Verification of a quality management theory: using a delphi study.
Mosadeghrad, Ali Mohammad
2013-11-01
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. 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. 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. A proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence.
Verification of a Quality Management Theory: Using a Delphi Study
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
A residency clinic chronic condition management quality improvement project.
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.
de la Mare, William; Ellis, Nick; Pascual, Ricardo; Tickell, Sharon
2012-04-01
Simulation models have been widely adopted in fisheries for management strategy evaluation (MSE). However, in catchment management of water quality, MSE is hampered by the complexity of both decision space and the hydrological process models. Empirical models based on monitoring data provide a feasible alternative to process models; they run much faster and, by conditioning on data, they can simulate realistic responses to management actions. Using 10 years of water quality indicators from Queensland, Australia, we built an empirical model suitable for rapid MSE that reproduces the water quality variables' mean and covariance structure, adjusts the expected indicators through local management effects, and propagates effects downstream by capturing inter-site regression relationships. Empirical models enable managers to search the space of possible strategies using rapid assessment. They provide not only realistic responses in water quality indicators but also variability in those indicators, allowing managers to assess strategies in an uncertain world. Copyright © 2012 Elsevier Ltd. All rights reserved.
Data Envelopment Analysis (DEA) Model in Operation Management
NASA Astrophysics Data System (ADS)
Malik, Meilisa; Efendi, Syahril; Zarlis, Muhammad
2018-01-01
Quality management is an effective system in operation management to develops, maintains, and improves quality from groups of companies that allow marketing, production, and service at the most economycal level as well as ensuring customer satisfication. Many companies are practicing quality management to improve their bussiness performance. One of performance measurement is through measurement of efficiency. One of the tools can be used to assess efficiency of companies performance is Data Envelopment Analysis (DEA). The aim of this paper is using Data Envelopment Analysis (DEA) model to assess efficiency of quality management. In this paper will be explained CCR, BCC, and SBM models to assess efficiency of quality management.
NASA Astrophysics Data System (ADS)
Garland, R. M.; Naidoo, M.; Sibiya, B.; Naidoo, S.; Bird, T.; von Gruenewaldt, R.; Liebenberg-Enslin, H.; Nekhwalivhe, M.; Netshandama, J.; Mahlatji, M.
2017-12-01
Ambient air pollution levels are regulated in South Africa; however in many areas pollution concentrations exceed these levels. The South African Air Quality Act also stipulates that government across all levels must have Air Quality Management Plans (AQMP) in place that outline the current state of air quality and emissions, as well as the implementable plan to manage, and where necessary improve, air quality. Historically, dispersion models have been used to support air quality management decisions, including in AQMPs. However, with the focus of air quality management shifting from focusing on industrial point sources to a more integrated and holistic management of all sources, chemical transport models are needed. CAMx was used in the review and development of the City of Johannesburg's AQMP to simulate hot spots of air pollution, as well as to model intervention scenarios. As the pollutants of concern in Johannesburg are ozone and particulate matter, it is critical to use a model that can simulate chemistry. CAMx was run at 1 km with a locally derived emissions inventory for 2014. The sources of pollution in the City are diverse (including, industrial, vehicles, domestic burning, natural), and many sources have large uncertainties in estimating emissions due to lack of necessary data and local emission factors. These uncertainties, together with a lack of measurements to validate the model against, hinder the performance of the model to simulate air quality and thus inform air quality management. However, as air quality worsens in Africa, it is critical for decision makers to have a strong evidence base on the state of air quality and impact of interventions in order to improve air quality effectively. This presentation will highlight the findings from using a chemical transport model for air quality management in the largest city in South Africa, the use and limitations of these for decision-makers, and proposed way forward.
The EFQM Excellence Model for Deploying Quality Management: A British-Russian Journey
ERIC Educational Resources Information Center
Steed, Carol; Maslow, Dmitry; Mazaletskaya, Anna
2005-01-01
This paper describes how the Excellence Model[R] developed by the European Foundation for Quality Management (EFQM) can be used and applied within higher education, with practical examples accompanying the Model in a Russian University to raise management quality. (Contains 5 figures, 2 tables, and 1 footnote.)
Useful measures and models for analytical quality management in medical laboratories.
Westgard, James O
2016-02-01
The 2014 Milan Conference "Defining analytical performance goals 15 years after the Stockholm Conference" initiated a new discussion of issues concerning goals for precision, trueness or bias, total analytical error (TAE), and measurement uncertainty (MU). Goal-setting models are critical for analytical quality management, along with error models, quality-assessment models, quality-planning models, as well as comprehensive models for quality management systems. There are also critical underlying issues, such as an emphasis on MU to the possible exclusion of TAE and a corresponding preference for separate precision and bias goals instead of a combined total error goal. This opinion recommends careful consideration of the differences in the concepts of accuracy and traceability and the appropriateness of different measures, particularly TAE as a measure of accuracy and MU as a measure of traceability. TAE is essential to manage quality within a medical laboratory and MU and trueness are essential to achieve comparability of results across laboratories. With this perspective, laboratory scientists can better understand the many measures and models needed for analytical quality management and assess their usefulness for practical applications in medical laboratories.
Manager personality, manager service quality orientation, and service climate: test of a model.
Salvaggio, Amy Nicole; Schneider, Benjamin; Nishii, Lisa H; Mayer, David M; Ramesh, Anuradha; Lyon, Julie S
2007-11-01
This article conceptually and empirically explores the relationships among manager personality, manager service quality orientation, and climate for customer service. Data were collected from 1,486 employees and 145 managers in grocery store departments (N = 145) to test the authors' theoretical model. Largely consistent with hypotheses, results revealed that core self-evaluations were positively related to managers' service quality orientation, even after dimensions of the Big Five model of personality were controlled, and that service quality orientation fully mediated the relationship between personality and global service climate. Implications for personality and organizational climate research are discussed. (c) 2007 APA
Outcomes-Balanced Framework for Emergency Management: A Predictive Model for Preparedness
2013-09-01
Management Total Quality Management (TQM) was developed by W. Edwards Deming in the post-World War II reconstruction period in Japan. It ushered in a...FIGURES Figure 1. From Total Quality Management Principles ....................................................30 Figure 2. Outcomes Logic Model (After...THIRA Threat and Hazard Identification and Risk Assessment TQM Total Quality Management UTL Universal Task List xiv ACKNOWLEDGMENTS German
Design and realization of high quality prime farmland planning and management information system
NASA Astrophysics Data System (ADS)
Li, Manchun; Liu, Guohong; Liu, Yongxue; Jiang, Zhixin
2007-06-01
The article discusses the design and realization of a high quality prime farmland planning and management information system based on SDSS. Models in concept integration, management planning are used in High Quality Prime Farmland Planning in order to refine the current model system and the management information system is deigned with a triangular structure. Finally an example of Tonglu county high quality prime farmland planning and management information system is introduced.
Doctors or technicians: assessing quality of medical education
Hasan, Tayyab
2010-01-01
Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products. PMID:23745059
Doctors or technicians: assessing quality of medical education.
Hasan, Tayyab
2010-01-01
Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.
Total Quality Management in a Knowledge Management