento Metropolitan Air Quality Management District...

A systematic review of instruments that assess the implementation of hospital quality management systems.

PubMed

Groene, Oliver; Botje, Daan; Suñol, Rosa; Lopez, Maria Andrée; Wagner, Cordula

2013-10-01

Health-care providers invest substantial resources to establish and implement hospital quality management systems. Nevertheless, few tools are available to assess implementation efforts and their effect on quality and safety outcomes. This review aims to (i) identify instruments to assess the implementation of hospital quality management systems, (ii) describe their measurement properties and (iii) assess the effects of quality management on quality improvement and quality of care outcomes. We performed a systematic literature search from 1990 to 2011 in PubMed, CINAHL, EMBASE, Cochrane Library and Web of Science. In addition, we used snowball strategies, screened the reference lists of eligible papers, reviewed grey literature and contacted experts in the field. and data extraction Two reviewers screened eligible papers based on pre-defined inclusion and exclusion criteria and all authors extracted data. Eligible papers are described in terms of general characteristics (settings, type and level of respondents, mode of data collection), methodological properties (sampling strategy, item derivation, conceptualization of quality management, assessment of reliability and validity, scoring) and application/implementation (accounting for context, organizational adaptations, sensitivity to change, deployment and effect size). Eighteen papers were deemed eligible for inclusion. While some common domains emerged in measurement conceptualization, substantial differences in scope persist. The instruments' measurement properties were insufficiently described and only few instruments assessed links between the implementation of quality management systems (QMS) and improvement strategies or outcomes. There is currently no well-established measure to assess the implementation and effectiveness of quality management systems. Future research should address this gap.

Total Quality Management Implementation Plan.

DTIC Science & Technology

1989-06-01

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

DLA-X Total Quality Management (TQM) Implementation Plan

DTIC Science & Technology

1989-07-01

PAGES TOM (Total Quality Management ), Continuous Process Improvement.( .) 4L-- Administration 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Pr.-cr,bed by ANSI Std ,,fl.f 296-102 DLA-X TOTAL QUALITY MANAGEMENT (TQM) IMPLEMENTATION PLAN o...application of proven Total Quality Management techniques. Quality Policy: Responsibility for quality is delegated to every employee ;11 DLA-X. Every

75 FR 61367 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Measure for Architectural Coatings,'' CARB, October 2007. 4. ``Improving Air Quality with Economic...

77 FR 66780 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-07

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Control Measure for Architectural Coatings,'' CARB, October 2007. 4. ``Improving Air Quality with Economic...

Implementing Total Quality Management in a University Setting.

ERIC Educational Resources Information Center

Coate, L. Edwin

1991-01-01

Oregon State University implemented Total Quality Management in nine phases: exploration; establishing a pilot study team; defining customer needs; adopting the breakthrough planning process; performing breakthrough planning in divisions; forming daily management teams; initiating cross-functional pilot projects; implementing cross-functional…

75 FR 19923 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State.... ``Improving Air Quality with Economic Incentive Programs,'' EPA- 452/R-01-001, January 2001. B. Does the rule...

75 FR 32293 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California... submit regulations that control the primary and secondary National Ambient Air Quality Standards (NAAQS...

76 FR 40303 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... limited disapproval of revisions to the South Coast Air Quality Management District (SCAQMD) portion of... designated nonattainment for the fine particulate matter (PM2.5) National Ambient Air Quality Standards...

78 FR 37757 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Quality Index rather than on 1-hour ozone forecasted values; (b) forecast criteria for allowing a...

77 FR 11992 - Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... limited disapproval of revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of...,'' Northeast States for Coordinated Air Use Management, December 2000. B. Does the rule meet the evaluation...

75 FR 46845 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...

76 FR 76115 - Revisions to the California State Implementation Plan, Feather River Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... the California State Implementation Plan, Feather River Air Quality Management District AGENCY... limited disapproval of revisions to the Feather River Air Quality Management District (FRAQMD) portion of..., Regulatory Planning and Review The Office of Management and Budget (OMB) has exempted this regulatory action...

76 FR 50128 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-12

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... not a ``significant regulatory action'' subject to review by the Office of Management and Budget under...

78 FR 18244 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...'' subject to review by the Office of Management and Budget under Executive Order 12866 (58 FR 51735, October...

78 FR 30768 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...

77 FR 13495 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); Does not...

Total Quality Management Implementation Plan for Military Personnel Management

DTIC Science & Technology

1989-09-01

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

Nurse Managers’ Work Life Quality and Their Participation in Knowledge Management: A Correlational Study

PubMed Central

Hashemi Dehaghi, Zahra; Sheikhtaheri, Abbas; Dehnavi, Fariba

2014-01-01

Background: The association between quality of work life and participation in knowledge management is unknown. Objectives: This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management. Materials and Methods: This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach’s alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson’s correlation coefficient and linear regression. Results: Nurse managers’ performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P < 0.001). The strongest correlations were found between implementation of knowledge management and participation of nurse managers in decision making (r = 0.82; P < 0.001). Conclusions: Improvement of nurse managers’ work life quality, especially in decision-making, may increase their participation in implementing knowledge management. PMID:25763267

77 FR 32398 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... action: Is not a ``significant regulatory action'' subject to review by the Office of Management and...

78 FR 56639 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

...] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... the Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); does...

A Logistic Life Cycle Cost-Benefit Analysis of Power Quality Management in the Avionics Repair Facility

DTIC Science & Technology

1998-06-01

quality management can have on the intermediate level of maintenance. Power quality management is a preventative process that focuses on identifying and correcting problems that cause bad power. Using cost-benefit analysis we compare the effects of implementing a power quality management program at AIMD Lemoore and AIMD Fallon. The implementation of power quality management can result in wide scale logistical support changes in regards to the life cycle costs of maintaining the DoD’s current inventory

78 FR 10589 - Revision of Air Quality Implementation Plan; California; Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... sources within the areas covered by the plan as necessary to assure that the National Ambient Air Quality...

Determinants of quality management systems implementation in hospitals.

PubMed

Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem

2009-03-01

To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.

77 FR 47535 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District portion... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...

76 FR 28942 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... action: Is not a ``significant regulatory action'' subject to review by the Office of Management and...

77 FR 63743 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...

Change and Transition--The Basis of the Effective Quality Management System = Kaita ir Keitimasis--Efektyvios Kokybes Vadybos Sistemos Pagrindas

ERIC Educational Resources Information Center

Misiunas, Mindaugas; Stravinskiene, Inga

2010-01-01

The article reasons the aspect of change and transition in higher education institutions implementing quality management systems. Psychological and behavioural responses of high school staff towards quality management system being implemented are discussed; transition phases of the employees are introduced; specific features of staff management in…

76 FR 41744 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0537; FRL-9432-1] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...

76 FR 78871 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0897; FRL-9499-8] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...

76 FR 38589 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0383; FRL-9428-1] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District AGENCY... the Antelope Valley Air Quality Management District (AVAQMD) portion of the California State...

76 FR 50891 - Revisions to the California State Implementation Plan, South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

... the California State Implementation Plan, South Coast Air Quality Management District (SCAQMD) AGENCY... sources, to achieve emissions reductions milestones, to attain and maintain ambient air quality standards... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...

76 FR 29182 - Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0030; FRL-9308-4] Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... the Mojave Desert Air Quality Management District (MDAQMD) portion of the California State...

75 FR 46880 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0503; FRL-9183-5] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...

75 FR 25798 - Revisions to the California State Implementation Plan, Yolo Solano Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0286; FRL-9138-7] Revisions to the California State Implementation Plan, Yolo Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State...

78 FR 49925 - Revisions to California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-16

... California State Implementation Plan, Antelope Valley Air Quality Management District and Ventura County Air...: EPA is taking direct final action to approve revisions to the Antelope Valley Air Quality Air Management District (AVAQMD) and Ventura County Air Pollution Control District (VCAPCD) portions of the...

77 FR 2496 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-18

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0987; FRL-9617-5] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District and Imperial... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...

78 FR 49992 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-16

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2013-0394; FRL-9845-4] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District and Ventura... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

PubMed Central

2014-01-01

Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.

PubMed

Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan

2014-04-02

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.

Total Quality Management Implementation Plan: DLA-N

DTIC Science & Technology

1989-07-01

e Wastimto , n. Othe 20 Seato3 4. TITLE AND SUBTITLE S. FUNDING NUMBERS DLA-N Total Quality Management 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S...PAGES TQM (Total Quality Management ), Continuous Process Improvement.(; , Defense National Stockpile 16. PRICE CODEI17. SECURITY CLASSIFICATION 18...IUNCLASSIFIED UL NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) pr"!Cbed ty ANSI Std Z39’B6 296-102 DLA - N TOTAL QUALITY MANAGEMENT IMPLEMENTATION PLAN I

Total Quality Management in Higher Education: Clearing the Hurdles. A Survey on Strategies for Implementing Quality Management Practices in Higher Education. A GOAL/QPC Application Report.

ERIC Educational Resources Information Center

Seymour, Daniel

Based on a survey of Quality Management (QM) practitioners at 21 colleges, this study presents the 10 most difficult implementation hurdles to QM in higher education and a set of hurdle-clearing strategies. The hurdles are: (1) lack of time to implement QM; (2) perception that QM is something for janitorial and housing staffs but not applicable to…

76 FR 48006 - Limited Federal Implementation Plan; Prevention of Significant Deterioration; California; North...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... Implementation Plan; Prevention of Significant Deterioration; California; North Coast Unified Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing a limited Federal Implementation Plan (FIP) for the North Coast Unified Air Quality Management...

[Quality Management for Surgeons: The Knowledge of Basic Contexts and Innovative Strategies Promotes the Competitiveness of Clinical Department].

PubMed

Hellmann, Wolfgang

2017-12-01

Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners. This paper provides basic knowledge on quality management, risk management, and quality assurance in the context of relevant medical terms. It demonstrates new ways for implementation on the level of a surgery department, and introduces a new model of quality. Georg Thieme Verlag KG Stuttgart · New York.

77 FR 23192 - Revisions to the California State Implementation Plan, Northern Sierra and Sacramento...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... proposing to approve revisions to the Northern Sierra Air Quality Management District (NSAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD) portions of the California State... the California State Implementation Plan, Northern Sierra and Sacramento Metropolitan Air Quality...

[Acute pain therapy in German hospitals as competitive factor. Do competition, ownership and case severity influence the practice of acute pain therapy?].

PubMed

Erlenwein, J; Hinz, J; Meißner, W; Stamer, U; Bauer, M; Petzke, F

2015-07-01

Due to the implementation of the diagnosis-related groups (DRG) system, the competitive pressure on German hospitals increased. In this context it has been shown that acute pain management offers economic benefits for hospitals. The aim of this study was to analyze the impact of the competitive situation, the ownership and the economic resources required on structures and processes for acute pain management. A standardized questionnaire on structures and processes of acute pain management was mailed to the 885 directors of German departments of anesthesiology listed as members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin). For most hospitals a strong regional competition existed; however, this parameter affected neither the implementation of structures nor the recommended treatment processes for pain therapy. In contrast, a clear preference for hospitals in private ownership to use the benchmarking tool QUIPS (quality improvement in postoperative pain therapy) was found. These hospitals also presented information on coping with the management of pain in the corporate clinic mission statement more often and published information about the quality of acute pain management in the quality reports more frequently. No differences were found between hospitals with different forms of ownership in the implementation of acute pain services, quality circles, expert standard pain management and the implementation of recommended processes. Hospitals with a higher case mix index (CMI) had a certified acute pain management more often. The corporate mission statement of these hospitals also contained information on how to cope with pain, presentation of the quality of pain management in the quality report, implementation of quality circles and the implementation of the expert standard pain management more frequently. There were no differences in the frequency of using the benchmarking tool QUIPS or the implementation of recommended treatment processes with respect to the CMI. In this survey no effect of the competitive situation of hospitals on acute pain management could be demonstrated. Private ownership and a higher CMI were more often associated with structures of acute pain management which were publicly accessible in terms of hospital marketing.

76 FR 60376 - Revisions to the California State Implementation Plan, Santa Barbara Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... Municipal Air Quality Management District and South Coast Air Quality Management District AGENCY... Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of...,'' revised September 20, 2010. (D) Sacramento Metropolitan Air Quality Management District. (1) Rule 466...

Integrated management system: The integration of ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000

NASA Astrophysics Data System (ADS)

Muzaimi, Hafizzudin; Chew, Boon Cheong; Hamid, Syaiful Rizal

2017-03-01

The implementation of integrated management system (IMS) for better quality management has become a preference for many organizations. This can be seen as many organizations used the combination of quality ISO 9001, an environment ISO 14001 and occupational health and safety management system OHSAS 18001 as a core for the IMS that largely implemented. Besides, the linked between quality management with risk management system need to be identified as the management system that enhance the effectiveness of IMS. Therefore, the risk management system ISO 31000 also presented as a part of integration. In nowadays competitive environment, the increasing pressure and needs from customer or stakeholders make it compulsory for the organization to propose the new system and standards. This paper presents and discusses about the benefit of integration, the management system components that can be converged and the implementation approach. A series of interview was conducted through in-depth interviews with 8 experts in this field, while data collected were analyzed qualitatively. The results consist of 16 factors of IMS implementation that have been identified and the use of PDCA approach for an effective implementation of IMS. As a conclusion, the paper proposes the integration of four management systems (ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000) and on how the IMS can be used to structure the process of management for quality management towards sustainability practices in the organization.

The development of effects-based air quality management regimes

NASA Astrophysics Data System (ADS)

Longhurst, J. W. S.; Irwin, J. G.; Chatterton, T. J.; Hayes, E. T.; Leksmono, N. S.; Symons, J. K.

This paper considers the evolution of attempts to control and manage air pollution, principally but not exclusively focussing upon the challenge of managing air pollution in urban environments. The development and implementation of a range of air pollution control measures are considered. Initially the measures implemented primarily addressed point sources, a small number of fuel types and a limited number of pollutants. The adequacy of such a source-control approach is assessed within the context of a changing and challenging air pollution climate. An assessment of air quality management in the United Kingdom over a 50-year timeframe exemplifies the range of issues and challenges in contemporary air quality management. The need for new approaches is explored and the development and implementation of an effects-based, risk management system for air quality regulation is evaluated.

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

PubMed

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

2017-01-01

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

California Air Quality State Implementation Plans; Final Approval; Butte County Air Quality Management District; Stationary Source Permits

EPA Pesticide Factsheets

EPA is taking final action to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California State Implementation Plan (SIP). This revision concerns the District's New Source Review (NSR) permitting program.

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

PubMed

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

2016-05-24

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

75 FR 18143 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0045; FRL-9124-4] Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD) portion of the...

77 FR 63781 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0754; FRL-9740-6] Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality Management Districts... approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD) portion of the...

77 FR 47581 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0311; FRL-9687-2] Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD) portion of the...

77 FR 39180 - Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9690-9] Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast Air Quality Management... State Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District...

Strategic collaborative quality management and employee job satisfaction

PubMed Central

Mosadeghrad, Ali Mohammad

2014-01-01

Background: This study aimed to examine Strategic Collaborative Quality Management (SCQM) impact on employee job satisfaction. Methods: The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees’ job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital. Results: The hospital reported a significant improvement in some dimensions of job satisfaction like management and supervision, organisational policies, task requirement, and working conditions. Conclusion: This paper provides detailed information on how a quality management model implementation affects employees. A well developed, well introduced and institutionalised quality management model can improve employees’ job satisfaction. However, the success of quality management needs top management commitment and stability. PMID:24847482

Strategic collaborative quality management and employee job satisfaction.

PubMed

Mosadeghrad, Ali Mohammad

2014-05-01

This study aimed to examine Strategic Collaborative Quality Management (SCQM) impact on employee job satisfaction. The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees' job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital. The hospital reported a significant improvement in some dimensions of job satisfaction like management and supervision, organisational policies, task requirement, and working conditions. This paper provides detailed information on how a quality management model implementation affects employees. A well developed, well introduced and institutionalised quality management model can improve employees' job satisfaction. However, the success of quality management needs top management commitment and stability.

The use of on-site visits to assess compliance and implementation of quality management at hospital level.

PubMed

Wagner, C; Groene, O; Dersarkissian, M; Thompson, C A; Klazinga, N S; Arah, O A; Suñol, R

2014-04-01

Stakeholders of hospitals often lack standardized tools to assess compliance with quality management strategies and the implementation of clinical quality activities in hospitals. Such assessment tools, if easy to use, could be helpful to hospitals, health-care purchasers and health-care inspectorates. The aim of our study was to determine the psychometric properties of two newly developed tools for measuring compliance with process-oriented quality management strategies and the extent of implementation of clinical quality strategies at the hospital level. We developed and tested two measurement instruments that could be used during on-site visits by trained external surveyors to calculate a Quality Management Compliance Index (QMCI) and a Clinical Quality Implementation Index (CQII). We used psychometric methods and the cross-sectional data to explore the factor structure, reliability and validity of each of these instruments. The sample consisted of 74 acute care hospitals selected at random from each of 7 European countries. The psychometric properties of the two indices (QMCI and CQII). Overall, the indices demonstrated favourable psychometric performance based on factor analysis, item correlations, internal consistency and hypothesis testing. Cronbach's alpha was acceptable for the scales of the QMCI (α: 0.74-0.78) and the CQII (α: 0.82-0.93). Inter-scale correlations revealed that the scales were positively correlated, but distinct. All scales added sufficient new information to each main index to be retained. This study has produced two reliable instruments that can be used during on-site visits to assess compliance with quality management strategies and implementation of quality management activities by hospitals in Europe and perhaps other jurisdictions.

Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

PubMed

Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

2017-03-01

Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

EDUCATING MANAGERS ABOUT QUALITY THROUGH CUSTOMER-SUPPLIER UNDERSTANDING

EPA Science Inventory

The successful implementation of a Quality System depends largely on the commitment to Quality by managers and their participation in the quality management process. oday, an accepted definition of quality is largely based on the concept of customer and supplier partnerships in a...

Essentials of total quality management: a meta-analysis.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

The purpose of this paper is to identify critical successful factors for Total Quality Management (TQM) implementation. A literature review was conducted to explore the critical successful factors for TQM implementation between 1980 and 2010. A successful TQM implementation need sufficient education and training, supportive leadership, consistent support of top management, customer focus, employee involvement, process management and continuous improvement of processes. The review was limited to articles written in English language during the past 30 years. From a practical point of view, the findings of this paper provide managers with a practical understanding of the factors that are likely to facilitate TQM implementation in organisations. Understanding the factors that are likely to promote TQM implementation would enable managers to develop more effective strategies that will enhance the chances of achieving business excellence.

78 FR 9703 - Food and Drug Administration/Xavier University PharmaLink Conference-Quality in a Global Supply...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... the Office of the Commissioner on the implementation of the FDA Safety and Innovation Act, Business Impact of Outsourcing, Supplier Management Models that Work, Implementing Quality by Design (QbD... quality and management through the following topics: Beyond our Borders--Maximizing the Impact of FDA's...

[Recommendations for implementing the quality policy and organisation of a quality management system].

PubMed

Daunizeau, A

2013-06-01

Preliminary issues to implement a quality management system are described. They include the definition of the structure, a hierarchical and functional organization chart and the engagement of the whole personnel to apply the requirements of the standard EN ISO 15189. The policy has to be translated into objectives.

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

PubMed Central

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

2017-01-01

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

The Quality Improvement Management Approach as Implemented in a Middle School.

ERIC Educational Resources Information Center

Bayless, David L.; And Others

1992-01-01

The Total Quality Management Theory of W. E. Deming can be adapted within an educational organization to build structures that support educators' beliefs. A case study of the implementation of Deming principles at the LeRoy Martin Middle School in Raleigh (North Carolina) illustrates the effectiveness of this management approach. (SLD)

77 FR 53773 - Revisions to the California State Implementation Plan, South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9711-2] Revisions to the California State Implementation Plan, South Coast Air Quality Management District (SCAQMD) AGENCY... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...

Implementing Total Quality Management in Vocational Education.

ERIC Educational Resources Information Center

Navaratnam, K. K.; Mountney, Peter

In an internationally competitive training environment, implementation of Total Quality Management (TQM) in vocational education can provide a comparative advantage in preparing the type of work force required for micro and macro economic reforms. The concept of TQM can be used as a management tool to improve the standards of vocational training.…

78 FR 37719 - Interim Final Determination To Defer Sanctions; California; South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... Determination To Defer Sanctions; California; South Coast Air Quality Management District AGENCY: Environmental... Quality Management District's (SCAQMD) portion of the California State Implementation Plan (SIP) published... California submitted the ``South Coast Air Quality Management District Proposed Contingency Measures for the...

21 CFR 820.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

PubMed

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

2018-05-16

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

76 FR 60405 - Revisions to the California State Implementation Plan, Santa Barbara Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... Municipal Air Quality Management District and South Coast Air Quality Management District AGENCY... the Santa Barbara Air Pollution Control District (SBAPCD), Sacramento Municipal Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the California State...

Electronic medical record system at an opioid agonist treatment programme: study design, pre-implementation results and post-implementation trends.

PubMed

Kritz, Steven; Brown, Lawrence S; Chu, Melissa; John-Hull, Carlota; Madray, Charles; Zavala, Roberto; Louie, Ben

2012-08-01

Electronic medical record (EMR) systems are commonly included in health care reform discussions. However, their embrace by the health care community has been slow. At Addiction Research and Treatment Corporation, an outpatient opioid agonist treatment programme that also provides primary medical care, HIV medical care and case management, substance abuse counselling and vocational services, we studied the implementation of an EMR in the domains of quality, productivity, satisfaction, risk management and financial performance utilizing a prospective pre- and post-implementation study design. This report details the research approach, pre-implementation findings for all five domains, analysis of the pre-implementation findings and some preliminary post-implementation results in the domains of quality and risk management. For quality, there was a highly statistically significant improvement in timely performance of annual medical assessments (P < 0.001) and annual multidiscipline assessments (P < 0.0001). For risk management, the number of events was not sufficient to perform valid statistical analysis. The preliminary findings in the domain of quality are very promising. Should the findings in the other domains prove to be positive, then the impetus to implement EMR in similar health care facilities will be advanced. © 2011 Blackwell Publishing Ltd.

Development of the supply chain oriented quality assurance system for aerospace manufacturing SMEs and its implementation perspectives

NASA Astrophysics Data System (ADS)

Hussein, Abdullahi; Cheng, Kai

2016-10-01

Aerospace manufacturing SMEs are continuously facing the challenge on managing their supply chain and complying with the aerospace manufacturing quality standard requirement due to their lack of resources and the nature of business. In this paper, the ERP system based approach is presented to quality control and assurance work in light of seamless integration of in-process production data and information internally and therefore managing suppliers more effectively and efficiently. The Aerospace Manufacturing Quality Assurance Standard (BS/EN9100) is one of the most recognised and essential protocols for developing the industry-operated-and-driven quality assurance systems. The research investigates using the ERP based system as an enabler to implement BS/EN9100 quality management system at manufacturing SMEs and the associated implementation and application perspectives. An application case study on a manufacturing SME is presented by using the SAP based implementation, which helps further evaluate and validate the approach and application system development.

[Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

PubMed

Enge, M; Koch, A; Müller, T; Vorländer, T

2010-12-01

The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.

NHEXAS PHASE I MARYLAND STUDY--QUALITY SYSTEMS AND IMPLEMENTATION PLAN (HSPH QSIP)

EPA Science Inventory

This document describes the project design and quality systems used by the Maryland Study for NHEXAS Phase 1. It contains the following sections: Project Planning and Organization, Project Implementation Plan, Data Acquisition and Management, Records Usage and Management, Routin...

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

PubMed

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

2012-07-01

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

PubMed Central

Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

1995-01-01

OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult challenges in this regard. PMID:7782222

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

PubMed

Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

1995-06-01

This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. The study involved cross-sectional examination of the named relationships. Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult challenges in this regard.

Quality in Web-Supported Learning.

ERIC Educational Resources Information Center

Fresen, Jill

2002-01-01

Discusses quality assurance for Web-based courses, based on experiences at the University of Pretoria. Topics include evaluation of courseware; the concept of quality, including quality control, quality assurance, and total quality management; implementing a quality management system; measurement techniques; and partnerships. (LRW)

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

PubMed

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

2006-09-20

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

Study Quality in Higher Education Institution: Philosophy and Praxeology of Management

ERIC Educational Resources Information Center

Juodaityte, Audrone

2004-01-01

This article defines total quality philosophy, its transformations and significance for study quality in higher education institution. It reveals the concepts, principles and problems of study quality management and provides overview of implementation of study quality management at today's European universities. The experience of two European…

Extent of Implementing the Total Quality Management Principles by Academic Departments Heads at Najran University from Faculty Members' Perspectives

ERIC Educational Resources Information Center

Al-Din, Hesham Moustafa Kamal; Abouzid, Mohamed Mahmoud

2016-01-01

This study aimed to identify the implementing degree of Total Quality Management (TQM) principals by Academic Departmental Heads (ADH) at the Najran University from faculty members' perspectives. It also aimed to determine significant differences between the average estimate of sample section of faculty members about the implementing degree of TQM…

Implementation research: a mentoring programme to improve laboratory quality in Cambodia

PubMed Central

Voeurng, Vireak; Sek, Sophat; Song, Sophanna; Vong, Nora; Tous, Chansamrach; Flandin, Jean-Frederic; Confer, Deborah; Costa, Alexandre; Martin, Robert

2016-01-01

Abstract Objective To implement a mentored laboratory quality stepwise implementation (LQSI) programme to strengthen the quality and capacity of Cambodian hospital laboratories. Methods We recruited four laboratory technicians to be mentors and trained them in mentoring skills, laboratory quality management practices and international standard organization (ISO) 15189 requirements for medical laboratories. Separately, we trained staff from 12 referral hospital laboratories in laboratory quality management systems followed by tri-weekly in-person mentoring on quality management systems implementation using the LQSI tool, which is aligned with the ISO 15189 standard. The tool was adapted from a web-based resource into a software-based spreadsheet checklist, which includes a detailed action plan and can be used to qualitatively monitor each laboratory’s progress. The tool – translated into Khmer – included a set of quality improvement activities grouped into four phases for implementation with increasing complexity. Project staff reviewed the laboratories’ progress and challenges in weekly conference calls and bi-monthly meetings with focal points of the health ministry, participating laboratories and local partners. We present the achievements in implementation from September 2014 to March 2016. Findings As of March 2016, the 12 laboratories have completed 74–90% of the 104 activities in phase 1, 53–78% of the 178 activities in phase 2, and 18–26% of the 129 activities in phase 3. Conclusion Regular on-site mentoring of laboratories using a detailed action plan in the local language allows staff to learn concepts of quality management system and learn on the job without disruption to laboratory service provision. PMID:27843164

40 CFR 35.2102 - Water quality management planning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Water quality management planning. 35... Administrator shall first determine that the project is: (a) Included in any water quality management plan being implemented for the area under section 208 of the Act or will be included in any water quality management plan...

[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.

Total Quality Management in Logistics: A Case Study from the Trucking Industry

DTIC Science & Technology

1992-06-01

Quality Management (TQM) movement on the logistics industry as a whole, and, more specifically, its impact within the trucking industry. Its focus then narrows to study the practical aspects of implementing a W. Edwards Deming-based quality program within a particular trucking company, Mason Transporters, Inc. The effectiveness of the company’s implementation effort is assessed using data collected from a survey questionnaire, formal interviews, and personal observations during an on- site visit. Successes and shortcomings of the implementation process are highlighted

Total Quality Management Implementation Strategy: Directorate of Quality Assurance

DTIC Science & Technology

1989-05-01

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

The quest for quality and productivity in health services.

PubMed

Sahney, V K; Warden, G L

1991-01-01

The leaders of health care organizations across the country are facing significant pressures to improve the quality of their services while reducing the rate of cost increases within the industry. Total Quality Management (TQM) has been credited, by many leaders in the manufacturing industry, as an effective tool to manage their organizations. This article presents key concepts of TQM as discussed by quality experts, namely, Deming, Juran, and Crosby. It discusses 12 key concepts that have formed the foundation of TQM implementation at Henry Ford Health System. The process of implementation is presented in detail, and the role of TQM in clinical applications is discussed. Success factors and visible actions by senior management designed to reinforce the implementation of TQM in any organization are presented.

Planning and Implementing total Quality Management in an Air Force Service Organization: A Case Study

DTIC Science & Technology

1988-09-01

Quality Management (TQM). Documentation of such implementation methods can provide useful crossfeed to other services organizations attempting similiar efforts. The following research questions were addressed to present the case in a useful context for interpretation: (1) What is TQM and how will it be implemented in AFALC; (2) How can the quality of service organizations be improved and what techniques may be useful for this purpose; (3) How does the environment at AFALC differ from most Air Force organizations implementing TQM and what obstacles must it overcome; (4) How

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

PubMed

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

1993-10-01

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

Air quality management in Mexico.

PubMed

Fernández-Bremauntz, Adrián

2008-01-01

Several significant program and policy measures have been implemented in Mexico over the past 15 yr to improve air quality. This article provides an overview of air quality management strategies in Mexico, including (1) policy initiatives such as vehicle use restrictions, air quality standards, vehicle emissions, and fuel quality standards, and (2) supporting programs including establishment of a national emission inventory, an air pollution episodes program, and the implementation of exposure and health effects studies. Trends in air pollution episodes and ambient air pollutant concentrations are described.

Quality Implementation in Transition: A Framework for Specialists and Administrators.

ERIC Educational Resources Information Center

Wald, Judy L.; Repetto, Jeanne B.

1995-01-01

Quality Implementation in Transition is a framework designed to guide transition specialists and administrators in the implementation of total quality management. The framework uses the tenets set forth by W. Edwards Deming and is intended to help professionals facilitate change within transition programs. (Author/JOW)

[Quality management in a clinical research facility: Evaluation of changes in quality in-house figures and the appraisal of in-house quality indicators].

PubMed

Aden, Bile; Allekotte, Silke; Mösges, Ralph

2016-12-01

For long-term maintenance and improvement of quality within a clinical research institute, the implementation and certification of a quality management system is suitable. Due to the implemented quality management system according to the still valid DIN EN ISO 9001:2008 desired quality objectives are achieved effectively. The evaluation of quality scores and the appraisal of in-house quality indicators make an important contribution in this regard. In order to achieve this and draw quality assurance conclusions, quality indicators as sensible and sensitive as possible are developed. For this, own key objectives, the retrospective evaluation of quality scores, a prospective follow-up and also discussions establish the basis. In the in-house clinical research institute the measures introduced by the quality management led to higher efficiency in work processes, improved staff skills, higher customer satisfaction and overall to more successful outcomes in relation to the self-defined key objectives. Copyright © 2016. Published by Elsevier GmbH.

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

PubMed Central

Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

2017-01-01

Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-04-01

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

A Multi-Level Examination of Leadership Practices in Quality Management: Implications for Organisational Performance in Healthcare

ERIC Educational Resources Information Center

Akdere, Mesut

2007-01-01

Organisations are continuously challenged to become more strategic, productive and cost-effective. As a result, quality management has become increasingly important to achieve desired organisational performance outcomes. Quality management considers leadership an important component to implement and sustain quality products and services to…

[Managing a health research institute: towards research excellence through continuous improvement].

PubMed

Olmedo, Carmen; Buño, Ismael; Plá, Rosa; Lomba, Irene; Bardinet, Thierry; Bañares, Rafael

2015-01-01

Health research institutes are a strategic commitment considered the ideal environment to develop excellence in translational research. Achieving quality research requires not only a powerful scientific and research structure but also the quality and integrity of management systems that support it. The essential instruments in our institution were solid strategic planning integrated into and consistent with the system of quality management, systematic evaluation through periodic indicators, measurement of key user satisfaction and internal audits, and implementation of an innovative information management tool. The implemented management tools have provided a strategic thrust to our institute while ensuring a level of quality and efficiency in the development and management of research that allows progress towards excellence in biomedical research. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Importance of the Primary Radioactivity Standard Laboratory and Implementation of its Quality Management

NASA Astrophysics Data System (ADS)

Sahagia, Maria; Razdolescu, Anamaria Cristina; Luca, Aurelian; Ivan, Constantin

2007-04-01

The paper presents some specific aspects of the implementation of the quality management in the Radionuclide Metrology Laboratory, from IFIN-HH, the owner of the primary Romanian standard in radioactivity. The description of the accreditation, according to the EN ISO/IEC 17025:2005, is presented.

Developing Flowcharted Procedures Manuals for School District Administration within the ISO 9000 Context.

ERIC Educational Resources Information Center

Schoch, Robert

2002-01-01

Describes how the School District of Lancaster, Pennsylvania, implemented a districtwide quality-management system based on the Geneva-based International Standards Organization 9001, a major component of which is the documentation of procedures. Includes sections on implementation, procedure manuals, quality management, uniformity, formatting,…

Improving Teachers' In-Service Professional Development in Mathematics and Science: The Role of Postsecondary Institutions.

ERIC Educational Resources Information Center

Desimone Laura; Garet, Michael S.; Birman, Beatrice F.; Porter, Andrew; Yoon, Kwang Suk

2003-01-01

As part of national evaluation of Eisenhower Professional Development Program, examines management and implementation strategies contributing to high-quality inservice teacher professional development in mathematics and science. Finds higher quality professional development is related to management and implementation strategies such as continuous…

Strategies for Implementation: The El Camino College Total Quality Management Story.

ERIC Educational Resources Information Center

Schauerman, Sam; Peachy, Burt

1994-01-01

Traces the development of the principles and practices of Total Quality Management (TQM) at El Camino College, in California. Discusses institutional resistance to change and the need for careful implementation analysis and constituent group involvement. Includes a nine-item bibliography of theoretical and descriptive works. (MAB)

[Quality assurance and total quality management in residential home care].

PubMed

Nübling, R; Schrempp, C; Kress, G; Löschmann, C; Neubart, R; Kuhlmey, A

2004-02-01

Quality, quality assurance, and quality management have been important topics in residential care homes for several years. However, only as a result of reform processes in the German legislation (long-term care insurance, care quality assurance) is a systematic discussion taking place. Furthermore, initiatives and holistic model projects, which deal with the assessment and improvement of service quality, were developed in the field of care for the elderly. The present article gives a critical overview of essential developments. Different comprehensive approaches such as the implementation of quality management systems, nationwide expert-based initiatives, and developments towards professionalizing care are discussed. Empirically based approaches, especially those emphasizing the assessment of outcome quality, are focused on in this work. Overall, the authors conclude that in the past few years comprehensive efforts have been made to improve the quality of care. However, the current situation still requires much work to establish a nationwide launch and implementation of evidence-based quality assurance and quality management.

Senior managers' viewpoints toward challenges of implementing clinical governance: a national study in iran.

PubMed

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

2013-11-01

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

[The organization of system of quality management in large multitype hospital].

PubMed

Taĭts, B M; Krichmar, G N; Stvolinskiĭ, I Iu; Grandilevskaia, O L

2013-01-01

The article presents the characteristics and assessment of functioning of model of quality management in large multitype hospital. The results of work of the municipal hospital of Saint Venerable martyr Elizabeth of St Petersburg concerning the implementation of system of quality management in 2001-2011 of the foundation of principles of total quality management of medical service and principles of quality management according international standards ISO and their Russian analogues.

Implementation of quality management for clinical bacteriology in low-resource settings.

PubMed

Barbé, B; Yansouni, C P; Affolabi, D; Jacobs, J

2017-07-01

The declining trend of malaria and the recent prioritization of containment of antimicrobial resistance have created a momentum to implement clinical bacteriology in low-resource settings. Successful implementation relies on guidance by a quality management system (QMS). Over the past decade international initiatives were launched towards implementation of QMS in HIV/AIDS, tuberculosis and malaria. To describe the progress towards accreditation of medical laboratories and to identify the challenges and best practices for implementation of QMS in clinical bacteriology in low-resource settings. Published literature, online reports and websites related to the implementation of laboratory QMS, accreditation of medical laboratories and initiatives for containment of antimicrobial resistance. Apart from the limitations of infrastructure, equipment, consumables and staff, QMS are challenged with the complexity of clinical bacteriology and the healthcare context in low-resource settings (small-scale laboratories, attitudes and perception of staff, absence of laboratory information systems). Likewise, most international initiatives addressing laboratory health strengthening have focused on public health and outbreak management rather than on hospital based patient care. Best practices to implement quality-assured clinical bacteriology in low-resource settings include alignment with national regulations and public health reference laboratories, participating in external quality assurance programmes, support from the hospital's management, starting with attainable projects, conducting error review and daily bench-side supervision, looking for locally adapted solutions, stimulating ownership and extending existing training programmes to clinical bacteriology. The implementation of QMS in clinical bacteriology in hospital settings will ultimately boost a culture of quality to all sectors of healthcare in low-resource settings. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

IMPLEMENTING ACCOUNTABILITY WITHIN A MULTI-POLLUTANT AIR QUALITY MANAGEMENT FRAMEWORK

EPA Science Inventory

In 2004, the National Research Council (NRC) published a major assessment of air quality management practices: Air Quality Management in the United States. The assessment resulted from a Congressional directive that the U.S. Environmental Protection Agency commission the Nationa...

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

PubMed Central

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

2006-01-01

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

Total quality management: Strengths and barriers to implementation and cultural adaptation

NASA Technical Reports Server (NTRS)

Siegfeldt, Denise V.; Glenn, Michael; Hamilton, Louise

1992-01-01

NASA/Langley Research Center (LaRC) is in the process of implementing Total Quality Management (TQM) throughout the organization in order to improve productivity and make the Center an even better place to work. The purpose of this project was to determine strengths and barriers to TQM being implemented and becoming a part of the organizational culture of the Human Resources Management Division (HRMD) at Langley. The target population for this project was both supervisory and nonsupervisory staff of the HMRD. In order to generate data on strengths and barriers to TQM implementation and cultural adaptation, a modified nominal group technique was used.

75 FR 24406 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... Metropolitan Air Quality Management District, San Joaquin Valley Unified Air Pollution Control District, and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Air Pollution Control District (PCAPCD), Sacramento Metropolitan Air Quality Management District...

75 FR 24544 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... Metropolitan Air Quality Management District, San Joaquin Valley Unified Air Pollution Control District, and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... District (PCAPCD), Sacramento Metropolitan Air Quality Management District (SMAQMD), San Joaquin Valley...

DISC (Defense Industrial Supply Center) TQM (Total Quality Management) Operations Plan

DTIC Science & Technology

1989-07-01

This document represents the continuance of the Defense Industrial Supply Center implementation of Total Quality Management which began in 1986. It...outlines how DISC intends to emphasize process improvement through the integration of all TQM initiates. Quality management at DISC prescribes defining

A residency clinic chronic condition management quality improvement project.

PubMed

Halverson, Larry W; Sontheimer, Dan; Duvall, Sharon

2007-02-01

Quality improvement in chronic disease management is a major agenda for improving health and reducing health care costs. A six-component chronic disease management model can help guide this effort. Several characteristics of the "new model" of family medicine described by the Future of Family Medicine (FFM) Project Leadership Committee are promulgated to foster practice changes that improve quality. Our objective was to implement and assess a quality improvement project guided by the components of a chronic disease management model and FFM new model characteristics. Diabetes was selected as a model chronic disease focus. Multiple practice changes were implemented. A mature electronic medical record facilitated data collection and measurement of quality improvement progress. Data from the diabetes registry demonstrates that our efforts have been effective. Significant improvement occurred in five out of six quality indicators. Multidisciplinary teamwork in a model residency practice guided by chronic disease management principles and the FFM new model characteristics can produce significant management improvements in one important chronic disease.

Total Quality Management Practices and Their Effects on Organizational Performance

ERIC Educational Resources Information Center

Hung, Richard Yu-Yuan; Lien, Bella Ya-Hui

2004-01-01

This paper reports a study designed to examine the key concepts of Total Quality Management (TQM) implementation and their effects on organizational performance. Process Alignment and People Involvement are two key concepts for successful implementation of TQM. The purpose of this paper is to discuss how these two constructs affect organizational…

How Do District Management and Implementation Strategies Relate to the Quality of the Professional Development That Districts Provide to Teachers?

ERIC Educational Resources Information Center

Desimone, Laura; Porter, Andrew C.; Birman, Beatrice F.; Garet, Michael S.; Yoon, Kwang Suk

2002-01-01

Examined policy mechanisms and processes that districts used to provide high quality inservice professional development to teachers. Data from a national probability sample of professional development coordinators in districts that received federal funding for professional development highlighted specific management and implementation strategies…

Introducing the Human Side of Total Quality Management into Educational Institutions.

ERIC Educational Resources Information Center

Thor, Linda M.

1994-01-01

Drawing from the experiences of Rio Salado Community College (Arizona) in implementing Total Quality Management, discusses common barriers to change (e.g., time, aversion to change, and pitfalls of change); leadership failure as a cause of failure in TQM implementation; and the importance of constancy of purpose, employee empowerment, and…

Hospital implementation of health information technology and quality of care: are they related?

PubMed

Restuccia, Joseph D; Cohen, Alan B; Horwitt, Jedediah N; Shwartz, Michael

2012-09-27

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians. We conducted surveys of quality managers and front-line clinicians (physicians and nurses) in 470 short-term, general hospitals to obtain data on hospitals' extent of HIT implementation, QI practices and strategies, assessments of quality performance, commitment to quality, and sufficiency of resources for QI. Of the 470 hospitals, 401 submitted complete data necessary for analysis. We also developed measures of hospital performance from several publicly data available sources: Hospital Compare adherence to process of care measures; Medicare Provider Analysis and Review (MEDPAR) file; and Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS® survey. We used Poisson regression analysis to examine the association between HIT implementation and QI practices and strategies, and general linear models to examine the relationship between HIT implementation and hospital performance measures. Controlling for potential confounders, we found that hospitals with high levels of HIT implementation engaged in a statistically significant greater number of QI practices and strategies, and had significantly better performance on mortality rates, patient satisfaction measures, and assessments of patient care quality by hospital quality managers; there was weaker evidence of higher assessments of patient care quality by front-line clinicians. Hospital implementation of HIT was positively associated with activities intended to improve patient care quality and with higher performance on four of six performance measures.

Air quality evaluation of Rhode Island's incident management program

DOT National Transportation Integrated Search

1997-09-01

The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

Total Quality Management (TQM) Bibliography

DTIC Science & Technology

1990-04-01

GTE FIE COPY DTIC c" ECTE 8JUL 25 1990u TOTAL QUALITY MANAGEMENT (TQM) BIBLIOGRAPHY APRIL-1990 Jointly supported by __’__________-_________ Jointly...Arsenal, AL 35898-5241 1I. TITLE (Include Security Classification) TOTAL QUALITY MANAGEMENT (TQM) BIBL IRAPHY APRIL-1990 12. PERSONAL AUTHOR(S) Knott...implementation of the concept of total quality management (TQM). The selected coverage includes books, periodical articles, conference papers and reports. Coded

Where Is the Xerox Corporation of the LIS Sector?

ERIC Educational Resources Information Center

Gilchrist, Alan; Brockman, John

1996-01-01

Discusses barriers to the implementation of quality management in the library and information science sector in Europe. Topics include Total Quality Management and other business experiences, an information quality infrastructure, supplier/customer relations, customer satisfaction, and a European Quality Model. (LRW)

Quality management in health care: a 20-year journey.

PubMed

Ruiz, Ulises

2004-01-01

In this article, the total quality programme in the Spanish healthcare system (1986-1992) and the subsequent quality improvement steps that have led to definition and implementation of such an integrated framework, seeking a quality management system and patient safety, are discussed.

An overview of Quality Management System implementation in a research laboratory

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Total Quality Management and Media Services: The Deming Method.

ERIC Educational Resources Information Center

Richie, Mark L.

1992-01-01

W. Edwards Deming built a 40-year record of quality management in Japan known as Total Quality Management (TQM). His 14 points require a change in the belief system of managers and media directors, but their implementation in government agencies and schools will produce increased time for better services, better communications, and new programs.…

77 FR 23130 - Revisions to the California State Implementation Plan, Northern Sierra and Sacramento...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... taking direct final action to approve revisions to the Northern Sierra Air Quality Management District (NSAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD) portions of the California...) Northern Sierra Air Quality Management District. (i) Flexible Package Printing, Flat Wood Paneling Coatings...

40 CFR 130.0 - Program summary and purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...

Quality Management Plus: The Continuous Improvement of Education.

ERIC Educational Resources Information Center

Kaufman, Roger; Zahn, Douglas

This book applies quality management, an organizational theory that has been successful in business and industry, to education. Chapter 1 describes the basic elements of quality management (QM)--continuous improvement, client satisfaction, positive return on investment, and doing it right the first and every time. Ways to implement Deming's 14…

40 CFR 130.0 - Program summary and purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...

40 CFR 130.0 - Program summary and purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...

40 CFR 130.0 - Program summary and purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...

Improving service user self-management: development and implementation of a strategy for the Richmond Response and Rehabilitation Team.

PubMed

Sanders, Julie; Fitzpatrick, Joanne M

2017-01-01

Community rapid response and rehabilitation teams are used to prevent avoidable hospital admissions for adults living with multiple long-term conditions and to support early hospital discharge by providing short-term intensive multidisciplinary support. Supporting self-management is an important service intervention if desired outcomes are to be achieved. A Care Quality Commission inspection of the Richmond Response and Rehabilitation Team in 2014 identified that self-management plans were not routinely developed with service users and reported this as requiring improvement. This quality improvement project aimed to develop and implement a self-management strategy for service users and for 90% of service users to have a personalised self-management plan within 3 months. The quality improvement intervention used the Plan-Do-Study-Act model comprising: (1) the development of a self-management plan, (2) staff education to support service users to self-manage using motivational interviewing techniques, (3) piloting the self-management plan with service users, (4) implementation of the self-management plan and (5) monthly audit and feedback. Evaluation involved an audit of the number and quality of self-management plans developed with service users and a survey of staff knowledge and confidence to support service users to self-manage. Following implementation of the intervention, the number of self-management plans developed in collaboration with service users increased from 0 to 187 over a 4-week period. Monthly audit data confirmed that this improvement has been sustained. Results indicated that staff knowledge and confidence improved after an education intervention. Quality improvement methods facilitated development and operationalisation of a self-management strategy by a community rapid response and rehabilitation team. The next phase of the project is to evaluate the impact of the self-management strategy on key service outcomes including self-efficacy, unplanned and emergency hospital admissions and early discharges.

78 FR 18936 - Revision to the California State Implementation Plan, South Coast Air Quality Management Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0920; FRL-9779-1] Revision to the California State Implementation Plan, South Coast Air Quality Management Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve a revision to the South...

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

PubMed

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

2012-08-01

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

[Practical implementation of a quality management system in a radiological department].

PubMed

Huber, S; Zech, C J

2011-10-01

This article describes the architecture of a project aiming to implement a DIN EN ISO 9001 quality management system in a radiological department. It is intended to be a practical guide to demonstrate each step of the project leading to certification of the system. In a planning phase resources for the implementation of the project have to be identified and a quality management (QM) group as core team has to be formed. In the first project phase all available documents have to be checked and compiled in the QM manual. Moreover all relevant processes of the department have to be described in so-called process descriptions. In a second step responsibilities for the project are identified. Customer and employee surveys have to be carried out and a nonconformity management system has to be implemented. In this phase internal audits are also needed to check the new QM system, which is finally tested in the external certification audit with reference to its conformity with the standards.

[Health insurance dentists' subjective perceptions of quality when implementing quality management in practice - results from a nationwide survey].

PubMed

Kettler, Nele; Chenot, Regine; Jordan, A Rainer

2015-01-01

Statutory health insurance dentists working in private practice have a duty to maintain and improve the quality of dental care. An individual practice's approach to quality management (QM) can be made to reflect the practice's philosophy on quality and standards and can be adapted to the specific requirements of the practice setting they are meant to serve. This study set out to collect data on the subjective perceptions of quality that exist among German dentists, and to canvass their views on the process and benefits of implementing QM systems. In doing so, this study aimed to identify the incentives and obstacles that currently exist in relation to the implementation and further development of practice-based QM systems. As part of a nationally representative cross-sectional study, a random sample of 2,084 dentists was asked to complete a questionnaire on perceptions of quality and QM. The response rate was 40.3 % (n=838). The study's primary end point was defined as the surveyed dentists' interpretative description of quality. The study's secondary end point was defined as the dentists' subjective evaluations of the benefits of QM in the day-to-day management of their own practices. Responses to open-ended questions were analysed using content analysis, while quantitative questions were analysed using descriptive univariate analysis. When analysing respondents' subjective perceptions of quality (primary end point), the following dimensions were revealed as highly significant: patient (mentioned by 31.4 % of the responders), quality of treatment (29.5 %) and staff (14.8 %). As far as the benefits of QM in the day-to-day management of the respondent's own practices (secondary end point) were concerned, these appeared to be linked to the ease of implementation of the organizational tools offered by QM systems: managing emergencies, team meetings and procedural check lists were ranked as "can be implemented to a reasonable degree" and "can be fully implemented" by 82.3 %, 80.2 % and 79.9 % of respondents, respectively. There appeared to be a disconnect between the respondents' subjective perceptions of quality and the benefits of QM as part of day-to-day practice management, with QM systems failing to reflect the respondents' subjective views on quality. The perceptions of QM among German statutory health insurance dentists are generally positive but marked by a disconnect between aspects of quality currently measured by QM systems and the dentists' views on what is required in order to assess quality standards in relation to the dimensions "patient", "quality of treatment" and "staff". A targeted review of the tools offered by QM systems may lead to improved ease of implementation. If QM is to form an integral part of clinical practice, all future developments need to consider the dentists' subjective perceptions of quality and their attitudes towards QM. Copyright © 2015. Published by Elsevier GmbH.

An evaluation of the total quality management implementation strategy for the advanced solid rocket motor project at NASA's Marshall Space Flight Center. M.S. Thesis - Tennessee Univ.

NASA Technical Reports Server (NTRS)

Schramm, Harry F.; Sullivan, Kenneth W.

1991-01-01

An evaluation of the NASA's Marshall Space Flight Center (MSFC) strategy to implement Total Quality Management (TQM) in the Advanced Solid Rocket Motor (ASRM) Project is presented. The evaluation of the implementation strategy reflected the Civil Service personnel perspective at the project level. The external and internal environments at MSFC were analyzed for their effects on the ASRM TQM strategy. Organizational forms, cultures, management systems, problem solving techniques, and training were assessed for their influence on the implementation strategy. The influence of ASRM's effort was assessed relative to its impact on mature projects as well as future projects at MSFC.

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

Implications of Modeling Uncertainty for Water Quality Decision Making

NASA Astrophysics Data System (ADS)

Shabman, L.

2002-05-01

The report, National Academy of Sciences report, "Assessing the TMDL Approach to Water Quality Management" endorsed the "watershed" and "ambient water quality focused" approach" to water quality management called for in the TMDL program. The committee felt that available data and models were adequate to move such a program forward, if the EPA and all stakeholders better understood the nature of the scientific enterprise and its application to the TMDL program. Specifically, the report called for a greater acknowledgement of model prediction uncertinaity in making and implementing TMDL plans. To assure that such uncertinaity was addressed in water quality decision making the committee called for a commitment to "adaptive implementation" of water quality management plans. The committee found that the number and complexity of the interactions of multiple stressors, combined with model prediction uncertinaity means that we need to avoid the temptation to make assurances that specific actions will result in attainment of particular water quality standards. Until the work on solving a water quality problem begins, analysts and decision makers cannot be sure what the correct solutions are, or even what water quality goals a community should be seeking. In complex systems we need to act in order to learn; adaptive implementation is a concurrent process of action and learning. Learning requires (1) continued monitoring of the waterbody to determine how it responds to the actions taken and (2) carefully designed experiments in the watershed. If we do not design learning into what we attempt we are not doing adaptive implementation. Therefore, there needs to be an increased commitment to monitoring and experiments in watersheds that will lead to learning. This presentation will 1) explain the logic for adaptive implementation; 2) discuss the ways that water quality modelers could characterize and explain model uncertinaity to decision makers; 3) speculate on the implications of the adaptive implementation for setting of water quality standards, for design of watershed monitoring programs and for the regulatory rules governing the TMDL program implementation.

[Quality management in pathology--an executive function and political implications].

PubMed

Turzynski, A

2013-09-01

Quality management (QM) is primarily an in-house executive function. It conduces to ensure a high quality service and has the external object to satisfy customer expectations. In Germany the implementation of quality management systems (QMS) is made compulsory for all medical facilities by law. However, details are not regulated and there is no need to certify the in-house QMS. Within the last 10 years many pathology institutions have become certified or accredited and have implemented voluntary measures of external quality assurance, such as quality circles and round robin trials. For non-certified institutions it might be helpful to be guided by established QM standards like the ISO 9001:2008. The fundamental concepts of QM, some pathology-specific aspects and some implications for the professional associations are discussed in this article.

Total quality management in blood transfusion.

PubMed

Smit-Sibinga, C T

2000-01-01

Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator.

Quality assurance and the need to evaluate interventions and audit programme outcomes.

PubMed

Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian

2017-06-01

Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.

Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study.

PubMed

Campmans-Kuijpers, Marjo J E; Lemmens, Lidwien C; Baan, Caroline A; Gorter, Kees J; Groothuis, Jolanda; van Vuure, Klementine H; Rutten, Guy E H M

2013-04-05

Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support. This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire. This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well.

Introduction of a quality improvement program in a children's hospital in Tehran: design, implementation, evaluation and lessons learned.

PubMed

Mohammadi, S Mehrdad; Mohammadi, S Farzad; Hedges, Jerris R; Zohrabi, Morteza; Ameli, Omid

2007-08-01

Reports addressing continuous quality improvement (CQI) methods in developing countries are scant and there are questions about the applicability of quality improvement methods in such settings. The structure and output of a formal quality improvement program implemented in a teaching hospital affiliated with the Tehran University of Medical Sciences is presented. OBJECTIVE METHOD: During a nine-month period, a multi-stage quality improvement program was implemented. It comprised: (i) training workshops; (ii) a steering committee; (iii) weekly consultation and facilitation of improvement projects; and (iv) a day-long demonstration and recognition meeting. Four cycles of workshops were held in which 132 employees were trained in the basics of CQI. Thirty improvement projects were initiated. Twenty-five of the projects were completed. In an evaluation survey more than 70% of respondents assessed a 'positive impact' on organizational culture, work efficiency and quality of services. More than 90% believed that the changes were sustained, and more than 60% reported that they have implemented additional improvement projects. Our quality improvement package supported rapid implementation of multiple projects. The underlying 'change structure' comprised the improvement teams, top management and the university's quality improvement office; it integrated project management, support and facilitation functions by the respective participant. Organization-wide change was more limited than anticipated. To institutionalize the program and ensure sustainability, a local structure for change should be organized, management coaching should be sustained, local facilitators should be developed, incentives should be established and physician involvement should be emphasized.

Office of Command Security Total Quality Management Plan

DTIC Science & Technology

1989-07-01

outlines the Office of Command Security instruction for TQM implementation. Keywords: TQM (Total Quality Management ), DLA Office of Command Security, Continuous process improvement, Automatic data processing security.

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

DTIC Science & Technology

1989-09-01

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

Leadership and Quality Management: An Analysis of Three Key Features of the Greek Education System

ERIC Educational Resources Information Center

Saiti, Anna

2012-01-01

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

77 FR 47581 - Revisions to the California State Implementation Plan, Mojave Desert, Northern Sierra, Sacramento...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

...EPA is proposing to approve revisions to the Mojave Desert Air Quality Management District (MDAQMD), Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan Air Quality Management District (SMAQMD) and San Diego County Air Pollution Control District (SDCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from automotive parts and component, automobile refinishing, metal parts and products, and miscellaneous coating and refinishing operations. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

[The experience of implementation of system of quality management in the Department of Laboratory Diagnostic of the N.V. Sklifosofskiy Research Institute of Emergency Care of Moscow Health Department: a lecture].

PubMed

Zenina, L P; Godkov, M A

2013-08-01

The article presents the experience of implementation of system of quality management into the practice of multi-field laboratory of emergency medical care hospital. The analysis of laboratory errors is applied and the modes of their prevention are demonstrated. The ratings of department of laboratory diagnostic of the N. V. Sklifosofskiy research institute of emergency care in the program EQAS (USA) Monthly Clinical Chemistry from 2007 are presented. The implementation of the system of quality management of laboratory analysis into department of laboratory diagnostic made it possible to support physicians of clinical departments with reliable information. The confidence of clinicians to received results increased. The effectiveness of laboratory diagnostic increased due to lowering costs of analysis without negative impact to quality of curative process.

Assuring the Quality of Test Results in the Field of Nuclear Techniques and Ionizing Radiation. The Practical Implementation of Section 5.9 of the EN ISO/IEC 17025 Standard

NASA Astrophysics Data System (ADS)

Cucu, Daniela; Woods, Mike

2008-08-01

The paper aims to present a practical approach for testing laboratories to ensure the quality of their test results. It is based on the experience gained in assessing a large number of testing laboratories, discussing with management and staff, reviewing results obtained in national and international PTs and ILCs and exchanging information in the EA laboratory committee. According to EN ISO/IEC 17025, an accredited laboratory has to implement a programme to ensure the quality of its test results for each measurand. Pre-analytical, analytical and post-analytical measures shall be applied in a systematic manner. They shall include both quality control and quality assurance measures. When designing the quality assurance programme a laboratory should consider pre-analytical activities (like personnel training, selection and validation of test methods, qualifying equipment), analytical activities ranging from sampling, sample preparation, instrumental analysis and post-analytical activities (like decoding, calculation, use of statistical tests or packages, management of results). Designed on different levels (analyst, quality manager and technical manager), including a variety of measures, the programme shall ensure the validity and accuracy of test results, the adequacy of the management system, prove the laboratory's competence in performing tests under accreditation and last but not least show the comparability of test results. Laboratory management should establish performance targets and review periodically QC/QA results against them, implementing appropriate measures in case of non-compliance.

A retrospective explanatory case study of the implementation of a bleeding management quality initiative, in an Australian cardiac surgery unit.

PubMed

Pearse, Bronwyn Louise; Rickard, Claire M; Keogh, Samantha; Lin Fung, Yoke

2018-03-09

Bleeding management in cardiac surgery is challenging. Many guidelines exist to support bleeding management; however, literature demonstrates wide variation in practice. In 2012, a quality initiative was undertaken at The Prince Charles Hospital, Australia to improve bleeding management for cardiac surgery patients. The implementation of the quality initiative resulted in significant reductions in the incidence of blood transfusion, re-exploration for bleeding; superficial leg and chest wound infections; length of hospital stay, and cost. Given the success of the initiative, we sought to answer the question; "How and why was the process of implementing a bleeding management quality initiative in the cardiac surgery unit successful, and sustainable?" A retrospective explanatory case study design was chosen to explore the quality initiative. Analysis of the evidence was reviewed through phases of the 'Knowledgeto Action' planned change model. Data was derived from: (1) document analysis, (2) direct observation of the local environment, (3) clinical narratives from interviews, and analysed with a triangulation approach. The study period extended from 10/2011 to 6/2013. Results demonstrated the complexity of changing practice, as well as the significant amount of dedicated time and effort required to support individual, department and system wide change. Results suggest that while many clinicians were aware of the potential to apply improved practice, numerous barriers and challenges needed to be overcome to implement change across multiple disciplines and departments. The key successful components of the QI were revealed through the case study analysis as: (1) an appropriately skilled project manager to facilitate the implementation process; (2) tools to support changes in workflow and decision making including a bleeding management treatment algorithm with POCCTs; (3) strong clinical leadership from the multidisciplinary team and; (4) the evolution of the project manager position into a perpetual clinical position to support sustainability. Copyright © 2018 Australian College of Critical Care Nurses Ltd. All rights reserved.

Supply Operations (DLA-O) Total Quality Management (TQM) Master Plan

DTIC Science & Technology

1989-07-01

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

Implementing a Quality Management Framework in a Higher Education Organisation: A Case Study

ERIC Educational Resources Information Center

O'Mahony, Kim; Garavan, Thomas N.

2012-01-01

Purpose: This paper aims to report and analyse the lessons learned from a case study on the implementation of a quality management system within an IT Division in a higher education (HE) organisation. Design/methodology/approach: The paper is based on a review of the relevant literatures and the use of primary sources such as document analysis,…

Challenges to Successful Total Quality Management Implementation in Public Secondary Schools: A Case Study of Kohat District, Pakistan

ERIC Educational Resources Information Center

Suleman, Qaiser; Gul, Rizwana

2015-01-01

The current study explores the challenges faced by public secondary schools in successful implementation of total quality management (TQM) in Kohat District. A sample of 25 heads and 75 secondary school teachers selected from 25 public secondary schools through simple random sampling technique was used. Descriptive research designed was used and a…

Principals' and Teachers' Perceptions of Quality Management in Hong Kong Primary Schools

ERIC Educational Resources Information Center

Cheng, Alison Lai Fong; Yau, Hon Keung

2011-01-01

Purpose: The purpose of this paper is to examine the perceptions of a sample of Hong Kong principals and teachers of the extent to which quality management (QM) has been effectively implemented in primary schools. The features of QM improvement implemented in Hong Kong primary schools include: values and duties, systems and teams(ST) resources and…

Obstacles to TQM success in health care systems.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

Many healthcare organisations have found it difficult to implement total quality management (TQM) successfully. The aim of this paper is to explore the barriers to TQM successful implementation in the healthcare sector. This paper reports a literature review exploring the major reasons for the failure of TQM programmes in healthcare organisations. TQM implementation and its impact depend heavily on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in healthcare organisations can be attributed to the strongly departmentalised, bureaucratic and hierarchical structure, professional autonomy, tensions between managers and professionals and the difficulties involved in evaluating healthcare processes and outcomes. Other obstacles to TQM success include lack of consistent managers' and employees' commitment to and involvement in TQM implementation, poor leadership and management, lack of a quality-oriented culture, insufficient training, and inadequate resources. The review was limited to empirical articles written in the English language during the past 30 years (1980-2010). The findings of this article provide policy makers and managers with a practical understanding of the factors that are likely to obstruct TQM implementation in the healthcare sector. Understanding the factors that obstruct TQM implementation would enable managers to develop more effective strategies for implementing TQM successfully in healthcare organisations.

[Construction and implementation of two quality indicators in nursing services].

PubMed

de Moura, Gisela Maria Schebela Souto; Juchem, Beatriz Cavalcanti; Falk, Maria Lucia Rodrigues; de Magalhães, Ana Maria Muller; Suzuki, Lyliam Midori

2009-03-01

Indicators monitor the quality of services and improve the attention offered to the patients. Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil, has been developing strategies to assess its services according to its institutional management policy of quality The present study aims to report the experience at this university hospital with the construction and implementation of quality indicators in its nursing services. In 2006, four indicators were established: incidence of pressure ulcer, with a goal of < or = 10:1000 patients per day/month and incidence of falls from bed whose goal was established as < or = 2:1000 patients per day/month. Our challenge was to build and implement these indicators as management tools to assess the quality of nursing services, for this is a large hospital.

Measuring, managing and maximizing refinery performance

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

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

1996-01-01

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

Summary statistics and graphical comparisons of historical hydrologic and water-quality data, Seco Creek Watershed, South-Central Texas

USGS Publications Warehouse

Brown, David W.; Slattery, Richard N.; Gilhousen, Jon R.

1998-01-01

The U.S. Geological Survey collected hydrologic (rainfall, streamflow, and reservoir content) and water-quality data in the Seco Creek watershed, south-central Texas. Most of the data from 15 sites were collected as part of a study in cooperation with the U.S. Department of Agriculture and the Texas State Soil and Water Conservation Board to evaluate the effects of agricultural best-management practices on surface- and ground-water quantity and quality in the 255-square-mile watershed. Nearly 400 best-management practices at 58 sites were implemented by landowners in the watershed during March 1990-September 1995. Most of the data are from the early 1990s, the period during and after implementation of best-management practices. Data from five sites include water quality and are summarized in tables and graphics in the text; and data from all 15 sites are summarized on a diskette. Maximum annual rainfall among the sites for which data are presented in the text (excluding one site) for the during-and-after-implementation period (March 1990-September 1995) was 53.27 inches in water year 1992. Maximum annual total streamflow among the sites for the period was 63,400 acre-feet, also in water year 1992. At the one site with water-quality data (under base-flow conditions) for both the before-implementation period and the during-and-after implementation period of best-management practices, percentiles (5, 25, 50, 75, 95) for specific conductance, nitrate concentration, and fecal coliform density were less for the during-and-after-implementation period than for the before-implementation period.

Continuous Improvement and Employee Engagement, Part 2: Design, Implementation, and Outcomes of a Daily Management System.

PubMed

Maurer, Marsha; Browall, Pamela; Phelan, Cynthia; Sanchez, Sandra; Sulmonte, Kimberlyann; Wandel, Jane; Wang, Allison

2018-04-01

A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.

Assurance of Medical Device Quality with Quality Management System: An Analysis of Good Manufacturing Practice Implementation in Taiwan

PubMed Central

Tu, Pei-Weng; Wu, Shiow-Ing

2015-01-01

The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development. PMID:26075255

Assurance of medical device quality with quality management system: an analysis of good manufacturing practice implementation in Taiwan.

PubMed

Li, Tzu-Wei; Tu, Pei-Weng; Liu, Li-Ling; Wu, Shiow-Ing

2015-01-01

The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development.

Why TQM does not work in Iranian healthcare organisations.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran. This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation. TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers' about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers' and employees' commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively. Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence. Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

An Introduction to Quality Management: Selected Readings.

DTIC Science & Technology

total quality management (TQM). Through the kind permission of a number of publishers, we have been able to reproduce here some key articles about...TQM. It is not the intent of this technical note to provide a comprehensive study of quality management , but rather to aid in planning for an...implementation of the Deming approach to TQM. Although the Navy aviation community chose the Deming approach to quality management , as reflected in the selected

Reported implementation lessons from a national quality improvement initiative; Productive Ward: Releasing Time to Care™. A qualitative, ward-based team perspective.

PubMed

White, Mark; Butterworth, Tony; Wells, John S G

2017-10-01

To explore the experiences of participants involved in the implementation of the Productive Ward: Releasing Time to Care™ initiative in Ireland, identifying key implementation lessons. A large-scale quality improvement programme Productive Ward: Releasing Time to Care™ was introduced nationwide into Ireland in 2011. We captured accounts from ward-based teams in an implementation phase during 2013-14 to explore their experiences. Semi-structured, in-depth interviews with a purposive sample of 24 members of ward-based teams from nine sites involved in the second national phase of the initiative were conducted. Interviews were analysed and coded under themes, using a seven-stage iterative process. The predominant theme identified was associated with the implementation and management of the initiative and included: project management; training; preparation; information and communication; and participant's negative experiences. The most prominent challenge reported related to other competing clinical priorities. Despite the structured approach of Productive Ward: Releasing Time to Care™, it appears that overstretched and busy clinical environments struggle to provide the right climate and context for ward-based teams to engage and interact actively with quality improvement tools, methods and activities. Findings highlight five key aspects of implementation and management that will help facilitate successful adoption of large-scale, ward-based quality improvement programmes such as Productive Ward: Releasing Time to Care™. Utilising pre-existing implementation or quality frameworks to assess each ward/unit for 'readiness' prior to commencing a quality improvement intervention such as Productive Ward: Releasing Time to Care™ should be considered. © 2017 John Wiley & Sons Ltd.

Quality Management Framework for Total Diet Study centres in Europe.

PubMed

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

2018-02-01

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

Implementation of a Quality Improvement Process Aimed to Deliver Higher-Value Physical Therapy for Patients With Low Back Pain: Case Report.

PubMed

Karlen, Emily; McCathie, Becky

2015-12-01

The current state of health care demands higher-value care. Due to many barriers, clinicians routinely do not implement evidence-based care even though it is known to improve quality and reduce cost of care. The purpose of this case report is to describe a theory-based, multitactic implementation of a quality improvement process aimed to deliver higher-value physical therapy for patients with low back pain. Patients were treated from January 2010 through December 2014 in 1 of 32 outpatient physical therapy clinics within an academic health care system. Data were examined from 47,755 patients (mean age=50.3 years) entering outpatient physical therapy for management of nonspecific low back pain, with or without radicular pain. Development and implementation tactics were constructed from adult learning and change management theory to enhance adherence to best practice care among 130 physical therapists. A quality improvement team implemented 4 tactics: establish care delivery expectations, facilitate peer-led clinical and operational teams, foster a learning environment focused on meeting a population's needs, and continuously collect and analyze outcomes data. Physical therapy utilization and change in functional disability were measured to assess relative cost and quality of care. Secondarily, charge data assessed change in physical therapists' application of evidence-based care. Implementation of a quality improvement process was measured by year-over-year improved clinical outcomes, decreased utilization, and increased adherence to evidence-based physical therapy, which was associated with higher-value care. When adult learning and change management theory are combined in quality improvement efforts, common barriers to implementing evidence-based care can be overcome, creating an environment supportive of delivering higher-value physical therapy for patients with low back pain. © 2015 American Physical Therapy Association.

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Developing a customised approach for strengthening tuberculosis laboratory quality management systems toward accreditation

PubMed Central

Trollip, Andre; Erni, Donatelle; Kao, Kekeletso

2017-01-01

Background Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS) in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA) programme. Development The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool. Implementation Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility-based approach in five tuberculosis laboratories in five countries. Conclusion Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories to achieve accreditation. PMID:28879165

Implementation of a 12-week disease management program improved clinical outcomes and quality of life in adults with asthma in a rural district hospital: pre- and post-intervention study.

PubMed

Chamnan, Parinya; Boonlert, Kittipa; Pasi, Wanit; Yodsiri, Songkran; Pong-on, Sirinya; Khansa, Bhoonsab; Yongkulwanitchanan, Pichapat

2010-03-01

Despite the availability of effective medical treatment and disease management guidelines, asthma remains a poorly controlled disease in developing countries. There is little evidence of the effectiveness of disease management guidelines in rural clinical practice. The effect of disease management guidelines on clinical outcomes and quality of life in asthmatic patients in a rural community hospital was examined. Fifty-seven patients aged > or = 16 years with physician-diagnosed asthma from a hospital outpatient clinic in Ubon-ratchathani, Thailand, were recruited. Asthma diagnosis was confirmed by reviewing clinical records. We implemented a 12-week disease management program, including the use of written asthma treatment plan and asthma action plan tailored to individual patients. Using one-group pre- and post-intervention design, we compared the average number of emergency visits and hospitalizations from acute asthmatic attacks before and after the implementation of interventions using the Wilcoxon matched-pairs signed-rank test. We also compared patient's asthma quality of life (AQL) scores, measured using the 7-point scaled Mini Asthma Quality of Life Questionnaire. It was found that among the 57 patients, 38 (67%) were women, and the mean age (SD) of the patients was 47.6 (17.0) years. Sixteen patients (28%) had a family history of asthma. Emergency visits decreased from 0.48 (SD = 0.83) per patient before implementation of interventions to 0.11 (0.37) per patient after implementation of interventions (p = 0.003). Hospitalizations with acute asthma attacks reduced from 0.14 (0.35) per patient to 0.04 (0.27) per patient (p = 0.034). Overall AQL scores increased significantly from 3.7 to 5.4 (p < 0.001), with most improvement observed in symptoms and emotions. It was concluded that implementation of a 12-week asthma disease management program could reduce emergency visits and hospitalizations, and improve patients' quality of life in a rural practice setting.

Embedding Quality: The Challenges for Higher Education

ERIC Educational Resources Information Center

Lomas, Laurie

2004-01-01

This paper reviews recent research, literature and the views of a small sample of senior managers and academics in English higher education institutions on the challenges associated with embedding quality. When implemented by a university, quality enhancement models such as total quality management and the European Foundation for Quality…

Implementing Model-Check for Employee and Management Satisfaction

NASA Technical Reports Server (NTRS)

Jones, Corey; LaPha, Steven

2013-01-01

This presentation will discuss methods to which ModelCheck can be implemented to not only improve model quality, but also satisfy both employees and management through different sets of quality checks. This approach allows a standard set of modeling practices to be upheld throughout a company, with minimal interaction required by the end user. The presenter will demonstrate how to create multiple ModelCheck standards, preventing users from evading the system, and how it can improve the quality of drawings and models.

[Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?].

PubMed

Lorenzen, J; Habermann, C; Utler, C; Grzyska, U; Weber, C; Adam, G; Koops, A

2009-10-01

To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000. Georg Thieme Verlag KG Stuttgart-New York.

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

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

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

Implementation of the affordable care act: a case study of a service line co-management company.

PubMed

Lanese, Bethany

2016-09-19

Purpose The purpose of this paper is to test and measure the outcome of a community hospital in implementing the Affordable Care Act (ACA) through a co-management arrangement. RQ1: do the benefits of a co-management arrangement outweigh the costs? RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? Design/methodology/approach A case study of a 350-bed non-profit community hospital co-management company. The quantitative data are eight quarters of quality metrics prior and eight quarters post establishment of the co-management company. The quality metrics are all based on standardized national requirements from the Joint Commission and Centers for Medicare and Medicaid Services guidelines. These measures directly impact the quality initiatives under the ACA that are applicable to all healthcare facilities. Qualitative data include survey results from hospital employees of the perceived effectiveness of the co-management company. A paired samples difference of means t-test was conducted to compare the timeframe before co-management and post co-management. Findings The findings indicate that the benefits of a co-management arrangement do outweigh the costs for both the physicians and the hospital ( RQ1). The physicians benefit through actual dollar payout, but also with improved communication and greater input in running the service line. The hospital benefits from reduced cost - or reduced penalties under the ACA - as well as better communication and greater physician involvement in administration of the service line. RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? The hospital improved in every quality metric under the co-management company. A paired sample difference of means t-test showed a statistically significant improvement in five of the six quality metrics in the study. Originality/value Previous research indicates the potential effectiveness of co-management companies in improving healthcare delivery and hospital-physician relations (Sowers et al., 2013). The current research takes this a step further to show that the data do in fact support these concepts. The hospital and the physicians carrying out the day-to-day actions have shared goals, better communication, and improved quality metrics under the co-management company. As the number of co-management companies increases across the USA, more research can be directed at determining their overall impact on quality care.

Safe drinking water in regional NSW, Australia.

PubMed

Byleveld, Paul M; Leask, Sandy D; Jarvis, Leslie A; Wall, Katrina J; Henderson, Wendy N; Tickell, Joshua E

2016-04-15

The New South Wales (NSW) Public Health Act 2010 requires water suppliers to implement a drinking water quality assurance program that addresses the 'Framework for management of drinking water quality' in the Australian drinking water guidelines. NSW Health has recognised the importance of a staged implementation of this requirement and the need to support regional water utilities. To date, NSW Health has assisted 74 regional utilities to develop and implement their management systems. The Public Health Act 2010 has increased awareness of drinking water risk management, and offers a systematic process to identify and control risks. This has benefited large utilities, smaller suppliers, and remote and Aboriginal communities. Work is continuing to ensure implementation of the process by private suppliers and water carters.

Managing Air Quality - Program Implementation

EPA Pesticide Factsheets

Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.

DOT report for implementing OMB's information dissemination quality guidelines

DOT National Transportation Integrated Search

2002-08-01

Consistent with The Office of : Management and Budgets (OMB) Guidelines (for Ensuring and Maximizing the Quality, : Objectivity, Utility, and Integrity of Information Disseminated by Federal Agencies) : implementing Section 515 of the Treasury and...

Data-Driven Decision Making in Out-of-School Time Programs. Part 6 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Organization-Level Activities. Research-to-Results Brief. Publication #2009-34

ERIC Educational Resources Information Center

Bandy, Tawana; Burkhauser, Mary; Metz, Allison J. R.

2009-01-01

Although many program managers look to data to inform decision-making and manage their programs, high-quality program data may not always be available. Yet such data are necessary for effective program implementation. The use of high-quality data facilitates program management, reduces reliance on anecdotal information, and ensures that data are…

Total Quality Management (TQM): Group Dynamics Workshop

DTIC Science & Technology

1990-05-15

interactions with other OSD decision-making bodies. " Remove barriers /facilitate implementation. " Direct action on unresolved process problems referred...TQM leadership. - Total Quality Management FUNCTIONS: * Translate goals to tangible internal initiatives. " Remove barriers . " Establish and...Quality Management FUNCTIONS: • Identify and remove barriers . " Develop practical process improvements. " Install solutions and measurement systems for

77 FR 50973 - Revision to the South Coast Portion of the California State Implementation Plan, CPV Sentinel...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... we are adding to our docket to revise the South Coast Air Quality Management District (District or... Quality Management Plan (AQMP) is appropriate for determining the base year to evaluate the availability... offsets; and (3) which District Air Quality Management Plan is appropriate for determining the base year...

Revitalizing Space Operations through Total Quality Management

NASA Technical Reports Server (NTRS)

Baylis, William T.

1995-01-01

The purpose of this paper is to show the reader what total quality management (TQM) is and how to apply TQM in the space systems and management arena. TQM is easily understood, can be implemented in any type of business organization, and works.

Quality circles: the nurse executive as mentor.

PubMed

Flarey, D L

1991-12-01

Changes within and around the health care environment are forcing health care executives to reexamine their managerial and leadership styles to confront the resulting turbulence. The nurse executive is charged with the profound responsibility of directing the delivery of nursing care throughout the organization. Care delivered today must be of high quality. Declining financial resources as well as personnel shortages cause the executive to be an effective innovator in meeting the increasing demands. Quality circles offer the nurse executive an avenue of recourse. Circles have been effectively implemented in the health care setting, as has been consistently documented over time. By way of a participative management approach, quality circles may lead to increased employee morale and productivity, cost savings, and decreased employee turnover rates, as well as realization of socialization and self-actualization needs. A most effective approach to their introduction would be implementation at the first-line manager level. This promotes an acceptance of the concept at the management level as well as a training course for managers to implement the process at the unit level. The nurse executive facilitates the process at the first-line manager level. This facilitation will cause a positive outcome to diffuse throughout the entire organization. Quality circles offer the nurse executive the opportunity to challenge the existing environmental turmoil and effect a positive and lasting change.

78 FR 12267 - Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2013-0094; FRL-9783-2] Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control District and Feather River Air Quality Management District; Stationary Source Permits AGENCY: Environmental Protection Agency...

Unisys' experience in software quality and productivity management of an existing system

NASA Technical Reports Server (NTRS)

Munson, John B.

1988-01-01

A summary of Quality Improvement techniques, implementation, and results in the maintenance, management, and modification of large software systems for the Space Shuttle Program's ground-based systems is provided.

Development of a validation process for parameters utilized in optimizing construction quality management of pavements.

DOT National Transportation Integrated Search

2006-01-01

The implementation of an effective performance-based construction quality management requires a tool for determining impacts of construction quality on the life-cycle performance of pavements. This report presents an update on the efforts in the deve...

Quality Management and Qualification Needs 1: Quality and Personnel Concepts of SMEs in Europe.

ERIC Educational Resources Information Center

Koper, Johannes; Zaremba, Hans Jurgen

This book examines how quality management is implemented in small and medium-sized enterprises (SMEs) in Germany, Finland, Greece, Ireland, Portugal, Sweden, and the United Kingdom. It presents the survey results as two sector studies. Competitive and specialization tendencies of the sectors and company concepts of "quality" and…

Total Quality Management Simplified.

ERIC Educational Resources Information Center

Arias, Pam

1995-01-01

Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

The clinical nurse specialist as resuscitation process manager.

PubMed

Schneiderhahn, Mary Elizabeth; Fish, Anne Folta

2014-01-01

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

Effective use of business intelligence.

PubMed

Glaser, John; Stone, John

2008-02-01

Business intelligence--technology to manage and leverage an organization's data--can enhance healthcare organizations' financial and operational performance and quality of patient care. Effective BI management requires five preliminary steps: Establish business needs and value. Obtain buy-in from managers. Create an end-to-end vision. Establish BI governance. Implement specific roles for managing data quality.

Implementation strategies influence the structure, process and outcome of quality systems: an empirical study of hospital departments in Sweden.

PubMed

Kunkel, S; Rosenqvist, U; Westerling, R

2009-02-01

To analyse whether the organisation of quality systems (structure, process, and outcome) is related to how these systems were implemented (implementation prerequisites, cooperation between managers and staff, and source of initiative). A questionnaire was developed, piloted and distributed to 600 hospital departments. Questions were included to reflect implementation prerequisites (adequate resources, competence, problem-solving capacity and high expectations), cooperative implementation, source of initiative (manager, staff and purchaser), structure (resources and administration), process (culture and cooperation) and outcome (goal evaluation and competence development). The adjusted response rate was 75%. Construct validity and reliability was assessed by confirmatory factor analysis, and Cronbach alpha scores were calculated. The relationships among the variables were analysed with structural equation modelling with LISREL. Implementation prerequisites were highly related to structure (0.51) and process (0.33). Cooperative implementation was associated with process (0.26) and outcome (0.34). High manager initiative was related to structure (0.19) and process (0.17). The numbers in parentheses can be interpreted as correlations. Construct validity was good, and reliability was excellent for all factors (Cronbach alpha>0.78). The model was a good representation of reality (model fit p value = 0.082). The implementation of organisationally demanding quality systems may require managers to direct and lead the process while assuring that their staff get opportunities to contribute to the planning and designing of the new system. This would correspond to a cooperative implementation strategy rather than to top-down or bottom-up strategies. The results of this study could be used to adjust implementation processes.

40 CFR 130.5 - Continuing planning process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...

40 CFR 130.5 - Continuing planning process.

Code of Federal Regulations, 2011 CFR

2011-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...

40 CFR 130.5 - Continuing planning process.

Code of Federal Regulations, 2014 CFR

2014-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...

The Quality Professor: Implementing TQM in the Classroom.

ERIC Educational Resources Information Center

Cornesky, Robert A.

This volume describes Total Quality Management (TQM) in the higher education classroom and guides college faculty in implementing TQM to improve their teaching. Chapter 1 introduces TQM and gives pointers on how to begin implementing it. Chapter 2 describes TQM approaches and principles including the Deming and Crosby approaches, describes the TQM…

7 CFR 3100.44 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Implementation. 3100.44 Section 3100.44 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ENVIRONMENTAL QUALITY, DEPARTMENT OF AGRICULTURE CULTURAL AND ENVIRONMENTAL QUALITY Enhancement, Protection, and Management of the Cultural...

7 CFR 3100.44 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Implementation. 3100.44 Section 3100.44 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ENVIRONMENTAL QUALITY, DEPARTMENT OF AGRICULTURE CULTURAL AND ENVIRONMENTAL QUALITY Enhancement, Protection, and Management of the Cultural...

7 CFR 3100.44 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Implementation. 3100.44 Section 3100.44 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ENVIRONMENTAL QUALITY, DEPARTMENT OF AGRICULTURE CULTURAL AND ENVIRONMENTAL QUALITY Enhancement, Protection, and Management of the Cultural...

7 CFR 3100.44 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Implementation. 3100.44 Section 3100.44 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ENVIRONMENTAL QUALITY, DEPARTMENT OF AGRICULTURE CULTURAL AND ENVIRONMENTAL QUALITY Enhancement, Protection, and Management of the Cultural...

7 CFR 3100.44 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Implementation. 3100.44 Section 3100.44 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ENVIRONMENTAL QUALITY, DEPARTMENT OF AGRICULTURE CULTURAL AND ENVIRONMENTAL QUALITY Enhancement, Protection, and Management of the Cultural...

The Autonomous Maintenance Implementation Directory as a Step Toward the Intelligent Quality Management System

NASA Astrophysics Data System (ADS)

Molenda, Michał

2016-12-01

The article describes the effects of the improvement of the production process which one of the industrial enterprises obtained by implementing the method of Autonomous Maintenance (AM), which is one of the pillars of the concept of Total Productive Maintenance (TPM). AM method was presented as an aid to the formation of intelligent, self-improving procesess of the quality management system (QMS). The main part of this article is to present results of studies that have been conducted in one of the large industrial enterprises in Poland, manufacturing for the automotive industry. The aim of the study was to evaluate the effectiveness of the implementation of the AM method as a tool for selfimprovement of industrial processes in the following company. The study was conducted in 2015. The gathering and comparison of data from the period of two years, ie. the year before and the year after the implementation of AM, helped to determine the effectiveness of AM in building intelligent quality management system.

Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study

PubMed Central

2013-01-01

Background Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support. Methods/design This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire. Discussion This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well. PMID:23561032

Evaluation of agricultural best-management practices in the Conestoga River headwaters, Pennsylvania; effects of nutrient management on water quality in the Little Conestoga Creek headwaters, 1983-89

USGS Publications Warehouse

Koerkle, E.H.; Fishel, D.K.; Brown, M.J.; Kostelnik, K.M.

1996-01-01

Water quality in the headwaters of the Little Conestoga Creek, Lancaster County, Pa., was investigated from April 1986 through September 1989 to determine possible effects of agricultural nutrient management on water quality. Nutrient management, an agricultural Best-Management Practice, was promoted in the 5.8-square-mile watershed by the U.S. Department of Agriculture Rural Clean Water Program. Nonpoint-source- agricultural contamination was evident in surface water and ground water in the watershed; the greatest contamination was in areas underlain by carbonate rock and with intensive row-crop and animal production. Initial implementation of nutrient management covered about 30 percent of applicable land and was concentrated in the Nutrient-Management Subbasin. By 1989, nutrient management covered about 45 percent of the entire Small Watershed, about 85 percent of the Nutrient- Management Subbasin, and less than 10 percent of the Nonnutrient-Management Subbasin. The number of farms implementing nutrient management increased from 14 in 1986 to 25 by 1989. Nutrient applications to cropland in the Nutrient- Management Subbasin decreased by an average of 35 percent after implementation. Comparison of base- flow surface-water quality from before and after implementation suggests that nutrient management was effective in slowing or reversing increases in concentrations of dissolved nitrate plus nitrite in the Nutrient-Management Subbasin. Although not statistically significant, the Mann-Whitney step-trend coefficient for the Nutrient-Management Subbasin was 0.8 milligram per liter, whereas trend coefficients for the Nonnutrient-Management Subbasin and the Small Watershed were 0.4 and 1.4 milligrams per liter, respectively, for the period of study. Analysis of covariance comparison of concurrent concentrations from the two sub- basins showed a significant decrease in concen- trations from the Nutrient-Management Subbasin compared to the Nonnutrient-Management Subbasin. The small, positive effect of nutrient management on base-flow water quality should be interpreted with caution. Lack of statistical significance for most tests, short-term variation in climate and agricultural activities, unknown ground-water flow rates, and insufficient agricultural-activity data for farms outside of the Nutrient-Management Subbasin were potential problems. A regression model relating nutrient applications to concen- trations of dissolved nitrate plus nitrite showed no significant explanatory relation.

ISO 9001 certification for hospitals in Bulgaria: does it help service?

PubMed

Stoimenova, Assena; Stoilova, Ani; Petrova, Guenka

2014-03-04

The aim of our study is to review the published literature on establishment and implementation of ISO 9001 QMS in European hospitals, to study the availability of International Organization for Standardization (ISO) quality management systems (QMS) in Bulgarian hospitals and to outline the main advantages of ISO implementation in the hospitals in Bulgaria. The information on availability of ISO QMS in the hospitals in Bulgaria was gathered via Bulgarian certification register, the registries of various quality associations, websites of hospitals and certification companies presented in Bulgaria. A total number of 312 hospitals in Bulgaria were screened for the availability of QMS certified against the ISO 9001 requirements. The experience of European hospitals that implemented QMS is positive and the used approaches to improve the processes and the demonstrated effects from ISO implementation are analysed by the researchers. Unlike other European Union member states, the establishment of quality management systems in Bulgaria is not compulsory. However, our study revealed that 14.42% of the hospitals in Bulgaria have implemented and have certified quality systems against the requirements of ISO 9001. Our study confirmed that a quality management system using the ISO 9001 standard is useful for the hospitals as it can help to increase the operational efficiencies, to reduce errors, improve patient safety and produce a more preventive approach instead of a reactive environment.

Translating knowledge into best practice care bundles: a pragmatic strategy for EBP implementation via moving postprocedural pain management nursing guidelines into clinical practice.

PubMed

Saunders, Hannele

2015-07-01

To describe quantitative and qualitative best evidence as sources for practical interventions usable in daily care delivery in order to integrate best evidence into clinical decision-making at local practice settings. To illustrate the development, implementation and evaluation of a pain management nursing care bundle based on a clinical practice guideline via a real-world clinical exemplar. Successful implementation of evidence-based practice requires consistent integration of best evidence into daily clinical decision-making. Best evidence comprises high-quality knowledge summarised in systematic reviews and translated into guidelines. However, consistent integration of guidelines into care delivery remains challenging, partly due to guidelines not being in a usable form for daily practice or relevant for the local context. A position paper with a clinical exemplar of a nurse-led, evidence-based quality improvement project to design, implement and evaluate a pain management care bundle translated from a national nursing guideline. A pragmatic approach to integrating guidelines into daily practice is presented. Best evidence from a national nursing guideline was translated into a pain management care bundle and integrated into daily practice in 15 medical-surgical (med-surg) units of nine hospitals of a large university hospital system in Finland. Translation of best evidence from guidelines into usable form as care bundles adapted to the local setting may increase implementation and uptake of guidelines and improve quality and consistency of care delivery. A pragmatic approach to translating a nursing guideline into a pain management care bundle to incorporate best evidence into daily practice may help achieve more consistent and equitable integration of guidelines into care delivery, and better quality of pain management and patient outcomes. © 2015 John Wiley & Sons Ltd.

Quality improvement in basic histotechnology: the lean approach.

PubMed

Clark, David

2016-01-01

Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

Water Quality Assessment and Management

EPA Pesticide Factsheets

Overview of Clean Water Act (CWA) restoration framework including; water quality standards, monitoring/assessment, reporting water quality status, TMDL development, TMDL implementation (point & nonpoint source control)

Potential of integrated continuous surveys and quality management to support monitoring, evaluation, and the scale-up of health interventions in developing countries.

PubMed

Rowe, Alexander K

2009-06-01

Well-funded initiatives are challenging developing countries to increase health intervention coverage and show impact. Despite substantial resources, however, major obstacles include weak health systems, a lack of reasonably accurate monitoring data, and inadequate use of data for managing programs. This report discusses how integrated continuous surveys and quality management (I-Q), which are well-recognized approaches in wealthy countries, could support intervention scale-up, monitoring and evaluation, quality control for commodities, capacity building, and implementation research in low-resource settings. Integrated continuous surveys are similar to existing national cross-sectional surveys of households and health facilities, except data are collected over several years by permanent teams, and most results are reported monthly at the national, province, and district levels. Quality management involves conceptualizing work as processes, involving all workers in quality improvement, monitoring quality, and teams that improve quality with "plan-do-study-act" cycles. Implementing and evaluating I-Q in a low-income country would provide critical information on the value of this approach.

Fuels planning: science synthesis and integration; social issues fact sheet 13: Strategies for managing fuels and visual quality

Treesearch

Christine Esposito

2006-01-01

The public's acceptance of forest management practices, including fuels reduction, is heavily based on how forests look. Fuels managers can improve their chances of success by considering aesthetics when making management decisions. This fact sheet reviews a three-part general strategy for managing fuels and visual quality: planning, implementation, and monitoring...

Lean Six Sigma implementation and organizational culture.

PubMed

Knapp, Susan

2015-01-01

The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components - management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings - In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p < 0.01, η2=1.28; infrastructure was not significant, F(3, 100)=1.55, p=0.21, η2=0.05; and using Lean Six Sigma methods was also not significant, F(3, 100)=1.34, p=0.26, η2=0.04. Post hoc analysis identified group and development cultures having significant interactions with management support. The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm's influence can utilize strategies to better implement Lean Six Sigma.

The TQM Coordinator as Change Agent in Implementing Total Quality Management

DTIC Science & Technology

1989-06-01

Quality Management involves a major change, a paradigm shift, in management philosophy. Implementing TQM requires the use of a change agent to act as a catalyst to change the organization. Interviews with TQM coordinators, and a survey of 143 organizations were done to examine the role of the TQM coordinator. Research identified criteria for selection, and location in the organizational structure. Use of an external consultant in a tem concept is examined. Resistance to change and overcoming that resistance are explored. Ways to measure success are discussed. Keywords:

Quality assurance in China: a sleeping tiger awakens

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

Baehr, R.M.

1996-12-31

The People`s Republic of China has undergone major economic reform in the past decade producing a new free-market system that is distinctly Chinese. The Chinese realize that to be successful in world trade, quality management and export trading must be given the highest priority in China`s strategic economic plans. Many manufacturing companies are now implementing Total Quality Management (TQM) and the ISO 9000 i quality management standards. A first hand survey of the quality movement in China today is the objective of this paper.

Highlights of Total Quality Management in the Department of Defense: Lessons Learned, Quality Measurements and Innovative Practices

DTIC Science & Technology

1991-09-26

Quality Management (TQM) through both quantitative and qualitative analyses. Interviews were conducted with top executives from ten exemplar organizations within the Department of Defense (DOD). Survey questionnaires on perceptions of quality practices were administered to a sample of 102 representing members of the executive steering committees at the same organizations. Research identifies lessons learned by top executives during TQM implementation, discusses measures of organization-wide quality management , specifies evaluation mechanisms to

Quality assurance, an administrative means to a managerial end: Part I. A historical overview.

PubMed

Clark, G B

1990-01-01

Quality has become the hallmark of industrial excellence. Many diverse factors have heightened national concern about managing quality control throughout the health-care industry, including laboratory services. Industry-wide focus on quality control has created a need for an administrative program to evaluate its effectiveness. That program is medical quality assurance. Because of national and industry-wide concern, development of quality assurance theory has gained increasing importance in medical accreditation and management circles. Scrutiny of the application of quality assurance has become particularly prominent during accreditation inspections. Implementing quality assurance programs now demands more of already finite resources. The professional laboratory manager should understand how quality assurance has developed in the United States during the past 150 years. The well-informed manager should recognize why the health-care industry only recently began to develop its own expertise in quality assurance. It is also worthwhile to understand how heavily health care has relied on the lessons learned in the non-health-care sector. This three-part series will present information that will help in applying quality assurance more effectively as a management tool in the medical laboratory. This first part outlines the early industrial, socioeconomic, and medicolegal background of quality assurance. Terminology is defined with some distinction made between the terms management and administration. The second part will address current accreditation requirements. Special emphasis will be placed on the practical application of accreditation guidelines, providing a template for quality assurance methods in the medical laboratory. The third part will provide an overview of quality assurance as a total management tool with some suggestions for developing and implementing a quality assurance program.

76 FR 67366 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... Metro Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct... Pollution Control District (PCAPCD) and Sacramento Metro Air Quality Management District (SMAQMD) portions..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...

An Empirical Study of Logistics Organization, Electronic Linkage, and Performance

DTIC Science & Technology

1993-01-01

utilization of transportation resources, and improved quality management. Researchers have proposed an information technology (IT) implementation model for...management, more efficient utilization of transportation resources, and improved quality management. Researchers have proposed an information...coordination of (1) facility structure, (2) forecasting and order management, (3) transportation , (4) inventory, and (5) warehousing and packaging. The

Instructional Leadership for Quality Learning: An Assessment of the Impact of the Primary School Management Development Project in Botswana

ERIC Educational Resources Information Center

Pansiri, Nkobi Owen

2008-01-01

A descriptive study using questionnaires was conducted in 2004 to assess the effectiveness of instructional leadership displayed by primary school management teams following the implementation of the Primary School Management Project in Botswana. Leadership skills, Coordination of instructional activities, management of curriculum and quality of…

Development of Management Methodology for Engineering Production Quality

NASA Astrophysics Data System (ADS)

Gorlenko, O.; Miroshnikov, V.; Borbatc, N.

2016-04-01

The authors of the paper propose four directions of the methodology developing the quality management of engineering products that implement the requirements of new international standard ISO 9001:2015: the analysis of arrangement context taking into account stakeholders, the use of risk management, management of in-house knowledge, assessment of the enterprise activity according to the criteria of effectiveness

Improving the Standards-Based Management-Recognition initiative to provide high-quality, equitable maternal health services in Malawi: an implementation research protocol.

PubMed

Mumtaz, Zubia; Salway, Sarah; Nyagero, Josephat; Osur, Joachim; Chirwa, Ellen; Kachale, Fannie; Saunders, Duncan

2016-01-01

The Government of Malawi is seeking evidence to improve implementation of its flagship quality of care improvement initiative-the Standards Based Management-Recognition for Reproductive Health (SBM-R(RH)). This implementation study will assess the quality of maternal healthcare in facilities where the SBM-R(RH) initiative has been employed, identify factors that support or undermine effectiveness of the initiative and develop strategies to further enhance its operation. Data will be collected in 4 interlinked modules using quantitative and qualitative research methods. Module 1 will develop the programme theory underlying the SBM-R(RH) initiative, using document review and in-depth interviews with policymakers and programme managers. Module 2 will quantitatively assess the quality and equity of maternal healthcare provided in facilities where the SBM-R(RH) initiative has been implemented, using the Malawi Integrated Performance Standards for Reproductive Health. Module 3 will conduct an organisational ethnography to explore the structures and processes through which SBM-R(RH) is currently operationalised. Barriers and facilitators will be identified. Module 4 will involve coordinated co-production of knowledge by researchers, policymakers and the public, to identify and test strategies to improve implementation of the initiative. The research outcomes will provide empirical evidence of strategies that will enhance the facilitators and address the barriers to effective implementation of the initiative. It will also contribute to the theoretical advances in the emerging science of implementation research.

[Quality management: its use in nursing].

PubMed

Antunes, A V; Trevizan, M A

2000-01-01

The Quality Management has been used and it is a reality in the hospitals. Thus the authors comment about its importance for Nursing and analyse its utilization in a Nursing Service of a private hospital, with purpose to evaluate the implementation form, nurses' involvement and the Deming' Principles application. Data show that the implementation has brought good results, nurses are engaged in the process and the Deming's Principles have been utilized, adequate or inadequately.

Determining the Effectiveness and Evaluating the Implementation Process of a Quality/Performance Circles System Model to Assist in Institutional Decision Making and Problem Solving at Lakeshore Technical Institute.

ERIC Educational Resources Information Center

Ladwig, Dennis J.

During the 1982-83 school year, a quality/performance circles system model was implemented at Lakeshore Technical Institute (LTI) to promote greater participation by staff in decision making and problem solving. All management staff at the college (N=45) were invited to participate in the process, and 39 volunteered. Non-management staff (N=240)…

An Ounce of Application Is Worth a Ton of Abstraction. A Practical Guide to Implementing Total Quality Management.

ERIC Educational Resources Information Center

Crouch, J. Michael

This book explains how to implement a Total Quality Management (TQM) program within an organization focusing in particular on ways to sustain the effort. Part 1 of five offers an overview of the TQM approach and the rationale for adopting it. Topics of discussion include signs of the need for change, what TQM is and what it is not, the basics of…

Implementing Continuous Improvement Management (CIM) in the Public Schools.

ERIC Educational Resources Information Center

Borgers, William E.; Thompson, Tommy A.

This book traces the restructuring of a Texas school district that moved from management by coercion to continuous improvement for quality. In 1990, the Dickinson Independent School District (Texas) began implementation of Continuous Improvement Management (CIM), based on the teachings of W. Edwards Deming, William Glasser, and J. M. Juran.…

E-Resources Management: How We Positioned Our Organization to Implement an Electronic Resources Management System

ERIC Educational Resources Information Center

White, Marilyn; Sanders, Susan

2009-01-01

The Information Services Division (ISD) of the National Institute of Standards and Technology (NIST) positioned itself to successfully implement an electronic resources management system. This article highlights the ISD's unique ability to "team" across the organization to realize a common goal, develop leadership qualities in support of…

Designing the role of the embedded care manager.

PubMed

Hines, Patricia; Mercury, Marge

2013-01-01

: The role of the professional case manager is changing rapidly. Health reform has called upon the industry to ensure that care is delivered in an efficient, effective, and high-quality and low cost manner. As a means to achieve this objective, health plans and health systems are moving the care manager out of a centralized location within their organizations to "embedding" them into physician offices. This move enables the care manager to work alongside the primary care physicians and their high-risk patients. This article discusses the framework for designing and implementing an embedded care manager role into a physician practice. Key elements of the program are discussed. IMPLICATIONS FOR CARE MANAGEMENT:: Historically care management has played a foundational role in improving the quality of care for individuals and populations via the efficient and effective use of resources. Now with the goals of health care reform, a successful transition from a volume-based to value-based reimbursement system requires primary care physicians to welcome care managers into their practices to improve patient care, quality, and costs through care coordination across health care settings and populations. : As patient-centered medical homes and integrated delivery systems formulate their plans for population health management, their efforts have included embedding a care manager in the primary practice setting. Having care managers embedded at the physician offices increases their ability to collaborate with the physician and their staff in the implementation and monitoring care plans for their patients. : Implementing an embedded care manager into an existing physician's practice requires the following:Although the embedded care manager is a highly evolving role, physician groups are beginning to realize the benefits from their care management collaborations. Examples cited include improved outreach and coordination, patient adherence to care plans, and improved quality of life.

Implementing hospital quality assurance policies in Iran: balancing licensing, annual evaluation, inspections and quality management systems.

PubMed

Aghaei Hashjin, Asgar; Delgoshaei, Bahram; Kringos, Dionne S; Tabibi, Seyed Jamaladin; Manouchehri, Jila; Klazinga, Niek S

2015-01-01

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran. A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government's strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Integrated Community Case Management of Childhood Illness in Ethiopia: Implementation Strength and Quality of Care

PubMed Central

Miller, Nathan P.; Amouzou, Agbessi; Tafesse, Mengistu; Hazel, Elizabeth; Legesse, Hailemariam; Degefie, Tedbabe; Victora, Cesar G.; Black, Robert E.; Bryce, Jennifer

2014-01-01

Ethiopia has scaled up integrated community case management of childhood illness (iCCM) in most regions. We assessed the strength of iCCM implementation and the quality of care provided by health extension workers (HEWs). Data collectors observed HEWs' consultations with sick children and carried out gold standard re-examinations. Nearly all HEWs received training and supervision, and essential commodities were available. HEWs provided correct case management for 64% of children. The proportions of children correctly managed for pneumonia, diarrhea, and malnutrition were 72%, 79%, and 59%, respectively. Only 34% of children with severe illness were correctly managed. Health posts saw an average of 16 sick children in the previous 1 month. These results show that iCCM can be implemented at scale and that community-based HEWs can correctly manage multiple illnesses. However, to increase the chances of impact on child mortality, management of severe illness and use of iCCM services must be improved. PMID:24799369

Implementation and evaluation of a nursing home fall management program.

PubMed

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

2007-03-01

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

Total quality management and shared governance: synergistic processes.

PubMed

Gardner, D B; Cummings, C

1994-01-01

"Synergism" accurately describes the gains that can be made when total quality management (TQM) and shared governance are employed for reciprocal development. This article explores the relationship between TQM and shared governance from a systems perspective. Systems thinking is the fundamental framework that must be learned by nursing managers. An example of this synergistic process is described from the National Institutes of Health nursing department's experience in implementing TQM and shared governance. The idea that structure is fundamental to problems and solutions when implementing change and focusing upon interdependency issues are the systemic competencies nursing managers need to develop in order to become strong nursing leaders.

Changing personnel behavior to promote quality care practices in an intensive care unit

PubMed Central

Cooper, Dominic; Farmery, Keith; Johnson, Martin; Harper, Christine; Clarke, Fiona L; Holton, Phillip; Wilson, Susan; Rayson, Paul; Bence, Hugh

2005-01-01

The delivery of safe high quality patient care is a major issue in clinical settings. However, the implementation of evidence-based practice and educational interventions are not always effective at improving performance. A staff-led behavioral management process was implemented in a large single-site acute (secondary and tertiary) hospital in the North of England for 26 weeks. A quasi-experimental, repeated-measures, within-groups design was used. Measurement focused on quality care behaviors (ie, documentation, charting, hand washing). The results demonstrate the efficacy of a staff-led behavioral management approach for improving quality-care practices. Significant behavioral change (F [6, 19] = 5.37, p < 0.01) was observed. Correspondingly, statistically significant (t-test [t] = 3.49, df = 25, p < 0.01) reductions in methicillin-resistant Staphylococcus aureus (MRSA) were obtained. Discussion focuses on implementation issues. PMID:18360574

Role of a quality management system in improving patient safety - laboratory aspects.

PubMed

Allen, Lynn C

2013-09-01

The aim of this study is to describe how implementation of a quality management system (QMS) based on ISO 15189 enhances patient safety. A literature review showed that several European hospitals implemented a QMS based on ISO 9001 and assessed the impact on patient safety. An Internet search showed that problems affecting patient safety have occurred in a number of laboratories across Canada. The requirements of a QMS based on ISO 15189 are outlined, and the impact of the implementation of each requirement on patient safety is summarized. The Quality Management Program - Laboratory Services in Ontario is briefly described, and the experience of Ontario laboratories with Ontario Laboratory Accreditation, based on ISO 15189, is outlined. Several hospitals that implemented ISO 9001 reported either a positive impact or no impact on patient safety. Patient safety problems in Canadian laboratories are described. Implementation of each requirement of the QMS can be seen to have a positive effect on patient safety. Average laboratory conformance on Ontario Laboratory Accreditation is very high, and laboratories must address and resolve any nonconformities. Other standards, practices, and quality requirements may also contribute to patient safety. Implementation of a QMS based on ISO 15189 provides a solid foundation for quality in the laboratory and enhances patient safety. It helps to prevent patient safety issues; when such issues do occur, effective processes are in place for investigation and resolution. Patient safety problems in Canadian laboratories might have been prevented had effective QMSs been in place. Ontario Laboratory Accreditation has had a positive impact on quality in Ontario laboratories. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

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

PubMed

Ruoff, Gary

2002-01-01

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

Total Quality Management (TQM), an Overview

DTIC Science & Technology

1991-09-01

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

Implementing a Quality Management System in the Medical Microbiology Laboratory.

PubMed

Carey, Roberta B; Bhattacharyya, Sanjib; Kehl, Sue C; Matukas, Larissa M; Pentella, Michael A; Salfinger, Max; Schuetz, Audrey N

2018-07-01

This document outlines a comprehensive practical approach to a laboratory quality management system (QMS) by describing how to operationalize the management and technical requirements described in the ISO 15189 international standard. It provides a crosswalk of the ISO requirements for quality and competence for medical laboratories to the 12 quality system essentials delineated by the Clinical and Laboratory Standards Institute. The quality principles are organized under three main categories: quality infrastructure, laboratory operations, and quality assurance and continual improvement. The roles and responsibilities to establish and sustain a QMS are outlined for microbiology laboratory staff, laboratory management personnel, and the institution's leadership. Examples and forms are included to assist in the real-world implementation of this system and to allow the adaptation of the system for each laboratory's unique environment. Errors and nonconforming events are acknowledged and embraced as an opportunity to improve the quality of the laboratory, a culture shift from blaming individuals. An effective QMS encourages "systems thinking" by providing a process to think globally of the effects of any type of change. Ultimately, a successful QMS is achieved when its principles are adopted as part of daily practice throughout the total testing process continuum. Copyright © 2018 American Society for Microbiology.

Implementation of quality management in early stages of research and development projects at a university.

PubMed

Fiehe, Sandra; Wagner, Georg; Schlanstein, Peter; Rosefort, Christiane; Kopp, Rüdger; Bensberg, Ralf; Knipp, Peter; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Arens, Jutta

2014-04-01

The ultimate objective of university research and development projects is usually to create knowledge, but also to successfully transfer results to industry for subsequent marketing. We hypothesized that the university technology transfer requires efficient measures to improve this important step. Besides good scientific practice, foresighted and industry-specific adapted documentation of research processes in terms of a quality management system might improve the technology transfer. In order to bridge the gap between research institute and cooperating industry, a model project has been accompanied by a project specific amount of quality management. However, such a system had to remain manageable and must not constrain the researchers' creativity. Moreover, topics and research team are strongly interdisciplinary, which entails difficulties regarding communication because of different perspectives and terminology. In parallel to the technical work of the model project, an adaptable quality management system with a quality manual, defined procedures, and forms and documents accompanying the research, development and validation was implemented. After process acquisition and analysis the appropriate amount of management for the model project was identified by a self-developed rating system considering project characteristics like size, innovation, stakeholders, interdisciplinarity, etc. Employees were trained according to their needs. The management was supported and the technical documentation was optimized. Finally, the quality management system has been transferred successfully to further projects.

Strategic Management of Quality: An American and British Perspective.

ERIC Educational Resources Information Center

Weller, L. David; McElwee, Gerard

1997-01-01

Total Quality Management is being implemented in American and British schools to improve educational outcomes. The 14 points of Deming's quality model and Porter's models of competition and drivers of cost provide a systematic, structured template to promote educational excellence and meet the demands of social, political, and economic forces.…

Gironacel[R]: A Virtual Tool for Learning Quality Management

ERIC Educational Resources Information Center

Mendez, Empar; Casadesus, Marti; De Ciurana, Quim

2006-01-01

This article describes the Gironacel[R] project--a virtual learning environment produced by the University of Girona. The purpose of this tool is to make it easier for students studying quality management courses within engineering schools to understand what the "quality culture" is and how to implement the ISO 9001:2000 standard in a…

Evaluating treatment process redesign by applying the EFQM Excellence Model.

PubMed

Nabitz, Udo; Schramade, Mark; Schippers, Gerard

2006-10-01

To evaluate a treatment process redesign programme implementing evidence-based treatment as part of a total quality management in a Dutch addiction treatment centre. Quality management was monitored over a period of more than 10 years in an addiction treatment centre with 550 professionals. Changes are evaluated, comparing the scores on the nine criteria of the European Foundation for Quality Management (EFQM) Excellence Model before and after a major redesign of treatment processes and ISO certification. In the course of 10 years, most intake, care, and cure processes were reorganized, the support processes were restructured and ISO certified, 29 evidence-based treatment protocols were developed and implemented, and patient follow-up measuring was established to make clinical outcomes transparent. Comparing the situation before and after the changes shows that the client satisfaction scores are stable, that the evaluation by personnel and society is inconsistent, and that clinical, production, and financial outcomes are positive. The overall EFQM assessment by external assessors in 2004 shows much higher scores on the nine criteria than the assessment in 1994. Evidence-based treatment can successfully be implemented in addiction treatment centres through treatment process redesign as part of a total quality management strategy, but not all results are positive.

IMPLEMENTATION OF QUALITY ASSURANCE OF MULTILABORATORY STUDIES WITHIN THE US EPA

EPA Science Inventory

Implementation of Quality Assurance on Multilaboratory Studies Within the U. S. EPA
Thomas J. Hughes1, Brenda Culpepper1, Nancy Adams2, and John Martinson3, 1National Health and Environmental Effects Research Laboratory (NHEERL), 2National Risk Management Research Laboratory...

Emergency Manuals: How Quality Improvement and Implementation Science Can Enable Better Perioperative Management During Crises.

PubMed

Goldhaber-Fiebert, Sara N; Macrae, Carl

2018-03-01

How can teams manage critical events more effectively? There are commonly gaps in performance during perioperative crises, and emergency manuals are recently available tools that can improve team performance under stress, via multiple mechanisms. This article examines how the principles of implementation science and quality improvement were applied by multiple teams in the development, testing, and systematic implementations of emergency manuals in perioperative care. The core principles of implementation have relevance for future patient safety innovations perioperatively and beyond, and the concepts of emergency manuals and interprofessional teamwork are applicable for diverse fields throughout health care. Copyright © 2017 Sara N. Goldhaber-Fiebert, Carl Macrae. Published by Elsevier Inc. All rights reserved.

Using Total Quality Management Principles To Implement School-Based Management.

ERIC Educational Resources Information Center

Terry, Paul M.

Those engaged in school restructuring can find direction in the philosophy of W. Edwards Deming, which has guided the operations of many American corporations. This paper provides an overview of Deming's Fourteen Points of Total Quality Management (TQM) and discusses their applications to education. To develop a successful TQM system, the school…

Defining wilderness quality: the role of standards in wilderness management—a workshop proceedings.

Treesearch

B. Shelby; G. Stankey; B. Shindler

1992-01-01

Integral to maintaining wilderness quality is the implementation of ecological, social, and management standards. A substantial body of wilderness research management experience exists nationwide as a common-pool resource for professionals with a specialized interest in incorporating standards into planning processes. In a 2-day interactive workshop, wilderness...

A review on effectiveness of best management practices in improving hydrology and water quality: Needs and opportunities

USDA-ARS?s Scientific Manuscript database

Best management practices (BMPs) have been widely used to address hydrology and water quality issues in both agricultural and urban areas. Increasing numbers of BMPs have been studied in research projects and implemented in watershed management projects, but a gap remains in quantifying their effect...

Total quality management: managing the human dimension in natural resource agencies

Treesearch

Denzil Verardo

1995-01-01

Stewardship in an era of dwindling human resources requires new approaches to the way business is conducted in the public sector, and Total Quality Management (TQM) can be the avenue for this transformation. Resource agencies are no exception to this requirement, although modifications to "traditional" private enterprise versions of TQM implementation...

Accountability and Other CAUSES of Total Quality Management.

ERIC Educational Resources Information Center

Aamot, Karen; Piotrowski, Craig

1995-01-01

Describes Total Quality Management (TQM) techniques implemented at Waukesha County Technical College (Wisconsin). The CAUSES program focuses on customers, accountability, understanding, self-improvement, education, and searching. Describes application of TQM to the fixed-asset team project. Four figures are included. (LMI)

Routine road maintenance water quality and habitat guide : best management practices

DOT National Transportation Integrated Search

2009-01-01

Since June 9, 1999 the Oregon Department of Transportation (ODOT) has implemented the Routine Road Maintenance: Water Quality and Habitat Guide Best Management Practices (the Guide), and is considered the cornerstone of the ODOT'd Office of Maintenan...

HISTORICAL DEVELOPMENT OF WET-WEATHER FLOW MANAGEMENT

EPA Science Inventory

The management of wet-weather flow (WWF) is necessary to maintain the quality of urban water resources. Throughout history strategies were implemented to control WWF for reasons, e.g., flood and water quality control, aesthetic improvement, waste removal and others. A comprehen...

SYN-OP-SYS™: A Computerized Management Information System for Quality Assurance and Risk Management

PubMed Central

Thomas, David J.; Weiner, Jayne; Lippincott, Ronald C.

1985-01-01

SYN·OP·SYS™ is a computerized management information system for quality assurance and risk management. Computer software for the efficient collection and analysis of “occurrences” and the clinical data associated with these kinds of patient events is described. The system is evaluated according to certain computer design criteria, and the system's implementation is assessed.

77 FR 12527 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) and San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portions of the California State Implementation Plan (SIP). These revisions concern negative declarations for volatile organic compound (VOC) and oxides of sulfur source categories. We are proposing to approve these negative declarations under the Clean Air Act as amended in 1990 (CAA or the Act).

[Measurement of customer satisfaction and participation of citizens in improving the quality of healthcare services.].

PubMed

Degrassi, Flori; Sopranzi, Cristina; Leto, Antonella; Amato, Simona; D'Urso, Antonio

2009-01-01

Managing quality in health care whilst ensuring equity is a fundamental aspect of the provision of services by healthcare organizations. Measuring perceived quality of care is an important tool for evaluating the quality of healthcare delivery in that it allows the implementation of corrective actions to meet the healthcare needs of patients. The Rome B (ASL RMB) local health authority adopted the UNI EN 10006:2006 norms as a management tool, therefore introducing the evaluation of customer satisfaction as an opportunity to involve users in the creation of quality healthcare services with and for the citizens. This paper presents the activities implemented and the results achieved with regards to shared and integrated continuous improvement of services.

Implementation and implication of total quality management on client- contractor relationship in residential projects

NASA Astrophysics Data System (ADS)

Murali, Swetha; Ponmalar, V.

2017-07-01

To make innovation and continuous improvement as a norm, some traditional practices must become unlearnt. Change for growth and competitiveness are required for sustainability for any profitable business such as the construction industry. The leading companies are willing to implement Total Quality Management (TQM) principles, to realise potential advantages and improve growth and efficiency. Ironically, researches recollected quality as the most significant provider for competitive advantage in industrial leadership. The two objectives of this paper are 1) Identify TQM effectiveness in residential projects and 2) Identify the client satisfaction/dissatisfaction areas using Analytical Hierarchy Process (AHP) and suggest effective mitigate measures. Using statistical survey techniques like set of questionnaire survey, it is observed that total quality management was applied in some leading successful organization to an extent. The main attributes for quality achievement can be defined as teamwork and better communication with single agreed goal between client and contractor. Onsite safety is a paramount attribute in the identifying quality within the residential projects. It was noticed that the process based quality methods such as onsite safe working condition; safe management system and modern engineering process safety controls etc. as interlinked functions. Training and effective communication with all stakeholders on quality management principles is essential for effective quality work. Late Only through effective TQM principles companies can avoid some contract litigations with an increased client satisfaction Index.

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

PubMed

White, D B

2000-01-01

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

Commitment to Quality Education Services through ISO 9000: A Case Study of Romania

ERIC Educational Resources Information Center

Paunescu, Carmen; Fok, Wing

2005-01-01

The paper discusses a model of quality management system for higher education. One of the main objectives of this paper is to highlight the challenges facing the school during implementation of the ISO 9001 standard and the benefits of successfully implementing such a quality system can bring to higher education. Based on the experience of a…

7 CFR 1466.23 - Payment rates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... conservation practice cost-effectiveness, implementation efficiency, and innovation, (2) The degree and...) Residue management; (B) Nutrient management; (C) Air quality management; (D) Invasive species management; (E) Pollinator habitat development or improvement; (F) Animal carcass management technology; or (G...

Information Security Management - Part Of The Integrated Management System

NASA Astrophysics Data System (ADS)

Manea, Constantin Adrian

2015-07-01

The international management standards allow their integrated approach, thereby combining aspects of particular importance to the activity of any organization, from the quality management systems or the environmental management of the information security systems or the business continuity management systems. Although there is no national or international regulation, nor a defined standard for the Integrated Management System, the need to implement an integrated system occurs within the organization, which feels the opportunity to integrate the management components into a cohesive system, in agreement with the purpose and mission publicly stated. The issues relating to information security in the organization, from the perspective of the management system, raise serious questions to any organization in the current context of electronic information, reason for which we consider not only appropriate but necessary to promote and implement an Integrated Management System Quality - Environment - Health and Operational Security - Information Security

Quality management in Irish health care.

PubMed

Ennis, K; Harrington, D

1999-01-01

This paper reports on the findings from a quantitative research study of quality management in the Irish health-care sector. The study findings suggest that quality management is what hospitals require to become more cost-effective and efficient. The research also shows that the culture of health-care institutions must change to one where employees experience pride in their work and where all are involved and committed to continuous quality improvement. It is recommended that a shift is required from the traditional management structures to a more participative approach. Furthermore, all managers whether from a clinical or an administration background must understand one another's role in the organisation. Finally, for quality to succeed in the health-care sector, strong committed leadership is required to overcome tensions in quality implementation.

Implementation Of Quality Management System For Irradiation Processing Services

NASA Astrophysics Data System (ADS)

Lungu, Ion-Bogdan; Manea, Maria-Mihaela

2015-07-01

In today's market, due to an increasing competitiveness, quality management has set itself as an indispensable tool and a reference point for every business. It is ultimately focused on customer satisfaction which is a stringent factor for every business. Implementing and maintaining a QMS is a rather difficult, time consuming and expensive process which must be done with respect of many factors. The aim of this paper is to present a case study for implementing QMS ISO 9001 in a gamma irradiation treatment service provider. The research goals are the identification of key benefits, reasons, advantages, disadvantages, drawbacks etc for a successful QMS implementation and use. Finally, the expected results focus on creating a general framework for implementing an efficient QMS plan that can be easily adapted to other kind of services and markets.

Turning Continuous Quality Improvement into Institutional Practice: The Tools and Techniques.

ERIC Educational Resources Information Center

Cornesky, Robert A.

This manual is intended to assist managers of support units at institutions of higher education in the implementation of Continuous Quality Improvement (CQI). The purpose is to describe a cooperative model for CQI which will permit managers to evaluate the quality of their units and institution, and by using the described tools and techniques, to…

76 FR 17368 - Approval and Promulgation of Air Quality Implementation Plans; Louisiana; Determination of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... failed to attain the 1-hour ozone standard by their attainment date. South Coast Air Quality Management... rationale for this action? \\3\\ As a result of the court decision in South Coast Air Quality Management.../MMBtu. Stationary Internal Combustion Engines: Lean-burn engines > 150 to 320 Hp 4 g/Hp-hr. Rich-burn...

[Recommendations for the evaluation and follow-up of the continuous quality improvement].

PubMed

Maurellet-Evrard, S; Daunizeau, A

2013-06-01

Continual improvement of the quality in a medical laboratory is based on the implementation of tools for systematically evaluate the quality management system and its ability to meet the objectives defined. Monitoring through audit and management review, addressing complaints and nonconformities and performing client satisfaction survey are the key for the continual improvement.

[Implementation of the technical requirements of the UNE-EN-ISO 15189 quality standard in a mycobacterial laboratory].

PubMed

Guna Serrano, M del Remedio; Ocete Mochón, M Dolores; Lahiguera, M José; Bresó, M Carmen; Gimeno Cardona, Concepción

2013-02-01

The UNE-EN-ISO 15189:2007 standard defines the requirements for quality and competence that must be met by medical laboratories. These laboratories should use this international standard to develop their own quality management systems and to evaluate their own competencies; in turn, this standard will be used by accreditation bodies to confirm or recognize the laboratories' competence. In clinical microbiology laboratories, application of the standard implies the implementation of the technical and specific management requirements that must be met to achieve optimal quality when carrying out microbiological tests. In Spain, accreditation is granted by the Spanish Accreditation Body (Entidad Nacional de Acreditación). This review aims to discuss the practical application of the standard's technical requirements in mycobacterial laboratory. Firstly, we define the scope of accreditation. Secondly, we specify how the items of the standard on personnel management, control of equipment, environmental facilities, method validation, internal controls and customer satisfaction surveys were developed and implemented in our laboratory. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Level of Adoption of Quality Management Systems Into the Mexican Pork Industry

NASA Astrophysics Data System (ADS)

Maldonado-Siman, Em; Ruíz-Flores, Agustín; Núñez-Domínguez, Rafael; González-Alcorta, Mariano; Hernández-Rodríguez, Bertha Alicia

This research studies the characteristics of the Mexican pork sector; adoption status of quality management systems, and product destinations. Ninety six percent of fifty enterprises have fully answered a questionnaire. Ninety percent are small and medium-sized, the rest are large-sized firms. Nineteen percent of them have totally adopted HACCP, sixty three percent are implementing or planning to do it, the rest have no plans to adopt it. Thirteen percent of the enterprises had ISO 9000. Thirty four percent of their sales go to supermarkets, 57% to other retail chains and 9% to exportation. Product destinations are mainly Central America, United States of America, Asia and Mexico. To improve efficiency and the quality of process it is necessary to implement HACCP. Besides, customers and legal requirements are the external factors, which result in this adoption. In the process of implementing, there are some problems, such as staff motivation and training. The results suggest that HACCP system operating is important for the Mexican pork industry. It also has relevant implications in domestic trade. It is necessary to encourage adoption of quality management systems in the sector.

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

PubMed Central

Yao, Katy; Nkengasong, John N.

2014-01-01

Background Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented widely throughout Africa, as well as in the Caribbean, Central and South America, and Southeast Asia. Objective We compiled results from local, national and global studies to provide a broad view of the programme and identify directions for the future. The review consists of two companion papers; this paper focuses on content analysis, examining various thematic components of the SLMTA programme and future priorities. Methods A systematic literature search identified 28 published articles about implementing the SLMTA programme. Results for various components of the SLMTA programme were reviewed and summarised. Results Local and national studies provide substantial information on previous experiences with quality management systems; variations on SLMTA implementation; building human resource capacity for trainers, mentors and auditors; the benefits and effectiveness of various types of mentorship; the importance of management buy-in to ensure country ownership; the need to instill a culture of quality in the laboratory; success factors and challenges; and future directions for the programme. Conclusions Local, national and global results suggest that the SLMTA programme has been overwhelmingly successful in transforming laboratory quality management. There is an urgent need to move forward in four strategic directions: progression (continued improvement in SLMTA laboratories), saturation (additional laboratories within countries that have implemented SLMTA), expansion (implementation in additional countries), and extension (adapting SLMTA for implementation beyond the laboratory), to lead to transformation of overall health systems and patient care. PMID:29043200

Preparing health care organizations for successful case management programs.

PubMed

Bonvissuto, C A; Kastens, J M; Atwell, S R

1997-01-01

This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

78 FR 21581 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Monterey Bay Unified Air Pollution Control District (MBUAPCD) and Santa Barbara County Air Pollution Control District (SCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions local rules that address emission statements for AVAQMD, rule rescissions that address public records for MBUAPCD, and define terms for SBCAPCD, under the Clean Air Act as amended in 1990 (CAA or the Act).

Teachers' Perceptions of the Integrated Quality Management System: Lessons from Mpumalanga, South Africa

ERIC Educational Resources Information Center

Queen-Mary, Thobela Nozidumo; Mtapuri, Oliver

2014-01-01

This article examines the attitudes and perceptions of teachers regarding the implementation of the Integrated Quality Management System (IQMS). In doing so, it aims to contribute to the global discourse of change management in education. The system is intended to develop educators by enhancing their capabilities to inculcate a culture of teaching…

Response of timber growth and avian communities to quality vegetation management in mid-rotation crp pine plantations

Treesearch

Brandon G. Sladek; Ian A. Munn; L. Wes Burder; Scott D. Roberts

2006-01-01

Provisions of the 2002 Farm Bill gave Conservation Reserve Program (CRP) participants greater flexibility to implement mid-contract management activities that encourage wildlife habitat improvement and timber production. Quality Vegetation Management (QVM) is one such technique that utilizes the selective herbicide Imazapyr and prescribed burning. Timber growth (d.b.h...

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

PubMed

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

2001-03-01

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

Final Environmental Assessment for C-17 Beddown at Elmendorf Air Force Base, Alaska

DTIC Science & Technology

2004-09-01

immediate construction area. Storm water quality would be protected by implementation of best management practices as specified in the EAFB’s Storm... Storm water quality would be protected by implementation of BMPs as specified in the EAFB’s Storm Water Pollution Prevention Plan. The slight

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

NASA Astrophysics Data System (ADS)

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

2015-06-01

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

DCCC Takes the TQM Plunge...And Tells How.

ERIC Educational Resources Information Center

Entner, Donald

1993-01-01

Activities at Delaware County Community College (Pennsylvania) in implementing Total Quality Management are examined and compared with criteria used by the United States Chamber of Commerce for making quality awards to businesses. Assessed areas include management leadership, strategic planning, customer focus, employee development, teamwork,…

Quality Management in Hungarian Higher Education: Organisational Responses to Governmental Policy

ERIC Educational Resources Information Center

Csizmadia, Tibor; Enders, Jurgen; Westerheijden, Don F.

2008-01-01

This article focuses on responses of higher education institutions to governmental policy. We investigate the influence of organisational characteristics on the implementation of quality management in Hungarian higher education institutions. Our theoretical framework is based on organisational theories (resource dependency and…

Social workers' role in disease management.

PubMed

Claiborne, N; Vandenburgh, H

2001-11-01

This article discusses social work's participation in a new paradigm for health care delivery, disease management. Attempts to improve health care quality havefocused on evidence-based methods of evaluating health care outcomes as well as quality of life issues with which social workers have been traditionally concerned. The fit between social work's ecological perspective and disease management and the needfor social workers to participate as patient case managers on interdisciplinary disease management teams are discussed. Quality and cost benefits can occur when social workers address such issues as adherence, psychosocialfactors, and depression in terms of the patient's global recovery and concurrent enhancement of quality of life. Potential barriers to disease management implementation with social work participation are discussed.

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

PubMed

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

2014-07-01

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

40 CFR 49.148-49.150 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian...

40 CFR 49.148-49.150 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian...

A quality implementation of Title I of the Americans With Disabilities Act of 1990.

PubMed

Rybski, D

1992-05-01

The Americans with Disabilities Act (ADA) of 1990 (Public Law 101-336) will have a major effect on private sector employers. Employers with 25 or more employees must provide qualified persons with disabilities equal access to employment with or without reasonable accommodations by July 1992. Employers with 15 to 24 employees must comply with the law by July 1994. Occupational therapy managers must understand the employment provisions of the law and develop strategies for implementation in order to comply with its regulations. This paper suggests the use of a total quality management approach, as espoused by W. E. Deming (1986), as a framework for an implementation plan. This approach focuses on quality improvement in the organization, respect of all workers for their abilities, replacement of fear of persons with disabilities with respect, and the building of partnerships between employers and employees with disabilities. A summary of the provisions of Title I as well as a checklist of measures and a sample job description that adheres to the regulations of Title I is presented to prepare an organization to become compliant. Occupational therapists are seen as uniquely skilled professionals who can contribute greatly in their own organizations as well as act as consultants to other managers in implementing Title I of the ADA using a total quality approach.

Total Quality Management Guide. Volume 2. A Guide to Implementation

DTIC Science & Technology

1990-02-15

Kaoru . Guide to Quality Control. Asian Productivity Organization. 1984. Ishikawa , Kaoru . What is Total Quality Control? The Japanese Way. Englewood...of the new Systems Age. The theories of Deming, Juran, Ishikawa , and other management methods that still predominate are pioneers of Systems Age...Feigenbaum, Armand V. Total Quality Control. New York: McGraw-Hill Book Company. 1983. bnai, Masaaki. Kaizen. New York: Random House. 1986. Ishikawa

Portuguese food composition database quality management system.

PubMed

Oliveira, L M; Castanheira, I P; Dantas, M A; Porto, A A; Calhau, M A

2010-11-01

The harmonisation of food composition databases (FCDB) has been a recognised need among users, producers and stakeholders of food composition data (FCD). To reach harmonisation of FCDBs among the national compiler partners, the European Food Information Resource (EuroFIR) Network of Excellence set up a series of guidelines and quality requirements, together with recommendations to implement quality management systems (QMS) in FCDBs. The Portuguese National Institute of Health (INSA) is the national FCDB compiler in Portugal and is also a EuroFIR partner. INSA's QMS complies with ISO/IEC (International Organization for Standardisation/International Electrotechnical Commission) 17025 requirements. The purpose of this work is to report on the strategy used and progress made for extending INSA's QMS to the Portuguese FCDB in alignment with EuroFIR guidelines. A stepwise approach was used to extend INSA's QMS to the Portuguese FCDB. The approach included selection of reference standards and guides and the collection of relevant quality documents directly or indirectly related to the compilation process; selection of the adequate quality requirements; assessment of adequacy and level of requirement implementation in the current INSA's QMS; implementation of the selected requirements; and EuroFIR's preassessment 'pilot' auditing. The strategy used to design and implement the extension of INSA's QMS to the Portuguese FCDB is reported in this paper. The QMS elements have been established by consensus. ISO/IEC 17025 management requirements (except 4.5) and 5.2 technical requirements, as well as all EuroFIR requirements (including technical guidelines, FCD compilation flowchart and standard operating procedures), have been selected for implementation. The results indicate that the quality management requirements of ISO/IEC 17025 in place in INSA fit the needs for document control, audits, contract review, non-conformity work and corrective actions, and users' (customers') comments, complaints and satisfaction, with minor adaptation. Implementation of the FCDB QMS proved to be a way of reducing the subjectivity of the compilation process and fully documenting it, and also facilitates training of new compilers. Furthermore, it has strengthened cooperation and trust among FCDB actors, as all of them were called to be involved in the process. On the basis of our practical results, we can conclude that ISO/IEC 17025 management requirements are an adequate reference for the implementation of INSA's FCDB QMS with the advantages of being well known to all members of staff and also being a common quality language among laboratories producing FCD. Combining quality systems and food composition activities endows the FCDB compilation process with flexibility, consistency and transparency, and facilitates its monitoring and assessment, providing the basis for strengthening confidence among users, data producers and compilers.

Integrating modal-based NDE techniques and bridge management systems using quality management

NASA Astrophysics Data System (ADS)

Sikorsky, Charles S.

1997-05-01

The intent of bridge management systems is to help engineers and managers determine when and where to spend bridge funds such that commerce and the motoring public needs are satisfied. A major shortcoming which states are experiencing is the NBIS data available is insufficient to perform certain functions required by new bridge management systems, such as modeling bridge deterioration and predicting costs. This paper will investigate how modal based nondestructive damage evaluation techniques can be integrated into bridge management using quality management principles. First, quality from the manufacturing perspective will be summarized. Next, the implementation of quality management in design and construction will be reinterpreted for bridge management. Based on this, a theory of approach will be formulated to improve the productivity of a highway transportation system.

Can There Ever Be Enough to Impact Water Quality? Evaluating BMPs in Elliot Ditch, Indiana Using the LTHIA-LID Model

NASA Astrophysics Data System (ADS)

Rahman, M. S.; Hoover, F. A.; Bowling, L. C.

2017-12-01

Elliot Ditch is an urban/urbanizing watershed located in the city of Lafayette, IN, USA. The city continues to struggle with stormwater management and combined sewer overflow (CSO) events. Several best-management practices (BMP) such as rain gardens, green roofs, and bioswales have been implemented in the watershed, but the level of adoption needed to achieve meaningful impact is currently unknown. This study's goal is to determine what level of BMP coverage is needed to impact water quality, whether meaningful impact is determined by achieving water quality targets or statistical significance. A power analysis was performed using water quality data for total suspended solids (TSS), E.coli, total phosphorus (TP) and nitrate (NO3-N) from Elliot Ditch from 2011 to 2015. The minimum detectable difference (MDD) was calculated as the percent reduction in load needed to detect a significant change in the watershed. The water quality targets were proposed by stakeholders as part of a watershed management planning process. The water quality targets and the MDD percentages were then compared to simulated load reductions due to BMP implementation using the Long-term Hydrologic Impact Assessment-Low Impact Development (LTHIA-LID) model. Seven baseline model scenarios were simulated by implementing the maximum number of each of six types of BMPs (rain barrels, permeable patios, green roofs, grassed swale/bioswales, bioretention/rain gardens, and porous pavement), as well as all the practices combined in the watershed. These provide the baseline for targeted implementation scenarios designed to determine if statistically and physically meaningful load reductions can be achieved through BMP implementation alone.

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review.

PubMed

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-02-01

Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.

California State Implementation Plan; Butte County Air Quality Management District; New Source Review (NSR) Permitting Program

EPA Pesticide Factsheets

EPA is proposing to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California SIP concerning the District's New Source Review (NSR) permitting program for new and modified sources of air pollution.

Assessment of runoff water quality for an integrated best-management practice system in an agricultural watershed

USDA-ARS?s Scientific Manuscript database

To better understand, implement and integrate best management practices (BMPs) in agricultural watersheds, critical information on their effectiveness is required. A representative agricultural watershed, Beasley Lake, was used to compare runoff water quality draining through an integrated system of...

An Analysis of Oregon State University's Total Quality Management Pilot Program.

ERIC Educational Resources Information Center

Coate, L. Edwin

1993-01-01

Adaptation of the Total Quality Management approach to organizational improvement at Oregon State University involved creation of 10 pilot finance and administration teams and implementation of a 10-step problem-solving process. The approach has improved staff morale as well as client services. (MSE)

[Lean logistics management in healthcare: a case study].

PubMed

Aguilar-Escobar, V G; Garrido-Vega, P

2013-01-01

To study the applicability of the principles of Lean Production to manage the supply chain of a hospital. In particular, to determine which Lean practices and principles are applicable, the benefits obtained and the main barriers for its implementation. Managing the hospital supply chain is an important issue, both for its effect on the quality of care and its impact on costs. This study is based on a case study. 2005-10. Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technological investments. The implementation of the comprehensive plan has reduced inventory, decreased lead times and improved service quality. Also, there have been other important improvements: enhanced employee satisfaction and increased staff productivity, both dedicated to health and the logistics. The experience analysed has shown the applicability and appropriateness of Lean principles and some of its techniques in managing the logistics of hospitals. It also identifies some of the main difficulties that may arise. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

A Program Manager’s Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs. The RAND Toolkit, Volume 4

DTIC Science & Technology

2014-01-01

Hughes EFX, Boerstler H, O’Connor EJ. “Assessing the Impact of Continuous Quality Improvement/ Total Quality Management : Concept versus...facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity. Gery...RAND Program Manager’s Guide helps managers assess program performance, consider options for improvement, implement solutions, then assess whether the

Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers.

PubMed

Odusola, Aina O; Stronks, Karien; Hendriks, Marleen E; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A

2016-01-01

Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider-insurer relationships; automated administration systems; and tailoring guidelines/patient education. By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.

Implementation Evaluation in a Private Nonprofit Setting: A Mixed-Methods Approach

ERIC Educational Resources Information Center

Walker, Jacquelyn Ann

2013-01-01

Demand for quality service provision in the human services industry requires that private nonprofit organizations have the administrative and management capacities to ensure successful implementation and sustain staff development programs. Unfamiliarity with implementation challenges, and limited awareness of implementation strategies, can trigger…

Shared Care: A Quality Improvement Initiative to Optimize Primary Care Management of Constipation

PubMed Central

Vernacchio, Louis; Trudell, Emily; Antonelli, Richard; Nurko, Samuel; Leichtner, Alan M.; Lightdale, Jenifer R.

2015-01-01

BACKGROUND: Pediatric constipation is commonly managed in the primary care setting, where there is much variability in management and specialty referral use. Shared Care is a collaborative quality improvement initiative between Boston Children’s Hospital and the Pediatric Physician’s Organization at Children’s (PPOC), through which subspecialists provide primary care providers with education, decision-support tools, pre-referral management recommendations, and access to advice. We investigated whether Shared Care reduces referrals and improves adherence to established clinical guidelines. METHODS: We reviewed the primary care management of patients 1 to 18 years old seen by a Boston Children’s Hospital gastroenterologist and diagnosed with constipation who were referred from PPOC practices in the 6 months before and after implementation of Shared Care. Charts were assessed for patient factors and key components of management. We also tracked referral rates for all PPOC patients for 29 months before implementation and 19 months after implementation. RESULTS: Fewer active patients in the sample were referred after implementation (61/27 365 [0.22%] vs 90/27 792 [0.36%], P = .003). The duration of pre-referral management increased, and the rate of fecal impaction decreased after implementation. No differences were observed in documentation of key management recommendations. Analysis of medical claims showed no statistically significant change in referrals. CONCLUSIONS: A multifaceted initiative to support primary care management of constipation can alter clinical care, but changes in referral behavior and pre-referral management may be difficult to detect and sustain. Future efforts may benefit from novel approaches to provider engagement and systems integration. PMID:25896837

Proceedings of the Acquisition Research Symposium: Imagnination, Innovation, and Implementation, 1991. Volume 1.

DTIC Science & Technology

1991-01-01

Construction Industry Institute, Austin, Texas, April 1990. 6. Ishikawa , Kaoru , What is Total Quality Control? The Japanese Way, Prentice-Hall, N.J., 1985. 7...customer. Ishikawa , a leading Japanese management and line personnel, and where authority on quality management, claims that appropriate, the customer

QUALITY MANAGEMENT PLAN FOR THE NATIONAL CHILDREN'S STUDY

EPA Science Inventory

EPA has taken the lead, in consort with NIH, in developing the Quality Management Plan (QMP) for the National Children's Study (NCS); the QMP will delineate a systematic planning process for the implementation of the NCS. The QMP will state the goals and objectives of the NCS, th...

33 CFR 385.21 - Quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

The implementation of quality management systems in hospitals: a comparison between three countries

PubMed Central

Wagner, C; Gulácsi, L; Takacs, E; Outinen, M

2006-01-01

Background Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. Methods The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. Results A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. Conclusion The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be assessed. The hypothesis that governmental legislation or financial reimbursement can stimulate the implementation of QM-activities, more than voluntary recommendations, could not be confirmed. However, the results show that specific obligations can stimulate the implementation of QM-activities more than general, framework legislation. PMID:16608510

Senior Managers’ Viewpoints Toward Challenges of Implementing Clinical Governance: A National Study in Iran

PubMed Central

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

2013-01-01

Background: Quality improvement should be assigned as the main mission for healthcare providers. Clinical Governance (CG) is used not only as a strategy focusing on responding to public and government’s intolerance of poor healthcare standards, but also it is implemented for quality improvement in a number of countries. This study aims to identify the key contributing factors in the implementation process of CG from the viewpoints of senior managers in curative deputies of Medical Universities in Iran. Methods: A quantitative method was applied via a questionnaire distributed to 43 senior managers in curative deputies of Iran Universities of Medical Sciences. Data were analyzed using SPSS. Results: Analysis revealed that a number of items were important in the successful implementation of CG from the senior managers’ viewpoints. These items included: knowledge and attitude toward CG, supportive culture, effective communication, teamwork, organizational commitment, and the support given by top managers. Medical staff engagement in CG implementation process, presence of an official position for CG officers, adequate resources, and legal challenges were also regarded as important factors in the implementation process. Conclusion: Knowledge about CG, organizational culture, managerial support, ability to communicate goals and strategies, and the presence of effective structures to support CG, were all related to senior managers’ attitude toward CG and ultimately affected the success of quality improvement activities. PMID:24596887

[From quality management to dynamic management through quality: Deployment within a radiotherapy group].

PubMed

Guerrier, B; Halm, É; Craman, M; Dujols, J-P; Norkowski, J-L; Meynard, K

2017-10-01

In 2015, the quality group of the radiotherapy clinic Groupement de Radiothérapie et d'Oncologie des Pyrénées (GROP, Pau, France) decided to review the deployment of its quality approach in order to optimize it continuously. For this, two improvements were proposed: an involvement of process drivers and a material and financial investment in document management software. The implementation of these organizational and managerial provisions enabled us to better cover the requirements of the ISO 9001 standard, the international reference in quality management. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Total quality management in orthodontic practice.

PubMed

Atta, A E

1999-12-01

Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

40 CFR 49.4169-49.5510 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes-Region VIII Federal Implementation Plan for Oil and Natural Gas Well Production Facilities; Fort Berthold Indian...

40 CFR 49.4169-49.5510 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes-Region VIII Federal Implementation Plan for Oil and Natural Gas Well Production Facilities; Fort Berthold Indian...

[The German program for disease management guidelines--implementation with pathways and quality management].

PubMed

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2007-07-15

In Germany, physicians enrolled in disease management programs are legally obliged to follow evidence-based clinical practice guidelines. That is why a Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 aiming at implementation of best-practice evidence-based recommendations for nationwide as well as regional disease management programs. Against this background the article reviews programs, methods and tools for implementing DM-CPGs via clinical pathways as well as regional guidelines for outpatient care. Special reference is given to the institutionalized program of adapting DM-CPGs for regional use by primary-care physicians in the State of Hesse.

[Implementation and (cost-)effectiveness of case management for people with dementia and their informal caregivers: results of the COMPAS study].

PubMed

van Mierlo, Lisa D; MacNeil-Vroomen, Janet; Meiland, Franka J M; Joling, Karlijn J; Bosmans, Judith E; Dröes, Rose Marie; Moll van Charante, Eric P; de Rooij, Sophia E J A; van Hout, Hein P J

2016-12-01

Different forms of case management for dementia have emerged over the past few years. In the COMPAS study (Collaborative dementia care for patients and caregivers study), two prominent Dutch case management forms were studied: the linkage and the integrated care form. Evaluation of the (cost)effectiveness of two dementia case management forms compared to usual care as well as factors that facilitated or impeded their implementation. A mixed methods design with a) a prospective, observational controlled cohort study with 2 years follow-up among 521 dyads of people with dementia and their primary informal caregiver with and without case management; b) interviews with 22 stakeholders on facilitating and impeding factors of the implementation and continuity of the two case management models. Outcome measures were severity and frequency of behavioural problems (NPI) for the person with dementia and mental health complaints (GHQ-12) for the informal caregiver, total met and unmet care needs (CANE) and quality adjusted life years (QALYs). Outcomes showed a better quality of life of informal caregivers in the integrated model compared to the linkage model. Caregivers in the control group reported more care needs than those in both case management groups. The independence of the case management provider in the integrated model facilitated the implementation, while the rivalry between multiple providers in the linkage model impeded the implementation. The costs of care were lower in the linkage model (minus 22 %) and integrated care model (minus 33 %) compared to the control group. The integrated care form was (very) cost-effective in comparison with the linkage form or no case management. The integrated care form is easy to implement.

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

PubMed

Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

2017-01-01

The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

A quality improvement approach to capacity building in low- and middle-income countries.

PubMed

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

2015-07-01

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

IS0 9000 Implementation and Assessment: A Guide to Developing and Evaluating Quality Management Systems

NASA Technical Reports Server (NTRS)

Navarro, Robert J.; Grimm, Barry

1996-01-01

The agency has developed this reference publication to aid NASA organizations and their suppliers in the transition to IS0 9000. This guide focuses on the standard s intent, clarifies its requirements, offers implementation examples and highlights interrelated areas. It can assist anyone developing or evaluating NASA or supplier quality management systems. The IS0 9000 standards contain the basic elements for managing those processes that affect an organization's ability to consistently meet customer requirements. IS0 9000 was developed through the International Organization for Standardization and has been adopted as the US. national standard. These standards define a flexible foundation for customer focused process measurement, management and improvement that is the hallmark of world class enterprises.

Bottom-up implementation of disease-management programmes: results of a multisite comparison.

PubMed

Lemmens, K M M; Nieboer, A P; Rutten-Van Mölken, M P M H; van Schayck, C P; Spreeuwenberg, C; Asin, J D; Huijsman, R

2011-01-01

To evaluate the implementation of three regional disease-management programmes on chronic obstructive pulmonary disease (COPD) based on bottlenecks experienced in professional practice. The authors performed a multisite comparison of three Dutch regional disease-management programmes combining patient-related, professional-directed and organisational interventions. Process (Assessing Chronic Illness Care survey) and outcome (disease specific quality of life (clinical COPD questionnaire (CCQ); chronic respiratory questionnaire (CRQ)), Medical Research Council dyspnoea and patients' experiences) data were collected for 370 COPD patients and their care providers. Bottlenecks in region A were mostly related to patient involvement, in region B to organisational issues and in region C to both. Selected interventions related to identified bottlenecks were implemented in all programmes, except for patient-related interventions in programme A. Within programmes, significant improvements were found on dyspnoea and patients' experiences with practice nurses. Outcomes on quality of life differed between programmes: programme A did not show any significant improvements; programme B did show any significant improvements on CCQ total (p<0.001), functional (p=0.011) and symptom (p<0.001), CRQ fatigue (p<0.001) and emotional scales (p<0.001); in programme C, CCQ symptom (p<0.001) improved significantly, whereas CCQ mental score (p<0.001) deteriorated significantly. Regression analyses showed that programmes with better implementation of selected interventions resulted in relatively larger improvements in quality of life (CCQ). Bottom-up implementation of COPD disease-management programmes is a feasible approach, which in multiple settings leads to significant improvements in outcomes of care. Programmes with a better fit between implemented interventions and bottlenecks showed more positive changes in outcomes.

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

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

CUSTOMER/SUPPLIER ACCOUNTABILITY AND PROGRAM IMPLEMENTATION

EPA Science Inventory

Quality assurance (QA) and quality control (QC) are the basic components of a QA program, which is a fundamental quality management tool. he quality of outputs and services strongly depends on the caliber of the communications between the "customer" and the "supplier." lear under...

Creating a national culture of quality: the Tanzania experience.

PubMed

Mwidunda, Patrick E; Eliakimu, Eliudi

2015-07-01

Although quality improvement has been a priority for Tanzania's health sector since the 1970s, few effective quality improvement initiatives were implemented, due to limited expertise, political commitment and resources. More recently, as the HIV epidemic gained momentum within the country, an influx of funding and of international organizations with quality improvement expertise accelerated the implementation of quality improvement projects, as well as efforts to institutionalize quality improvement at the national level. The support of US President's Emergency Plan for AIDS Relief (PEPFAR) and other donors, and the increasing numbers of HIV-implementing partners focused on quality management, and quality improvement strategies catalysed the development of HIV-specific quality improvement initiatives first, and then of national quality improvement frameworks. The diversity of quality improvement approaches championed by various donors and partners also presented important challenges to harmonization and institutionalization of quality improvement programmes.

77 FR 26475 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Eastern Kern Air Pollution Control District (EKAPCD), and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions to local rules that define terms used in other air pollution regulations in these areas and a rule rescission that address Petroleum Coke Calcining Operations--Oxides of Sulfur, under the Clean Air Act as amended in 1990 (CAA or the Act).

78 FR 21545 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

...EPA is taking direct final action to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) and Monterey Bay Unified Air Pollution Control District (MBUAPCD) and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). Under authority of the Clean Air Act as amended in 1990 (CAA or the Act), we are approving local rules that address emission statements for AVAQMD, rule rescissions that addresses public records for MBUAPCD, and define terms for SBCAPCD.

Quality management and perceptions of teamwork and safety climate in European hospitals.

PubMed

Kristensen, Solvejg; Hammer, Antje; Bartels, Paul; Suñol, Rosa; Groene, Oliver; Thompson, Caroline A; Arah, Onyebuchi A; Kutaj-Wasikowska, Halina; Michel, Philippe; Wagner, Cordula

2015-12-01

This study aimed to investigate the associations of quality management systems with teamwork and safety climate, and to describe and compare differences in perceptions of teamwork climate and safety climate among clinical leaders and frontline clinicians. We used a multi-method, cross-sectional approach to collect survey data of quality management systems and perceived teamwork and safety climate. Our data analyses included descriptive and multilevel regression methods. Data on implementation of quality management system from seven European countries were evaluated including patient safety culture surveys from 3622 clinical leaders and 4903 frontline clinicians. Perceived teamwork and safety climate. Teamwork climate was reported as positive by 67% of clinical leaders and 43% of frontline clinicians. Safety climate was perceived as positive by 54% of clinical leaders and 32% of frontline clinicians. We found positive associations between implementation of quality management systems and teamwork and safety climate. Our findings, which should be placed in a broader clinical quality improvement context, point to the importance of quality management systems as a supportive structural feature for promoting teamwork and safety climate. To gain a deeper understanding of this association, further qualitative and quantitative studies using longitudinally collected data are recommended. The study also confirms that more clinical leaders than frontline clinicians have a positive perception of teamwork and safety climate. Such differences should be accounted for in daily clinical practice and when tailoring initiatives to improve teamwork and safety climate. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Air quality management: evolution of policy and practice in the UK as exemplified by the experience of English local government

NASA Astrophysics Data System (ADS)

Beattie, C. I.; Longhurst, J. W. S.; Woodfield, N. K.

The air quality management (AQM) framework in the UK is designed to be an effects-based solution to air pollutants currently affecting human health. The AQM process has been legislated through The Environment Act 1995, which required the National Air Quality Strategy (NAQS) to be published. AQM practice and capability within local authorities has flourished since the publication of the NAQS in March 1997. This paper outlines the policy framework within which the UK operates, both at a domestic and European level, and reviews the air quality management process relating to current UK policy and EU policy. Data from questionnaire surveys are used to indicate the involvement of various sectors of local government in the air quality management process. These data indicate an increasing use of monitoring, and use of air dispersion modelling by English local authorities. Data relating to the management of air quality, for example, the existence and work of air quality groups, dissemination of information to the public and policy measures in place on a local scale to improve air quality, have also been reported. The UK NAQS has been reviewed in 1999 to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the socio-economic issues involved. The AQM process, as implemented by UK local authorities, provides an effective model for other European member states with regards to the implementation of the Air Quality Framework Directive. The future direction of air quality policy in the UK is also discussed.

Upper Illinois River basin

USGS Publications Warehouse

Friedel, Michael J.

1998-01-01

During the past 25 years, industry and government made large financial investments that resulted in better water quality across the Nation; however, many water-quality concerns remain. Following a 1986 pilot project, the U.S. Geological Survey began implementation of the National Water-Quality Assessment (NAWQA) Program in 1991. This program differs from other national water-quality assessment studies in that the NAWQA integrates monitoring of surface- and ground-water quality with the study of aquatic ecosystems. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers (water-bearing sediments and rocks), (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality.The Upper Illinois River Basin National Water- Quality Assessment (NAWQA) study will increase the scientific understanding of surface- and ground-water quality and the factors that affect water quality in the basin. The study also will provide information needed by water-resource managers to implement effective water-quality management actions and evaluate long-term changes in water quality.

Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

PubMed

Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

2013-01-01

With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.

Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa

PubMed Central

de Dieu Iragena, Jean; Kao, Kekeletso; Erni, Donatelle; Mekonen, Teferi

2017-01-01

Background Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS) and laboratory accreditation are key to improving patient care. Objectives The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs) in the African Region. Method An online questionnaire was administered to NTRL managers in 47 World Health Organization Regional Office for Africa member states in the region, between February and April 2015, regarding the knowledge of QMS tools and progress toward implementation to inform strategies for tuberculosis diagnostic services strengthening in the region. Results A total of 21 laboratories (43.0%) had received SLMTA/TB-SLMTA training, of which 10 had also used the Global Laboratory Initiative accreditation tool. However, only 36.7% of NTRLs had received a laboratory audit, a first step in quality improvement. Most NTRLs participated in acid-fast bacilli microscopy external quality assurance (95.8%), although external quality assurance for other techniques was lower (60.4% for first-line drug susceptibility testing, 25.0% for second-line drug susceptibility testing, and 22.9% for molecular testing). Barriers to accreditation included lack of training and accreditation programmes. Only 28.6% of NTRLs had developed strategic plans and budgets which included accreditation. Conclusion Good foundations are in place on the continent from which to scale up accreditation efforts. Laboratory audits should be conducted as a first step in developing quality improvement action plans. Political commitment and strong leadership are needed to drive accreditation efforts; advocacy will require clear evidence of patient impact and cost-benefit. PMID:28879161

Strengthening decentralized primary healthcare planning in Nigeria using a quality improvement model: how contexts and actors affect implementation.

PubMed

Eboreime, Ejemai Amaize; Nxumalo, Nonhlanhla; Ramaswamy, Rohit; Eyles, John

2018-05-08

Quality improvement models have been applied across various levels of health systems with varying success leading to scepticisms about effectiveness. Health systems are complex, influenced by contexts and characterized by numerous interests. Thus, a shift in focus from examining whether improvement models work, to understanding why, when and where they work most effectively is essential. Nigeria introduced DIVA (Diagnose-Intervene-Verify-Adjust) as a model to strengthen decentralized PHC planning. However, implementation has been poorly sustained. This article explores the role of actors and context in implementation and sustainability of DIVA in two local government areas (LGAs) in Nigeria. We employed an integrated mixed method approach in which qualitative data was used in conjunction with quantitative to understand effects of actors and contexts on implementation outcomes. We analysed policy documents and conducted interviews with PHC managers. Then using the Model for Understanding Success in Quality (MUSIQ), we measured contextual factors affecting implementation of DIVA in the selected LGAs. The LGAs scored 117.42 and 104.67 out of 168 points on the MUSIQ scale, respectively, indicating contextual barriers exist. Both have strong DIVA team attributes, but these could not independently ensure quality implementation. Although external support accounted for the greatest contextual disparities, the utmost implementation challenges relate to subnational government leadership, management, financial and technical support. Although higher levels of government may set visionary goals for PHC, interventions are potentially skewed towards donor interests at lower (implementation) levels. Thus, subnational political will is a key determinant of quality implementation. Consequently, advocacy for responsible and accountable political governance is essential in comparable decentralized contexts.

Quantification of BMPs Selection and Spatial Placement Impact on Water Quality Controlling Plans in Lower Bear River Watershed, Utah

NASA Astrophysics Data System (ADS)

Salha, A. A.; Stevens, D. K.

2016-12-01

The aim of the watershed-management program in Box Elder County, Utah set by Utah Division of Water Quality (UDEQ) is to evaluate the effectiveness and spatial placement of the implemented best-management practices (BMP) for controlling nonpoint-source contamination at watershed scale. The need to evaluate the performance of BMPs would help future policy and program decisions making as desired end results. The environmental and costs benefits of BMPs in Lower Bear River watershed have seldom been measured beyond field experiments. Yet, implemented practices have rarely been evaluated at the watershed scale where the combined effects of variable soils, climatic conditions, topography and land use/covers and management conditions may significantly change anticipated results and reductions loads. Such evaluation requires distributed watershed models that are necessary for quantifying and reproducing the movement of water, sediments and nutrients. Soil and Water Assessment Tool (SWAT) model is selected as a watershed level tool to identify contaminant nonpoint sources (critical zones) and areas of high pollution risks. Water quality concerns have been documented and are primarily attributed to high phosphorus and total suspended sediment concentrations caused by agricultural and farming practices (required load is 460 kg/day of total phosphorus based on 0.075 mg/l and an average of total suspended solids of 90 mg/l). Input data such as digital elevation model (DEM), land use/Land cover (LULC), soils, and climate data for 10 years (2000-2010) is utilized along with observed water quality at the watershed outlet (USGS) and some discrete monitoring points within the watershed. Statistical and spatial analysis of scenarios of management practices (BMP's) are not implemented (before implementation), during implementation, and after BMP's have been studied to determine whether water quality of the two main water bodies has improved as required by the LBMR watershed's TMDL and if the BMPs are cost-effectively targeting the critical zones.

Will the circle be unbroken: a history of the U.S. National Ambient Air Quality Standards.

PubMed

Bachmann, John

2007-06-01

In celebration of the 100th anniversary of the Air & Waste Management Association, this review examines the history of air quality management (AQM) in the United States over the last century, with an emphasis on the ambient standards programs established by the landmark 1970 Clean Air Act (CAA) Amendments. The current CAA system is a hybrid of several distinct air pollution control philosophies, including the recursive or circular system driven by ambient standards. Although this evolving system has resulted in tremendous improvements in air quality, it has been far from perfect in terms of timeliness and effectiveness. The paper looks at several periods in the history of the U.S. program, including: (1) 1900-1970, spanning the early smoke abatement and smog control programs, the first federal involvement, and the development of a hybrid AQM approach in the 1970 CAA; (2) 1971-1976, when the first National Ambient Air Quality Standards (NAAQS) were set and implemented; (3) 1977-1993, a period of the first revisions to the standards, new CAA Amendments, delays in implementation and decision-making, and key science/policy/legislative developments that would alter both the focus and scale of air pollution programs and how they are implemented; and (4) 1993-2006, the second and third wave of NAAQS revisions and their implementation in the context of the 1990 CAA. This discussion examines where NAAQS have helped drive implementation programs and how improvements in both effects and air quality/control sciences influenced policy and legislation to enhance the effectiveness of the system over time. The review concludes with a look toward the future of AQM, emphasizing challenges and ways to meet them. The most significant of these is the need to make more efficient progress toward air quality goals, while adjusting the system to address the growing intersections between air quality management and climate change.

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

PubMed Central

Breckenkamp, Juergen; Wiskow, Christiane; Laaser, Ulrich

2007-01-01

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

Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals.

PubMed

Shamsuddin Alaraki, Mohammad

The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi hospitals. It appears that the most important contributing factors to the successful implementation of QI in Saudi hospitals are proper human resources utilization and effective quality management. Through careful planning, change management, proper utilization of human resources, supportive quality information systems, focus on processes and systems, structural support, and an organizational culture that is compatible with QI philosophy, Saudi hospitals will be more capable in achieving sustained measureable improvements in the quality and safety of patient care.

An Alternative View of Quality Assurance and Enhancement

ERIC Educational Resources Information Center

Wong, Viola Yuk-Yue

2012-01-01

This paper attempts to deal with the elusive nature of quality in quality management, using a case study to examine quality control measures implemented in an academic context and to show an emergent framework for quality enhancement. This paper introduces the concept of the ecology of quality assurance and examines efforts to maintain and advance…

The Quality Education Challenge.

ERIC Educational Resources Information Center

Downey, Carolyn J.; And Others

Attempts to implement W. Edwards Deming's Total Quality Management (TQM) principles in education and transform school systems into world-class, quality learning environments have proved somewhat disappointing. This book asserts that educators need a way to translate the ideas about corporate quality for adaptation and use in schools. The…

40 CFR 49.10711 - Federal Implementation Plan for the Astaris-Idaho LLC Facility (formerly owned by FMC Corporation...

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the Fort Hall Indian Reservation. Bag leak detection guidance means Office of Air Quality Planning... FEDERAL ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes... the meaning accorded them under the Clean Air Act, except as follows: Astaris-Idaho or Astaris-Idaho...

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review

PubMed Central

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-01-01

Background and aim: Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. Methods: We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. Results: We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists’ perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Conclusion: Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers. PMID:26878037

Implementing a statewide outcomes management system for consumers of public mental health services.

PubMed

Clardy, J A; Booth, B M; Smith, L G; Nordquist, C R; Smith, G R

1998-02-01

The authors describe the development and implementation of an outcomes management system designed to measure outcomes and processes of care for public mental health consumers in Arkansas. The public-academic project was implemented in 1995 and is based on the Shewhart-Deming model of continuous quality improvement. All 15 community mental health centers (CMHCs) in the state participate in the project, which prospectively measures longitudinal outcomes of care for the tracer conditions of major depression and schizophrenia. Multiperspective measurement tools are used to measure patients' psychiatric status and general health status at periodic intervals; information is gathered on functioning, symptoms, severity of illness, social factors, demographic characteristics, and quality of life. A problem encountered during implementation was the relatively low rate of referral of patients with the tracer conditions for monitoring. Voluntary rather than mandatory participation in the outcomes management system by the CMHCs as well as clinicians' misperceptions about the system's purpose and concerns about confidentiality may have partly accounted for the low rate.

Implementation of cold risk management in occupational safety, occupational health and quality practices. Evaluation of a development process and its effects at the finnish maritime administration.

PubMed

Risikko, Tanja; Remes, Jouko; Hassi, Juhani

2008-01-01

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

Quality Management in U.S. High Schools: Evidence from the Field.

ERIC Educational Resources Information Center

Detert, James R.; Bauerly Kopel, Michelle E.; Mauriel, John J.; Jenni, Roger W.

2000-01-01

Reports on a longitudinal study examining implementation of a Quality Management reform based on Deming's seven principles. Interview and survey data from a national sample of purposefully chosen high schools show limited results as to teachers' effective use and institutionalization of TQM principles. The principal's role is critical. (Contains…

Quality Management and System Change in Three Suburban Public School Districts.

ERIC Educational Resources Information Center

Obisesan, Anthonia A.

This report examines the potential of Quality Management (QM) to enhance system change by analyzing its implementation in three suburban public school districts. The paper assessed the capacity of QM to increase the efficiency and productivity of the school districts, validated the potential to sustain systemic change in a school organization, and…

Planning and Implementing Total Quality Management in the Royal Australian Air Force: A Multiple Case Study Analysis

DTIC Science & Technology

1990-09-01

change barriers, and necessary checks and balances built into processes. Furthermore, this assessment should address management system variables which...organisation’s 69 immediate product and their worklife . Focus must be maintained on improving RAAF processes. In addition to a quality committee structure as

Application of the Total Quality Management Approach Principles and the ISO 9000 Standards in Engineering Education.

ERIC Educational Resources Information Center

Waks, Shlomo; Frank, Moti

1999-01-01

Discusses the applicability of the definition, principles, and underlying strategies of total quality management (TQM) for engineering education. Describes several tools and methods for the implementation of TQM and its suitability for a variety of school activities. Presents a TQM course outline combining lectures, discussions, suggested…

The Application of a Total Quality Management Approach to Support Student Recruitment in Schools of Music

ERIC Educational Resources Information Center

Weinstein, Larry

2009-01-01

One of the greatest challenges music programme administrators face is that of recruiting students for their programmes. This article suggests that administrators should investigate the benefits of implementing a comprehensive total quality management programme in their institutions. The core values, techniques and tools embodied in the Total…

Human Resources as a Strategic Partner: Sitting at the Table with Six Sigma

ERIC Educational Resources Information Center

Fazzari, Alan J.; Levitt, Kenneth

2008-01-01

For nearly three decades, the quality management philosophy known as Six Sigma has brought competitive advantage to organizations implementing it. The typical approach, however, has been to have leaders from operations, engineering, quality, and marketing manage this strategic initiative. Human resource's role has been to default to the…

Total Quality Management: Implications for Higher Education.

ERIC Educational Resources Information Center

Hoffman, Allan M., Ed.; Julius, Daniel J., Ed.

This book contains 19 papers describing the implementation of Total Quality Management in a variety of higher education settings. Following a Foreword by Peter Likins and a Preface by Daniel J. Julius, the chapter titles and authors are: (1) "TQM: Implications for Higher Education--A Look Back to the Future" (Allan M. Hoffman and Randall…

77 FR 1895 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... approve South Coast Air Quality Management District (SCAQMD) Rule 317, ``Clean Air Act Non- Attainment Fee... Rule 317, an equivalent alternative program, is not less stringent than the program required by section... equivalent alternative programs, and, if so, whether Rule 317 would constitute an approvable equivalent...

77 FR 74372 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... of South Coast Air Quality Management District (SCAQMD) Rule 317, ``Clean Air Act Non- Attainment Fee... determined that SCAQMD's alternative fee-equivalent program is not less stringent than the program required by section 185, and, therefore, is approvable as an equivalent alternative program, consistent with...

The SLMTA programme: Transforming the laboratory landscape in developing countries

PubMed Central

Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.

2014-01-01

Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335

Environmental Assessment for the Implementation of the Integrated Natural Resources Management Plan for 45th Space Wing

DTIC Science & Technology

2008-08-01

the Proposed Action and as a basis for assessing the significance of potential impacts. The areas of environmental consideration were air quality... ENVIRONMENTAL ASSESSMENT FOR THE IMPLEMENTATION OF THE INTEGRATED NATURAL RESOURCES MANAGEMENT PLAN FOR 45th SPACE WING August...DATE AUG 2008 2. REPORT TYPE 3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Environmental Assessment for the Implementation of

Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

PubMed Central

Odusola, Aina O.; Stronks, Karien; Hendriks, Marleen E.; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A.

2016-01-01

Background Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Results Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA. PMID:26880152

Management of government quality assurance functions for NASA contracts

NASA Technical Reports Server (NTRS)

1993-01-01

This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.

Management of government quality assurance functions for NASA contracts

NASA Astrophysics Data System (ADS)

1993-04-01

This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.

Managed care and total quality management: a necessary integration.

PubMed

Phoon, J; Corder, K; Barter, M

1996-01-01

The process of quality improvement/total quality management (QI/TQM) plays a key role in the delivery of health care in a managed care system. The concepts and ideas surrounding QI/TQM and managed care are interrelated, and the success of health care delivery depends on the integration and coexistence of these two philosophies. In looking more closely at these concepts, it becomes clear that the principles of QI/TQM must underlie strategic decisions involved in the implementation of a managed care system. Nurses play a key role in the success of this integration as nurse case managers, nurse practitioners, and nurse administrators. They have a direct impact on the many variables and goals of both QI/TQM and managed care.

Quality focus shining on corporate ethics.

PubMed

2003-01-01

Compliance just scratches the surface of a comprehensive ethics policy. Being true to your mission is a critical component of governance responsibilities. Quality managers play an important role in feedback, implementation.

The influence of enterprise resource planning (ERP) systems' performance on earnings management

NASA Astrophysics Data System (ADS)

Tsai, Wen-Hsien; Lee, Kuen-Chang; Liu, Jau-Yang; Lin, Sin-Jin; Chou, Yu-Wei

2012-11-01

We analyse whether there is a linkage between performance measures of enterprise resource planning (ERP) systems and earnings management. We find that earnings management decreases with the higher performance of ERP systems. The empirical result is as expected. We further analyse how the dimension of the DeLone and McLean model of information systems success affects earnings management. We find that the relationship between the performance of ERP systems and earnings management depends on System Quality after ERP implementation. The more System Quality improves, the more earnings management is reduced.

Pay-for-performance in disease management: a systematic review of the literature.

PubMed

de Bruin, Simone R; Baan, Caroline A; Struijs, Jeroen N

2011-10-14

Pay-for-performance (P4P) is increasingly implemented in the healthcare system to encourage improvements in healthcare quality. P4P is a payment model that rewards healthcare providers for meeting pre-established targets for delivery of healthcare services by financial incentives. Based on their performance, healthcare providers receive either additional or reduced payment. Currently, little is known about P4P schemes intending to improve delivery of chronic care through disease management. The objectives of this paper are therefore to provide an overview of P4P schemes used to stimulate delivery of chronic care through disease management and to provide insight into their effects on healthcare quality and costs. A systematic PubMed search was performed for English language papers published between 2000 and 2010 describing P4P schemes related to the implementation of disease management. Wagner's chronic care model was used to make disease management operational. Eight P4P schemes were identified, introduced in the USA (n = 6), Germany (n = 1), and Australia (n = 1). Five P4P schemes were part of a larger scheme of interventions to improve quality of care, whereas three P4P schemes were solely implemented. Most financial incentives were rewards, selective, and granted on the basis of absolute performance. More variation was found in incented entities and the basis for providing incentives. Information about motivation, certainty, size, frequency, and duration of the financial incentives was generally limited. Five studies were identified that evaluated the effects of P4P on healthcare quality. Most studies showed positive effects of P4P on healthcare quality. No studies were found that evaluated the effects of P4P on healthcare costs. The number of P4P schemes to encourage disease management is limited. Hardly any information is available about the effects of such schemes on healthcare quality and costs. © 2011 de Bruin et al; licensee BioMed Central Ltd.

Pay-for-performance in disease management: a systematic review of the literature

PubMed Central

2011-01-01

Background Pay-for-performance (P4P) is increasingly implemented in the healthcare system to encourage improvements in healthcare quality. P4P is a payment model that rewards healthcare providers for meeting pre-established targets for delivery of healthcare services by financial incentives. Based on their performance, healthcare providers receive either additional or reduced payment. Currently, little is known about P4P schemes intending to improve delivery of chronic care through disease management. The objectives of this paper are therefore to provide an overview of P4P schemes used to stimulate delivery of chronic care through disease management and to provide insight into their effects on healthcare quality and costs. Methods A systematic PubMed search was performed for English language papers published between 2000 and 2010 describing P4P schemes related to the implementation of disease management. Wagner's chronic care model was used to make disease management operational. Results Eight P4P schemes were identified, introduced in the USA (n = 6), Germany (n = 1), and Australia (n = 1). Five P4P schemes were part of a larger scheme of interventions to improve quality of care, whereas three P4P schemes were solely implemented. Most financial incentives were rewards, selective, and granted on the basis of absolute performance. More variation was found in incented entities and the basis for providing incentives. Information about motivation, certainty, size, frequency, and duration of the financial incentives was generally limited. Five studies were identified that evaluated the effects of P4P on healthcare quality. Most studies showed positive effects of P4P on healthcare quality. No studies were found that evaluated the effects of P4P on healthcare costs. Conclusion The number of P4P schemes to encourage disease management is limited. Hardly any information is available about the effects of such schemes on healthcare quality and costs. PMID:21999234

Developing a Total Quality Improvement Course for the Preparation of Technical-Management Personnel.

ERIC Educational Resources Information Center

Zargari, Ahmad

1997-01-01

Presents information about the need for, planning, and implementation of a total quality improvement course for undergraduate technology education students. The course involves the study of total quality concepts and their impact on the quality and competitiveness of industrial products. (JOW)

Exploring readiness for the adoption of new molecular water quality tests: Insights from interviews with policy makers, laboratory managers and watershed managers.

PubMed

Henrich, Natalie; Holmes, Bev; Isaac-Renton, Judith; Prystajecky, Natalie

2016-01-01

Adoption of molecular-based water quality tests has been limited despite their advantage over traditional culture-based tests. A better understanding of the factors affecting adoption of these tests is needed for effective implementation. The Consolidated Framework for Implementation Research (CFIR) was used to analyze interviews with policy makers, watershed managers and laboratory managers in British Columbia (BC), Canada about their perceptions of molecular water tests currently under development in order to assess readiness for adoption and identify factors that may impact implementation. Many of the CFIR constructs were addressed by study participants, thus confirming their validity in the water-testing context. Other constructs were not mentioned, which suggests that awareness about these constructs need to be increased to ensure that they are incorporated into implementation strategies. In general, there was much enthusiasm for the new tests, which were seen to provide valuable information that could enable improved management of watersheds and treatment of source water. However, prior to adopting the tests, stakeholders would require evidence supporting the tests' validity and reliability, would need to assess the complexity of introducing the tests into laboratories and water sampling processes, and would require support interpreting the test results. Even if all the aforementioned issues are satisfactorily addressed, the tests may not be adopted unless regulations and policies were changed to allow the use of these test results to inform decision making. The results support that implementation of new technologies, such as these water quality tests, need to address potential barriers that could hinder uptake despite the advantages of the new product. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of Quality Engineering Practices in Malaysian and Indonesian Automotive Related Companies

NASA Astrophysics Data System (ADS)

Putri, Nilda Tri; Sha'ri Mohd, Yusof; Irianto, Dradjad

2016-02-01

The main motivating factor driving this research is to find differences between the automotive related companies in Malaysia and Indonesia with regard to quality engineering (QE) implementation. A comparative study between Malaysia and Indonesia provides the opportunity to gain perspective and thorough understanding of the similarities and differences on the critical factors for successful QE practices in the context of both these countries. Face to face interviews are used to compare the QE practices in two automotive companies in Malaysia and Indonesia, respectively. The findings of study showed that both countries have clear quality objectives to achieving zero defects in processes and products and total customer satisfaction. Top and middle management in both countries were found to be directly involved in quality improvement on the shop floor to provide On-The-Job training and actively encourage team members to perform quality problem solving through the formation of quality control circles (QCC) particularly in Indonesia automotive industry. In Malaysia automotive industry, the implementation was not fully effective, but they have started to cultivate those values in the daily execution. Based on the case study results and analysis, the researcher has provided suggestions for both countries as an improvement plan for successful QE implementation. These recommendations will allow management to implement appropriate strategies for better QE implementation which hopefully can improve company's performance and ultimately the making the automotive industry in both countries to reach world class quality. It is strongly believed that the findings of this study can help Malaysia and Indonesia automotive industries in their efforts to become more effective and competitive.

Assessing the quality of cost management

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

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

1995-12-31

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

Are Improvements in Measured Performance Driven by Better Treatment or "Denominator Management"?

PubMed

Harris, Alex H S; Chen, Cheng; Rubinsky, Anna D; Hoggatt, Katherine J; Neuman, Matthew; Vanneman, Megan E

2016-04-01

Process measures of healthcare quality are usually formulated as the number of patients who receive evidence-based treatment (numerator) divided by the number of patients in the target population (denominator). When the systems being evaluated can influence which patients are included in the denominator, it is reasonable to wonder if improvements in measured quality are driven by expanding numerators or contracting denominators. In 2003, the US Department of Veteran Affairs (VA) based executive compensation in part on performance on a substance use disorder (SUD) continuity-of-care quality measure. The first goal of this study was to evaluate if implementing the measure in this way resulted in expected improvements in measured performance. The second goal was to examine if the proportion of patients with SUD who qualified for the denominator contracted after the quality measure was implemented, and to describe the facility-level variation in and correlates of denominator contraction or expansion. Using 40 quarters of data straddling the implementation of the performance measure, an interrupted time series design was used to evaluate changes in two outcomes. All veterans with an SUD diagnosis in all VA facilities from fiscal year 2000 to 2009. The two outcomes were 1) measured performance-patients retained/patients qualified and 2) denominator prevalence-patients qualified/patients with SUD program contact. Measured performance improved over time (P < 0.001). Notably, the proportion of patients with SUD program contact who qualified for the denominator decreased more rapidly after the measure was implemented (p = 0.02). Facilities with higher pre-implementation denominator prevalence had steeper declines in denominator prevalence after implementation (p < 0.001). These results should motivate the development of measures that are less vulnerable to denominator management, and also the exploration of "shadow measures" to monitor and reduce undesirable denominator management.

PDA survey of quality risk management practices in the pharmaceutical, devices, & biotechnology industries.

PubMed

Ahmed, Ruhi; Baseman, Harold; Ferreira, Jorge; Genova, Thomas; Harclerode, William; Hartman, Jeffery; Kim, Samuel; Londeree, Nanette; Long, Michael; Miele, William; Ramjit, Timothy; Raschiatore, Marlene; Tomonto, Charles

2008-01-01

In July 2006 the Parenteral Drug Association's Risk Management Task Force for Aseptic Processes, conducted an electronic survey of PDA members to determine current industry practices regarding implementation of Quality Risk Management in their organizations. This electronic survey was open and publicly available via the PDA website and targeted professionals in our industry who are involved in initiating, implementing, or reviewing risk management programs or decisions in their organizations. One hundred twenty-nine members participated and their demographics are presented in the sidebar "Correspondents Profile". Among the major findings are: *The "Aseptic Processing/Filling" operation is the functional area identified as having the greatest need for risk assessment and quality risk management. *The most widely used methodology in industry to identify risk is Failure Mode and Effects Analysis (FMEA). This tool was most widely applied in assessing change control and for adverse event, complaint, or failure investigations. *Despite the fact that personnel training was identified as the strategy most used for controlling/minimizing risk, the largest contributors to sterility failure in operations are still "Personnel". *Most companies still rely on "Manufacturing Controls" to mitigate risk and deemed the utilization of Process Analytical Technology (PAT) least important in this aspect. *A majority of correspondents verified that they did not periodically assess their risk management programs. *A majority of the correspondents desired to see case studies or examples of risk analysis implementation (as applicable to aseptic processing) in future PDA technical reports on risk management.

40 CFR 49.152 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... trailers to house construction management or staff and contractor personnel. Commence construction means... materials, storing of equipment or setting up temporary trailers to house construction management or staff...: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Minor New...

EPA Announces Improvements to Keep Massachusetts Waters Clean

EPA Pesticide Factsheets

Today, US EPA announced a major step forward for Massachusetts’ water quality with improved stormwater management requirements as well as an array of training and implementation tools to assist municipalities with implementation.

Antimicrobial Stewardship Program Implementation of a Quality Improvement Intervention Using Real-Time Feedback and an Electronic Order Set for the Management of Staphylococcus aureus Bacteremia.

PubMed

Rosa, Rossana; Zavala, Bruno; Cain, Natalie; Anjan, Shweta; Aragon, Laura; Abbo, Lilian M

2018-03-01

Antimicrobial stewardship programs can optimize the management of Staphylococcus aureus bacteremia by integrating information technology and microbiology laboratory resources. This study describes our experience implementing an intervention consisting of real-time feedback and the use of an electronic order set for the management of S. aureus bacteremia. Infect Control Hosp Epidemiol 2018;39:346-349.

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

PubMed

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

2013-01-01

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

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

PubMed Central

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

2013-01-01

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

[Quality management in oncology supported by clinical cancer registries].

PubMed

Klinkhammer-Schalke, Monika; Gerken, Michael; Barlag, Hagen; Tillack, Anett

2015-01-01

Efforts in nationwide quality management for oncology have so far failed to comprehensively document all levels of care. New organizational structures such as population-based clinical cancer registries or certified organ cancer centers were supposed to solve this problem more sufficiently, but they have to be accompanied by valid trans-sectoral documentation and evaluation of clinical data. To measure feasibility and qualitative effectiveness of guideline implementation we approached this problem with a nationwide investigation from 2000 to 2011. The rate of neoadjuvant radio/chemotherapy in stage UICC II/III rectum cancer, cut-off point 80% for separating good from insufficient quality, was used as a quality indicator. The nationwide analysis indicates an increase from 45% to 70%, but only with the implementation strategy of CME. The combination of new structures, evidence-based quality indicators, organ cancer center and clinical cancer registries has shown good feasibility and seems promising. Copyright © 2015. Published by Elsevier GmbH.

Data collection automation and total quality management: case studies in the health-service industry.

PubMed

Smith, Alan D; Offodile, O Felix

2008-01-01

The limitations, immeasurable, and seemly unquantifiable aspects of the healthcare service industry, make it imperative that quality assurance programs include total quality management (TQM) and automatic identification and data capture (AIDC)-related technologies. Most of standards used in TQM and AIDC require data, to measure improvement and achieve standardization. Major difference between managing a service firm and managing a product-manufacturing firm is the difficulty of achieving consistently high quality. Examination of two different healthcare service providers in the Pittsburgh, Pennsylvania area offers different views as to the implementation and practice of total quality management techniques and AIDC integration. Since the healthcare service industry must take into account its high customization needs, there are positive steps to make the hospital structure itself more patient friendly and quality related; hence improving its heath-marketing strategies to the general public.

Energy and water quality management systems for water utility's operations: a review.

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quality and Safety as a Core Leadership Competency.

PubMed

Bleich, Michael R

2018-05-01

A leader's toolbox of competencies comprises knowledge, skills, and abilities in clinical care, finance, human resource management, and more. As essential as these are, a strong command of quality and safety competencies is sovereign in leading and managing, ensuring an optimal patient experience. Four core areas of quality and safety competencies are presented: systems science, knowledge workers, implementation science and big data, and quality safety tools and techniques. J Contin Educ Nurs. 2018;49(5):200-202. Copyright 2018, SLACK Incorporated.

Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.

PubMed

Stockdale, Susan E; Zuchowski, Jessica; Rubenstein, Lisa V; Sapir, Negar; Yano, Elizabeth M; Altman, Lisa; Fickel, Jacqueline J; McDougall, Skye; Dresselhaus, Timothy; Hamilton, Alison B

Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread. We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques. All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues. Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support were critical. In order to successfully facilitate systematic, sustainable primary care quality improvement, regional and executive health care system leaders should engage interdisciplinary practice level leadership in a priority-setting process that encourages frontline innovation and establish local structures such as quality councils to coordinate quality improvement initiatives, ensure accountability, and promote spread of best practices.

Information Architecture for Quality Management Support in Hospitals.

PubMed

Rocha, Álvaro; Freixo, Jorge

2015-10-01

Quality Management occupies a strategic role in organizations, and the adoption of computer tools within an aligned information architecture facilitates the challenge of making more with less, promoting the development of a competitive edge and sustainability. A formal Information Architecture (IA) lends organizations an enhanced knowledge but, above all, favours management. This simplifies the reinvention of processes, the reformulation of procedures, bridging and the cooperation amongst the multiple actors of an organization. In the present investigation work we planned the IA for the Quality Management System (QMS) of a Hospital, which allowed us to develop and implement the QUALITUS (QUALITUS, name of the computer application developed to support Quality Management in a Hospital Unit) computer application. This solution translated itself in significant gains for the Hospital Unit under study, accelerating the quality management process and reducing the tasks, the number of documents, the information to be filled in and information errors, amongst others.

Lecturers' and Students' Perception on Educational Policy Implementation Factors as Predictors for Quality Education in Nigerian Universities

ERIC Educational Resources Information Center

Oredein, Afolakemi O.; Durojaye, Toluwase G.

2012-01-01

This study is based on lecturers' and students' perception on educational policy implementation factors and quality education in Nigerian universities. Educational policies have always been formulated purposely to guide the present and future thinking, actions and decisions of managers. The potency of policy is not in formulation but in its proper…

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

PubMed Central

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill

2013-01-01

Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859

Implementing and evaluating a multicomponent inpatient diabetes management program: putting research into practice.

PubMed

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M; Golden, Sherita Hill

2012-05-01

Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. CONCEPTUAL MODEL COMPONENTS: The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staffwhile incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Overall the average patient-day-weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives.

Facilitators and Barriers to Implementing Clinical Governance: A Qualitative Study among Senior Managers in Iran.

PubMed

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

2014-09-01

Health care systems should assign quality improvement as their main mission. Clinical governance (CG) is a key strategy to improve quality of health care services. The Iranian Ministry of Health and Medical Education (MOHME) has promoted CG as a framework for safeguarding quality and safety in all hospitals since 2009. The purpose of this study was to explore perceived facilitators and barriers to implementing CG by deputies for curative affairs of Iranian medical universities. A qualitative study was conducted using face to face interviews with a purposeful sample of 43 deputies for curative affairs of Iranian Medical Universities and documents review. Thematic analysis was used to analyze the data. Five themes were explored including: knowledge and attitude toward CG, culture, organizational factors, managerial factors and barriers. The main perceived facilitating factors were adequate knowledge and positive attitude toward CG, supporting culture, managers' commitment, effective communication and well designed incentives. Pe rceived barriers were the reverse of facilitators noted above in addition to insufficient resources, legal challenges, workload and parallel quality programs. Successful implementation of CG in Iran will require identifying barriers and challenges existing in the way of CG implementation and try to mitigate them by using appropriate facilitators.

A Review of Quality Assurance Methods to Assist Professional Record Keeping: Implications for Providers of Interpersonal Violence Treatment

PubMed Central

Bradshaw, Kelsey M.; Donohue, Brad; Wilks, Chelsey

2014-01-01

Errors have been found to frequently occur in the management of case records within mental health service systems. In cases involving interpersonal violence, such errors have been found to negatively impact service implementation and lead to significant trauma and fatalities. In an effort to ensure adherence to specified standards of care, quality assurance programs (QA) have been developed to monitor and enhance service implementation. These programs have generally been successful in facilitating record management. However, these systems are rarely disseminated, and not well integrated. Therefore, within the context of interpersonal violence, we provide an extensive review of evidence supported record keeping practices, and methods to assist in assuring these practices are implemented with adherence. PMID:24976786

A Guide for Implementing Total Quality Management in the U.S. Coast Guard Reserve

DTIC Science & Technology

1991-12-01

quality field were reviewed. The main ones studied were: Total Quality (Deming 1988); Single-Minute Exchange of Die (SMED) (Shingo 1985); Poka - yoke (mistake...Productivity Press, 1985. Shingo, Shigeo. Zero Quality Control: Source Inspection and the Poka - Yoke System. Cambridge, MA: Productivity Press, 1986. Snead

Sharpening policy instruments with catchment evaluations and the water quality continuum

NASA Astrophysics Data System (ADS)

Jordan, P.; Melland, A. R.; Mellander, P.-E.; Murphy, P.; Shortle, G.; Wall, D.; Mechan, S.; Shine, O.

2012-04-01

There is a scale dichotomy in water quality management in European agricultural catchments due to the fact that impacts identified at river basin scale are mitigated by management that is typically asserted from research at field or plot scale and implemented at farm scale. Evaluations of management impact are then undertaken back at the river basin scale. The policy instruments in place to mitigate water quality impacts are also based on the integration of scientific research and stakeholder negotiations and can sometimes be blunt compromises. Nevertheless, expectations of accruing water quality benefits remain high and sometimes unchallenged. Evaluating all catchment components of a pollution transfer continuum from source to impact enables important elements such as lag time between policy implementation and water quality response, water body sampling frequency and allocation of correct dose-response mechanisms to be assessed. These points are particularly important in complex agricultural catchments where multiple nutrient pollution sources have variable impacts on different water body types - and at different times of year. The tools of catchment water quality policy evaluation are diverse and include metrics of natural resource management, soil and water chemistry, hydrology, ecology and palaeolimnology. Used in combination and with river basin scale and site-specific data inventories, they can provide a powerful suite of evidence for further iterations of water quality policy and projecting realistic expectations of policy success.

Implementation of occupational health service improvements through application of total quality management processes.

PubMed

Thomas, Elizabeth Anne

2011-06-01

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

Evaluation of the Impact of Quality Management Systems on School Climate

ERIC Educational Resources Information Center

Egido Gálvez, Inmaculada; Fernández Cruz, Francisco José; Fernández Díaz, Mª José

2016-01-01

Purpose: Implementation of quality management systems in educational institutions has gradually increased over the last few decades, even though there are still questions about the actual usefulness of these systems for improving school processes and outcomes. The purpose of this paper is to take an in-depth look at the impact, understood as…

California State Implementation Plan; Final Approval of Revision; Yolo-Solano Air Quality Management District; Reasonably Available Control Technology Requirements for 1997 8-hour Ozone NAAQS

EPA Pesticide Factsheets

EPA is taking final action to approve a revision to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California SIP concerning YSAQMD regarding RACT)requirements the 1997 8-hour ozone NAAQS and approve negative declarations into SIP.

77 FR 71404 - Intent To Prepare an Environmental Impact Statement for the Proposed Flood Risk Management Study...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-30

... Policy Act (NEPA) of 1969 as implemented by the Council on Environmental Quality regulations (40 CFR... specifically, this document will discuss measures to improve flood risk management, navigation, water quality.... The overall goal of the study is to reduce flood risk by saving lives and minimizing property damage...

"Advances in Linked Air Quality, Farm Management and Biogeochemistry Models to Address Bidrectional Ammonia Flux in CMAQ"

EPA Science Inventory

Recent increases in anthropogenic inputs of nitrogen to air, land and water media pose a growing threat to human health and ecosystems. Modeling of air-surface N flux is one area in need of improvement. Implementation of a linked air quality and cropland management system is de...

Care Planning, Quality Assurance, and Personnel Management in Long-Term Care Facilities. Final Report.

ERIC Educational Resources Information Center

Patchner, Michael A.; Balgopal, Pallassana R.

Three studies were undertaken to examine topics of care planning, personnel management, and quality assurance in long-term care facilities. The first study examined the formulation and implementation processes of care planning for nursing home residents. The exemplary homes' care planning included the existence of strong care planning leadership,…

New Controls and Accountability for South African Teachers and Schools: The Integrated Quality Management System

ERIC Educational Resources Information Center

Weber, Everard

2005-01-01

This article analyses the Integrated Quality Management System (IQMS), an agreement reached in 2003 between the South African Education Department and the major teacher organisations in the country by using discourse analysis. The IQMS was scheduled to be implemented in public schools in 2004. Three discursive tensions are identified and…

Towards More Efficient Student Course Evaluations for Use at Management Level

ERIC Educational Resources Information Center

Rønsholdt, Bent; Brohus, Henrik

2014-01-01

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

Applying Knowledge-Based Methods to Design and Implement an Air Quality Workshop

Treesearch

Daniel L. Schmoldt; David L. Peterson

1991-01-01

In response to protection needs in class I wilderness areas, forest land managers of the USDA Forest Service must provide input to regulatory agencies regarding air pollutant impacts on air quality-related values. Regional workshops have been convened for land managers and scientists to discuss the aspects and extent of wilderness protection needs. Previous experience...

Advances in Linked Air Quality, Farm Management and Biogeochemistry Models to Address Bidirectional Ammonia Flux in CMAQ

EPA Science Inventory

Recent increases in anthropogenic inputs of nitrogen to air, land and water media pose a growing threat to human health and ecosystems. Modeling of air-surface N flux is one area in need of improvement. Implementation of a linked air quality and cropland management system is de...

The Evidence for a Risk-Based Approach to Australian Higher Education Regulation and Quality Assurance

ERIC Educational Resources Information Center

Edwards, Fleur

2012-01-01

This paper explores the nascent field of risk management in higher education, which is of particular relevance in Australia currently, as the Commonwealth Government implements its plans for a risk-based approach to higher education regulation and quality assurance. The literature outlines the concept of risk management and risk-based approaches…

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

PubMed

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

2018-06-11

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

The impact of SLMTA in improving laboratory quality systems in the Caribbean Region.

PubMed

Guevara, Giselle; Gordon, Floris; Irving, Yvette; Whyms, Ismae; Parris, Keith; Beckles, Songee; Maruta, Talkmore; Ndlovu, Nqobile; Albalak, Rachel; Alemnji, George

Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow. To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA) training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS). Audits were conducted at baseline, six months, exit (at 12 months) and post-SLMTA (at 18 months) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

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

PubMed

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

2012-01-01

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

Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success.

PubMed

Rangachari, Pavani

2018-01-01

In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as "innovation implementation failure" in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the "what"), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the "how"). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health care innovations. This paper summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues.

Service quality: understanding and implementing the concept in the clinical laboratory. Match service quality to consumer expectations.

PubMed

O'Connor, S J

1989-01-01

The increasingly competitive health-care marketplace has mandated that health-care managers pay careful attention to the issue of quality from the perspective of the consumer. The importance of this issue is underscored by the fact that numerous health-care institutions and associations have recently begun to recognize the urgent need to obtain a greater understanding of service quality in a health-care situation. This article suggests means to understand, identify, improve, and implement effective approaches to this vital aspect of the marketing mix.

Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model.

PubMed

Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Vafaee Najar, Ali; Meraji, Marziye; Ebrahimipour, Hossein

2015-04-08

The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety. © 2015 by Kerman University of Medical Sciences.

Effects of organizational context on Lean implementation in five hospital systems.

PubMed

Harrison, Michael I; Paez, Kathryn; Carman, Kristin L; Stephens, Jennifer; Smeeding, Lauren; Devers, Kelly J; Garfinkel, Steven

2016-01-01

Despite broad agreement among researchers about the value of examining how context shapes implementation of improvement programs and projects, limited attention has been paid to contextual effects on implementation of Lean. To help reduce gaps in knowledge of effects of intraorganizational context, we researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. All projects aimed at improving clinical care delivery. On the basis of the literature on Lean, innovation, and quality improvement, we developed a framework of factors likely to affect Lean implementation and outcomes. Drawing on the framework, we conducted semistructured interviews and applied qualitative codes to the transcribed interviews. Available documents, data, and observations supplemented the interviews. We constructed case studies of Lean implementation in each organization, compared implementation across organizations, and compared the 12 projects. Intraorganizational characteristics affecting organization-wide Lean initiatives and often also shaping project outcomes included CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, alignment of the Lean initiative with the organizational mission, dedication of resources and experts to Lean, staff training before and during projects, establishment of measurable and relevant project targets, planning of project sequences that enhance staff capabilities and commitment without overburdening them, and ensuring communication between project members and other affected staff. Dependence of projects on inputs of new information technology was a barrier to project success. Incremental implementation of Lean produced reported improvements in operational efficiency and occasionally in care quality. However, even under the relatively favorable circumstances prevailing in our study sites, incremental implementation did not readily change organizational culture. This study should alert researchers, managers, and teachers of management to ways that contexts shape Lean implementation and may affect other types of process redesign and quality improvement.

First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.

PubMed

Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

2014-01-01

The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal

PubMed Central

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M. Juliana; Hural, John

2014-01-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×106 ±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8–3.2×106 cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%–130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. PMID:24709391

EPA Announces Improvements to Keep New Hampshire Waters Clean

EPA Pesticide Factsheets

Today, US EPA announced a major step forward for New Hampshire’ water quality with improved stormwater management requirements as well as an array of training and implementation tools to assist municipalities with implementation.

Electronic audit and feedback intervention with action implementation toolbox to improve pain management in intensive care: protocol for a laboratory experiment and cluster randomised trial.

PubMed

Gude, Wouter T; Roos-Blom, Marie-José; van der Veer, Sabine N; de Jonge, Evert; Peek, Niels; Dongelmans, Dave A; de Keizer, Nicolette F

2017-05-25

Audit and feedback is often used as a strategy to improve quality of care, however, its effects are variable and often marginal. In order to learn how to design and deliver effective feedback, we need to understand their mechanisms of action. This theory-informed study will investigate how electronic audit and feedback affects improvement intentions (i.e. information-intention gap), and whether an action implementation toolbox with suggested actions and materials helps translating those intentions into action (i.e. intention-behaviour gap). The study will be executed in Dutch intensive care units (ICUs) and will be focused on pain management. We will conduct a laboratory experiment with individual ICU professionals to assess the impact of feedback on their intentions to improve practice. Next, we will conduct a cluster randomised controlled trial with ICUs allocated to feedback without or feedback with action implementation toolbox group. Participants will not be told explicitly what aspect of the intervention is randomised; they will only be aware that there are two variations of providing feedback. ICUs are eligible for participation if they submit indicator data to the Dutch National Intensive Care Evaluation (NICE) quality registry and agree to allocate a quality improvement team that spends 4 h per month on the intervention. All participating ICUs will receive access to an online quality dashboard that provides two functionalities: gaining insight into clinical performance on pain management indicators and developing action plans. ICUs with access to the toolbox can develop their action plans guided by a list of potential barriers in the care process, associated suggested actions, and supporting materials to facilitate implementation of the actions. The primary outcome measure for the laboratory experiment is the proportion of improvement intentions set by participants that are consistent with recommendations based on peer comparisons; for the randomised trial it is the proportion of patient shifts during which pain has been adequately managed. We will also conduct a process evaluation to understand how the intervention is implemented and used in clinical practice, and how implementation and use affect the intervention's impact. The results of this study will inform care providers and managers in ICU and other clinical settings how to use indicator-based performance feedback in conjunction with an action implementation toolbox to improve quality of care. Within the ICU context, this study will produce concrete and directly applicable knowledge with respect to what is or is not effective for improving pain management, and under which circumstances. The results will further guide future research that aims to understand the mechanisms behind audit and feedback and contribute to identifying the active ingredients of successful interventions. ClinicalTrials.gov NCT02922101 . Registered 26 September 2016.

Hospital quality: a product of good management as much as good treatment.

PubMed

Hyde, Andy; Frafjord, Anders

2013-01-01

In Norway, as in most countries, the demands placed on hospitals to reduce costs and improve the quality of services are intense. Although many say that improving quality reduces costs, few can prove it. Futhermore, how many people can show that improving quality improves patient satisfaction. Diakonhjemmet hospital in Norway has designed and implemented a hospital management system based on lean principles and the PDCA (Plan-Do-Check-Act) quality circle introduced by WE Deming (Deming 2000). The results are quite impressive with improvements in quality and patient satisfaction. The hospital also runs at a profit.

[Quality management in implementing specialist pediatric palliative home care in Lower Saxony, Germany].

PubMed

Kremeike, Kerstin; Eulitz, Nina; Sens, Brigitte; Geraedts, Max; Reinhardt, Dirk

2012-01-01

To provide comprehensive high-quality health care is a great challenge in the context of high specialisation and intensive costs. This problem becomes further aggravated in service areas with low patient numbers and low numbers of specialists. Therefore, a multidimensional approach to quality development was chosen in order to optimise the care of children and adolescents with life-limiting conditions in Lower Saxony, a German federal state with a predominantly rural infrastructure. Different service structures were implemented and a classification of service provider's specialisation was defined on the basis of existing references of professional associations. Measures to optimise care were implemented in a process-oriented manner. High-quality health care can be facilitated by carefully worded requirements concerning the quality of structures combined with optimally designed processes. Parts of the newly implemented paediatric palliative care structures are funded by the statutory health insurance. Copyright © 2012. Published by Elsevier GmbH.

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.

Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

PubMed

Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

2015-04-01

The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

[RehaFuturReal®: Evaluation of Implementation in Organizational Structure and in Counseling Process - An Overview of Results].

PubMed

Arling, V; Knispel, J; Spijkers, W

2016-08-01

Due to prevailing future challenges in vocational rehabilitation, development process RehaFutur (BMAS) was initiated. In this context, recommendations were made to secure a future-oriented, innovative vocational rehabilitation in Germany. Deutsche Rentenversicherung (DRV) Westfalen transferred these recommendations into a new and applicable counseling concept RehaFutuReal(®). Rehabilitation managers (RM) are central protagonists in counseling process. Therefore, RehaFuturReal(®) focused on optimization of counseling performance. To achieve this aim, rehabilitation managers were taught to work with a case management (CM) based approach. RWTH Aachen supported RehaFuturReal(®) from an academic point of view and conducted a formative and summative evaluation. Primary aim of RWTH Aachen was to support DRV Westfalen during implementation of RehaFuturReal(®) into their organizational structure. Additionally, RWTH Aachen controlled whether transfer of RehaFutuReal(®) in counseling process was successful. From 04-01-13 until 12-31-14, RehaFuturReal(®) was tested by DRV Westfalen in the intervention district Dortmund with 10 RM. There were 3 selection criteria for the overall sample of N=320 insurants: participants were required to have an active employment status, suffered from integration issues and were in need of support to achieve vocational integration. Evaluation of RehaFuturReal(®) was realized summative (pre-post-comparison) and formative (process-orientated). Evaluative judgment regarding implementation in organizational structure and counseling process was performed by using three-stage-concept of Donabedian (quality of structure, process and results). Thereby, feedback of RM, insurants and employers was taken into account. Analysis of evaluation results revealed a positive overall impression. Implementation into organizational structure was successful on all 3 quality stages: concept of project and CM-training were an adequate basis and appropriately put into practice by fulfilling prescribed objectives, topics and schedule (quality of structure). Rehabilitation managers identified themselves with the implementation process into DRV Westfalen (grading of CM training: M=1,67; SD=0,65; quality of process). Analogous, consultants reported a high level of satisfaction during implementation of new counseling process (possible span: 1-4; M=3,11; SD=0,33; quality of results). Regarding implementation of counseling process, sample fitted into 3 selection criteria wherefore the correct insurants were picked in RehaFuturReal(®) (quality of structure). CM-orientated counseling approach was properly implemented into everyday work of RM by using CM-instruments for documentation (quality of process). RM were highly satisfied (possible span: 1-4) with counseling performance (M=3,43; SD=0,77). Employers also rated counseling performance positively (M=3,38; SD=0,85). By contrast, surveying insurants revealed a heterogeneous impression of satisfaction (M=2,97; SD=1,03) (quality of results). © Georg Thieme Verlag KG Stuttgart · New York.

Quality management systems for your in vitro fertilization clinic's laboratory: Why bother?

PubMed

Olofsson, Jan I; Banker, Manish R; Sjoblom, Late Peter

2013-01-01

Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF) clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART) laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services. This review contains the proceedings a quality management session at the Indian Fertility Experts Meet (IFEM) 2010 and focuses on the creation of a patient-oriented best-in-class IVF laboratory.

Quality management systems for your in vitro fertilization clinic's laboratory: Why bother?

PubMed Central

Olofsson, Jan I; Banker, Manish R; Sjoblom, Late Peter

2013-01-01

Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF) clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART) laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services. This review contains the proceedings a quality management session at the Indian Fertility Experts Meet (IFEM) 2010 and focuses on the creation of a patient-oriented best-in-class IVF laboratory. PMID:23869142

Quality Control and Nondestructive Evaluation Techniques for Composites. Part 1. Overview of Characterization Techniques for Composite Reliability

DTIC Science & Technology

1982-05-01

MONITORING AND MANAGEMENT , 34 7.0 NONDESTRUCTIVE EVALUATION ( NDE ) 37 8. 0 SURFACE NDE 44 9.0 PERFORMANCE AND PROOF TESTING 46 10.0 SUMMARY AND...Chemical Quality Assurance Testing 2. Processability Testing 3. Cure Monitoring and Management 4. Nondestructive Evaluation ( NDE ) 5. Performance and...the management concept for implementing the specific tests. Chemical analysis, nondestructive evaluation ( NDE ) and environmental fatigue testing of

Performance Management: The Neglected Imperative of Accountability Systems in Education

ERIC Educational Resources Information Center

Mosoge, M. J.; Pilane, M. W.

2014-01-01

The first aim of this paper is to clarify the concept "performance management" as an aspect of the Integrated Quality Management System (IQMS). The second is to report on an exploration into the experiences and perceptions of management teams in the implementation of performance management. As part of the qualitative research design, the…

Case management for the subacute patient in a skilled nursing facility.

PubMed

Carr, D D

2000-01-01

The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

Optimal implementation of best management practices to improve agricultural hydrology and water quality

NASA Astrophysics Data System (ADS)

Liu, Y.; Engel, B.; Collingsworth, P.; Pijanowski, B. C.

2017-12-01

Nutrient loading from the Maumee River watershed is a significant reason for the harmful algal blooms (HABs) problem in Lake Erie. Strategies to reduce nutrient loading from agricultural areas in the Maumee River watershed need to be explored. Best management practices (BMPs) are popular approaches for improving hydrology and water quality. Various scenarios of BMP implementation were simulated in the AXL watershed (an agricultural watershed in Maumee River watershed) using Soil and Water Assessment Tool (SWAT) and a new BMP cost tool to explore the cost-effectiveness of the practices. BMPs of interest included vegetative filter strips, grassed waterways, blind inlets, grade stabilization structures, wetlands, no-till, nutrient management, residue management, and cover crops. The following environmental concerns were considered: streamflow, Total Phosphorous (TP), Dissolved Reactive Phosphorus (DRP), Total Kjeldahl Nitrogen (TKN), and Nitrate+Nitrite (NOx). To obtain maximum hydrological and water quality benefits with minimum cost, an optimization tool was developed to optimally select and place BMPs by connecting SWAT, the BMP cost tool, and optimization algorithms. The optimization tool was then applied in AXL watershed to explore optimization focusing on critical areas (top 25% of areas with highest runoff volume/pollutant loads per area) vs. all areas of the watershed, optimization using weather data for spring (March to July, due to the goal of reducing spring phosphorus in watershed management plan) vs. full year, and optimization results of implementing BMPs to achieve the watershed management plan goal (reducing 2008 TP levels by 40%). The optimization tool and BMP optimization results can be used by watershed groups and communities to solve hydrology and water quality problems.

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

PubMed

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

2016-01-01

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

Implementing Knowledge Management as a Strategic Initiative

DTIC Science & Technology

2003-12-01

Quality Management (TQM); Development Metrics Standards; Philosophy Hierarchical, Centralized or Decentralized; Sociolinguistics ...disciplines of operations research, logic, psychology, philosophy, sociolinguistics , management science, management information science, organizational...needs of customers for America and its Allies.” (CECOM AC Strategic Plan, 2001) Given the mission and vision statements, an organization needs to

Developing a Holistic Model for Quality in Higher Education.

ERIC Educational Resources Information Center

Srikanthan, G.; Dalrymple, John F.

2002-01-01

Proposes a holistic model for quality management in higher education which incorporates both service and academic functions. Discusses the crucial role played by organizational culture in implementation of any quality strategy, and asserts that ideal organizational behavior embodies the "learning communities" concept. (EV)

DCASR (Defense Contract Administration Services Region) Dallas Total Quality Management Implementation Plan

DTIC Science & Technology

1989-07-01

Competitive Success e. What is Total Quality Kaoru Ishikawa Control? The Japanese Way f. Managerial Break Through J. M. Juran g. The Deming Route to...Berger and Thomas H. Hart p. Juran’s Quality Control J. M. Juran Handbook, Fourth Edition q. Guide to Quality Control Kaoru Ishikawa r. Quality Assurance

Farmer Heroes Manage Nutrients On Farm

EPA Pesticide Factsheets

These featured farmers have been identified by the National Association of Conservation Districts and EPA for implementing specific best management practices to reduce pollution while also improving or sustaining their profits, soil quality or yields.

Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success

PubMed Central

Rangachari, Pavani

2018-01-01

In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as “innovation implementation failure” in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on “innovation implementation” in hospitals and health systems over the last decade, since the spotlight was cast on “innovation implementation failure” in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the “what”), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the “how”). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health care innovations. This paper summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues. PMID:29546884

Experimenting Design and Implementation of an Educational Services Management System Based on ISO/IEC 20000 Standard

NASA Astrophysics Data System (ADS)

Lezcano, Jean-Marc; Adachihara, Hatsuo; Prunier, Marc

European higher education organizations are encouraged to implement quality management practices. Existing quality standards and frameworks do not capitalize an important set of best practices addressing educational services delivery. The ISO/IEC 20000 standard, elaborated from IT service management issues, is widening its field of application and may represent an interesting alternative. A specific approach is needed to apprehend the particular nature of educational services, consider the systemic cooperating roles of educational system and learning system, and define ISO/IEC 20000 vocabulary and concepts adapted to the domain. ISO/IEC 20000 may provide an answer to European Standard Guideline compliance and improve educational services management. The current experimentation is expected to cast light on the complexity, practicality and effectiveness of the use of ISO/IEC 20000 in a first field of "non IT" services.

The impact of parity on major depression treatment quality in the Federal Employees' Health Benefits Program after parity implementation.

PubMed

Busch, Alisa B; Huskamp, Haiden A; Normand, Sharon-Lise T; Young, Alexander S; Goldman, Howard; Frank, Richard G

2006-06-01

Since the 1990s, parity laws have been implemented to reduce inequities in mental health coverage compared with that for general medical conditions. It is unclear if parity under managed care is associated with improvements in mental health treatment quality. Major depressive disorder (MDD) is a prevalent but often undetected and undertreated and thus could potentially benefit from parity implementation. The objective of this study was to examine the association between parity implementation and changes in MDD treatment quality in the Federal Employees' Health Benefits (FEHB) Program. We conducted retrospective analyses of insurance claims data. Logistic regression models estimated quality changes for MDD-diagnosed enrollees from pre- to postparity. Subjects included MDD-diagnosed FEHB insured enrollees, aged 18-64, across multiple states and 6 FEHB plans before (1999-2000) and after (2001-2002) parity implementation. Measures included receipt of any antidepressant or psychotherapy within a given calendar year of diagnosis; receipt of appropriate psychotherapy frequency/intensity and duration; and pharmacotherapy duration during acute-phase treatment episodes. Postparity, several plans improved significantly in the likelihood of receiving antidepressant medication. In the acute-phase episodes, the greatest improvement was seen in the likelihood of follow up >or=4 months. Few or no other changes were observed in the acute-phase treatment intensity or duration quality measures. Parity under managed care was associated with modest improvements. The observed improvements were consistent with secular trends in MDD treatment. Whereas mental health parity is an important policy goal, these results highlight its limitations: improving the financing of care may not be sufficient to improve quality.

Forestry BMP Implementation Costs for Virginia

Treesearch

R.M. Shaffer; H.L. Haney; E.G. Worrell; W.M. Aust

1998-01-01

Forestry Best Management Practices (BMPs) are operational techniques used to protect water quality during timber harvesting operations. The implementation cost of BMPs is important to loggers, forest landowners, and the forest industry. This study provides an estimate of BMP implementation cost on a per harvested acre basis for the coastal plain, Piedmont, and...

[The opinion of personnel of medical organizations concerning effectiveness of systems of quality management and international certification].

PubMed

Lindenbraten, A L; Dubinin, N D; Ludupova, E Yu; Kriutchkov, D V; Nikolaev, N S; Dubograii, E V

2016-01-01

The sociological study was carried out concerning effectiveness of systems of quality management. The technique of questionnaire survey was implemented in medical organizations with functioning systems of quality management and internationally certified systems. The evaluation by medical personnel impact of system of quality management on their activities based on results of using the given management sub-system was selected as a study object. At that, opinion ofpersonnel concerning time dynamics of indices of activity was served as a study subject. The involvement of personnel, alterations in activities of organization, remuneration of labor, effectiveness of treatment from point of view of organizations' staff members were considered. The conclusion was made that personnel of considered organizations has favorable opinion concerning effectiveness of the given systems. Among particular characteristics ofmedical care, 67% of respondents marked improvement of organization of functioning and 36% out of them marked significant improvement. The most of respondents (69%) felt positive dynamics of activities. At that, personnel of organizations mark no increasing of income in 68% of all cases and only 24% of respondents indicated salary increasing. Among negative outcomes of implementation of system of quality management, the respondents focused on increasing of workload. This trend was marked by 53% of personnel and 30% out of them indicated significant increasing of workload. The absence of alterations was marked by 38% of respondents and decreasing of workload was confirmed only by 9% of respondents.

How Are the Results of Quality Assurance Programs Used to Inform Practices at a Distance Higher Education?

ERIC Educational Resources Information Center

Darojat, Ojat

2018-01-01

This paper is to examine the implementation of quality assurance (QA) programs in distance higher education. Different challenges related to the development of QA programs at a distance higher institution and how to manage and implement the programs are discussed to show how the programs have been used to ensure the survival of the institution. A…

Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

PubMed

Tao, Ziqi

2015-06-01

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

Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative.

PubMed

Gimbel, Sarah; Mwanza, Moses; Nisingizwe, Marie Paul; Michel, Cathy; Hirschhorn, Lisa

2017-12-21

High-quality data are critical to inform, monitor and manage health programs. Over the seven-year African Health Initiative of the Doris Duke Charitable Foundation, three of the five Population Health Implementation and Training (PHIT) partnership projects in Mozambique, Rwanda, and Zambia introduced strategies to improve the quality and evaluation of routinely-collected data at the primary health care level, and stimulate its use in evidence-based decision-making. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this paper: 1) describes and categorizes data quality assessment and improvement activities of the projects, and 2) identifies core intervention components and implementation strategy adaptations introduced to improve data quality in each setting. The CFIR was adapted through a qualitative theme reduction process involving discussions with key informants from each project, who identified two domains and ten constructs most relevant to the study aim of describing and comparing each country's data quality assessment approach and implementation process. Data were collected on each project's data quality improvement strategies, activities implemented, and results via a semi-structured questionnaire with closed and open-ended items administered to health management information systems leads in each country, with complementary data abstraction from project reports. Across the three projects, intervention components that aligned with user priorities and government systems were perceived to be relatively advantageous, and more readily adapted and adopted. Activities that both assessed and improved data quality (including data quality assessments, mentorship and supportive supervision, establishment and/or strengthening of electronic medical record systems), received higher ranking scores from respondents. Our findings suggest that, at a minimum, successful data quality improvement efforts should include routine audits linked to ongoing, on-the-job mentoring at the point of service. This pairing of interventions engages health workers in data collection, cleaning, and analysis of real-world data, and thus provides important skills building with on-site mentoring. The effect of these core components is strengthened by performance review meetings that unify multiple health system levels (provincial, district, facility, and community) to assess data quality, highlight areas of weakness, and plan improvements.

40 CFR 49.140 - Introduction.

Code of Federal Regulations, 2013 CFR

2013-07-01

...: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian Reservation (mandan..., production operations, and storage operations at existing, new and modified oil and natural gas production...

40 CFR 49.140 - Introduction.

Code of Federal Regulations, 2014 CFR

2014-07-01

...: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian Reservation (mandan..., production operations, and storage operations at existing, new and modified oil and natural gas production...

The role of disease management programs in the health behavior of chronically ill patients.

PubMed

Cramm, Jane Murray; Adams, Samantha A; Walters, Bethany Hipple; Tsiachristas, Apostolos; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P M H; Nieboer, Anna Petra

2014-04-01

Investigate the effects of disease management program (DMP) implementation on physical activity, smoking, and physical quality of life among chronically ill patients. This study used a mixed-methods approach involving qualitative (35 interviews with project managers) and quantitative (survey of patients from 18 DMPs) data collection. Questionnaire response rates were 51% (2010; 2619/5108) at T0 and 47% (2011; 2191/4693) at T1. Physical activity and the percentage of smokers improved significantly over time, whereas physical quality of life declined. After adjusting for patients' physical quality of life at T0, age, educational level, marital status, and gender, physical activity at T0 (p<0.01), changes in physical activity (p<0.001), and percentage of smokers at T0 (p<0.05) predicted physical quality of life at T1. Project managers reported that DMPs improved patient-professional interaction. The ability to set more concrete targets improved patients' health behaviors. DMPs appear to improve physical activity among chronically ill patients over time. Furthermore, (changes in) health behavior are important for the physical quality of life of chronically ill patients. Redesigning care systems and implementing DMPs based on the chronic care model may improve health behavior among chronically ill patients. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The tissue bank at the Instituto Nacional de Investigaciones Nucleares: ISO 9001:2000 certification of its quality management system.

PubMed

Martínez-Pardo, María Esther; Mariano-Magaña, David

2007-01-01

Tissue banking is a complex operation concerned with the organisation and coordination of all the steps, that is, from donor selection up to storage and distribution of the final products for therapeutic, diagnostic, instruction and research purposes. An appropriate quality framework should be established in order to cover all the specific methodology as well as the general aspects of quality management, such as research and development, design, instruction and training, specific documentation, traceability, corrective action, client satisfaction, and the like. Such a framework can be obtained by developing a quality management system (QMS) in accordance with a suitable international standard: ISO 9001:2000. This paper presents the implementation process of the tissue bank QMS at the Instituto Nacional de Investigaciones Nucleares in Mexico. The objective of the paper is to share the experience gained by the tissue bank personnel [radiosterilised tissue bank (BTR)] at the Instituto Nacional de Investigaciones Nucleares (ININ, National Institute of Nuclear Research), during implementation of the ISO 9001:2000 certification process. At present, the quality management system (QMS) of ININ also complies with the Mexican standard NMX-CC-9001:2000. The scope of this QMS is Research, Development and Processing of Biological Tissues Sterilised by Gamma Radiation, among others.

KCBX Quality Assurance Project Plan - October 2014

EPA Pesticide Factsheets

This revised plan's standards for data quality, sampling and testing methods, and task management guide the implementation of Ambient Air Monitoring by URS Corporation at the KCBX Terminals Company North and South Terminals in Chicago, Ill.

KCBX Quality Assurance Project Plan - February 2014

EPA Pesticide Factsheets

This plan's standards for data quality, sampling and testing methods, and task management guide the implementation of Ambient Air Monitoring, by URS Corporation, at the KCBX Terminals Company North and South Terminals in Chicago, IL.

Assessing quality in volcanic ash soils

Treesearch

Terry L. Craigg; Steven W. Howes

2007-01-01

Forest managers must understand how changes in soil quality resulting from project implementation affect long-term productivity and watershed health. Volcanic ash soils have unique properties that affect their quality and function; and which may warrant soil quality standards and assessment techniques that are different from other soils. We discuss the concept of soil...

Increasing nursing treatment for pediatric procedural pain.

PubMed

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

2014-03-01

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

The Role of "Meeting Pupil Needs and Empowering Staff" in Quality Management System

ERIC Educational Resources Information Center

Cheng, Alison Lai Fong; Yau, Hon Keung

2012-01-01

The study aims to examine the effectiveness of the implementation of "Meeting Pupil Needs and Empowering Staff" in the quality management in Hong Kong primary schools. A case study of nine primary schools was conducted and a qualitative method of interviews was adopted in this study. A total of 9 principals and 9 teachers from 9 primary…

A Strategy for Improved System Assurance

DTIC Science & Technology

2007-06-20

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

Middle Managers' Experience of Policy Implementation and Mediation in the Context of the Scottish Quality Enhancement Framework

ERIC Educational Resources Information Center

Saunders, Murray; Sin, Cristina

2015-01-01

This paper analyses how middle managers perform and experience their role in enacting policy in Scottish higher education institutions. The policy focus is the quality enhancement framework (QEF) for learning and teaching in higher education, which was launched in 2003. The data-set was collected between 2008 and 2010, during the evaluation of the…

77 FR 39181 - Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... Register on February 28, 2012 and concern glass furnaces and biomass boilers. We are approving local rules... MDAQMD 1165 Glass Melting Furnaces......... 08/12/08 12/23/08 YSAQMD 2.43 Biomass Boilers 11/10/10 04/05.... * * * * * (388) * * * (i) * * * (F) Yolo-Solano Air Quality Management District. (1) Rule 2.43, ``Biomass Boilers...

The evolution of diagnosis-related groups (DRGs): from its beginnings in case-mix and resource use theory, to its implementation for payment and now for its current utilization for quality within and outside the hospital.

PubMed

Goldfield, Norbert

2010-01-01

Policymakers are searching for ways to control health care costs and improve quality. Diagnosis-related groups (DRGs) are by far the most important cost control and quality improvement tool that governments and private payers have implemented. This article reviews why DRGs have had this singular success both in the hospital sector and, over the past 10 years, in ambulatory and managed care settings. Last, the author reviews current trends in the development and implementation of tools that have the key ingredients of DRG success: categorical clinical model, separation of the clinical model from payment weights, separate payment adjustments for nonclinical factors, and outlier payments. Virtually all current tools used to manage health care costs and improve quality do not have these characteristics. This failure explains a key reason for the failure, for example, of the Medicare Advantage program to control health care costs. This article concludes with a discussion of future developments for DRG-type models outside the hospital sector.

Total quality management practices in Malaysia healthcare industry

NASA Astrophysics Data System (ADS)

Ahmad, Md Fauzi; Nee, Phoi Soo; Nor, Nik Hisyamudin Muhd; Wei, Chan Shiau; Hassan, Mohd Fahrul; Hamid, Nor Aziati Abdul

2017-10-01

The aim of total quality management (TQM) is to achieve customer satisfaction. Healthcare industry is very important in Malaysia for providing good healthcare services to public. However, failure to improve quality and efficiency is a big challenge in a healthcare industry in order to increase quality healthcare services. The objectives of this research are to identify the extent level of TQM implementation; and to determine the impact of TQM implementation on business sustainable in healthcare industry. Quantitative approach has been chosen as the methodology of this study. The survey respondents targeted in this research are staffs in Malaysia private clinic. 70 respondents have participated in this research. Data were analysed by Statistical Package Social Science (SPSS). Analysis result showed that there was a positive significant relationship between TQM practices and business sustainable (r=0.774, P<0.05). All TQM factors have significant relationship with business sustainable factors. The findings of this research will help healthcare industry to understand a better and deeper valuable information on the impact of TQM implementation towards business sustainable in Malaysia healthcare industry.

British Thoracic Society quality standards for the investigation and management of pulmonary nodules.

PubMed

Baldwin, David; Callister, Matthew; Akram, Ahsan; Cane, Paul; Draffan, Jeanette; Franks, Kevin; Gleeson, Fergus; Graham, Richard; Malhotra, Puneet; Pearson, Philip; Subesinghe, Manil; Waller, David; Woolhouse, Ian

2018-01-01

The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. 7 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for the investigation and management of pulmonary nodules, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. BTS Quality Standards for the investigation and management of pulmonary nodules form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline recommendations.

British Thoracic Society quality standards for the investigation and management of pulmonary nodules

PubMed Central

Baldwin, David; Callister, Matthew; Akram, Ahsan; Cane, Paul; Draffan, Jeanette; Franks, Kevin; Gleeson, Fergus; Graham, Richard; Malhotra, Puneet; Pearson, Philip; Subesinghe, Manil; Waller, David; Woolhouse, Ian

2018-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Methods Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 7 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for the investigation and management of pulmonary nodules, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. Discussion BTS Quality Standards for the investigation and management of pulmonary nodules form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline recommendations. PMID:29682290

The disparity of frontline clinical staff and managers' perceptions of a quality and patient safety initiative.

PubMed

Parand, Anam; Burnett, Susan; Benn, Jonathan; Pinto, Anna; Iskander, Sandra; Vincent, Charles

2011-12-01

Arguably, a shared perspective between managers and their clinical staff on an improvement initiative would allow for most effective implementation and increase programme success. However, it has been reported that research has failed to differentiate between managers and line employees on quality management implementation and examine their differences in perceptions of quality and safety initiatives. The aim of this study was to compare clinical frontline staff and senior managers' perceptions on the importance of an organization-wide quality and safety collaborative: the Safer Patients Initiative (SPI). A quantitative study obtained 635 surveys at 20 trusts participating in SPI. Participants included the teams and frontline staff involved within the programme at each organization. Independent T-tests were carried out between frontline staff and senior managers' perceptions of SPI programme elements, success factors and impact & sustainability. Statistically significant differences were found between the perceptions of frontline staff and senior managers on a wide number of issues, including the frontline perceiving a significantly larger improvement on the timeliness of care delivery (t = 2.943, P = 0.004), while managers perceived larger improvement on the culture within the organization for safe, effective and reliable care (t = -2.454, P = 0.014). This study has identified statistically significant disparities in perceptions of an organization-wide improvement initiative between frontline staff and senior managers. This holds valuable implications for the importance of getting both frontline and management perspectives when designing such interventions, in monitoring their performance, and in evaluating their impact. © 2010 Blackwell Publishing Ltd.

Evaluation of agricultural best-management practices in the Conestoga River headwaters, Pennsylvania; effects of nutrient management on quality of surface runoff at a small carbonate-rock site near Ephrate, Pennsylvania, 1984-90

USGS Publications Warehouse

Hall, D.W.; Lietman, P.L.; Koerkle, E.J.

1997-01-01

The U.S. Geological Survey and the Pennsylvania Department of Environmental Protection conducted a study from 1984 to 1990 to determine theeffects of the implementation and practice of nutrient management [an agricultural best-management practice (BMP)] on the quality of surface runoff and ground water at a 55-acre crop and livestock farm in carbonate terrain nearEphrata, Pa. Implementation of nutrient management at Field-Site 2 resulted in application decreases of 33 percent for nitrogen and 29 percent for phosphorus. There wereno significant changes in nitrogen or phosphorusloads for a given amount of runoff from the pre-BMP to the post-BMP periods. However, less than 2 percent of the applied nutrients weredischarged with runoff throughout the study period.After the implementation of nutrient management, statistically significant decreases in concentrations of nitrate in ground-water samples occurred at threeof the four wells monitored throughout the pre- and post-BMP periods. The largest decreases in nitrate concentrations occurred at wells where samples hadthe largest nitrate concentrations prior to nutrient management. Changes in nitrogen applications to the contributing areas of five wells were correlated with nitrate concentrations of the well water. The correlations between the timing and amount of applied nitrogen and changes in ground-water quality met the four conditions that are characteristic of a cause-effect relation: an association, consistency, responsiveness, and a mechanism. Changes in ground-water nitrate concentrations lagged behind changes in loading of nitrogen fertilizers (primarily manure) by approximately 4 to 19 months.

First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care

PubMed Central

Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

2015-01-01

The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested. PMID:25628769

TU-FG-201-10: Quality Management of Accelerated Partial Breast Irradiation (APBI) Plans

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

Ji, H; Lorio, V; Cernica, G

2016-06-15

Purpose: Since 2008, over 700 patients received high dose rate (HDR) APBI treatment at Virginia Hospital Center. The complexity involved in the planning process demonstrated a broad variation between patient geometry across all applicators, in relation to anatomical regions of interest. A quality management program instituting various metrics was implemented in March 2013 with the goal of ensuring an optimal plan is achieved for each patient. Methods: For each plan, an in-house complexity index, geometric conformity index, and plan quality index were defined. These indices were obtained for all patients treated. For patients treated after the implementation, the conformity indexmore » and quality index were maximized while other dosimetric limits, such as maximum skin and rib doses, were strictly kept. Subsequently, all evaluation parameters and applicator information were placed in a database for cross-evaluation with similar complexity. Results: Both the conformity and quality indices show good correlation with the complexity index. They decrease as complexity increases for all applicators. Multi lumen type balloon applicators demonstrate a minimal advantage over single lumen applicators in increasingly complex patient geometries, as compared to SAVI applicators which showed considerably greater advantage in these circumstances. After the implementation of the in-house planning protocol, there is a direct improvement of quality for SAVI plans. Conclusion: Due to their interstitial nature, SAVI devices show a better conformity in comparison to balloon-based devices regardless of the number of lumens, especially in complex cases. The quality management program focuses on optimizing indices by utilizing prior planning knowledge based on complexity levels. The database of indices assists in decision making and has subsequently aided in balancing the experience level among planners. This approach has made APBI planning more robust for patient care, with a measurable improvement in the plan quality.« less

Duke University's Quality Appearance Program

ERIC Educational Resources Information Center

Jackson, Joe

2008-01-01

The Grounds Services Unit at Duke University has implemented a new program that involves a process of self evaluation, which embraces the concept of perpetual and continuous improvement. The Quality Appearance Program (QAP) embellishes and expands upon the Quality Assurance Program concept, but with a twist to grounds management improvement…

Just-in-time: maximizing its success potential.

PubMed

Johnston, S K

1990-08-01

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

Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

PubMed

Pawa, Jasmine; Robson, John; Hull, Sally

2017-11-01

Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.

Combating Obesity at Community Health Centers (COACH): A Quality Improvement Collaborative for Weight Management Programs

PubMed Central

Wilkes, Abigail E.; John, Priya M.; Vable, Anusha M.; Campbell, Amanda; Heuer, Loretta; Schaefer, Cynthia; Vinci, Lisa; Drum, Melinda L.; Chin, Marshall H.; Quinn, Michael T.; Burnet, Deborah L.

2013-01-01

Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians’ Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians’ Network members expressed interest in an obesity QI program. This pilot study aimed to determine whether the QI model can be feasibly implemented with limited resources at CHCs to improve weight management programs. Five health centers with weight management programs enrolled with CHC staff as primary study participants; this study did not attempt to measure patient outcomes. Participants attended learning sessions and monthly conference calls to build QI skills and share best practices. Tailored coaching addressed local needs. Topics rated most valuable were patient recruitment/retention strategies, QI techniques, evidence-based weight management, motivational interviewing. Challenges included garnering provider support, high staff turnover, and difficulty tracking patient-level data. This paper reports practical lessons about implementing a weight management QI collaborative in CHCs. PMID:23727964

Total Quality Management in Space Shuttle Main Engine manufacturing

NASA Technical Reports Server (NTRS)

Ding, J.

1992-01-01

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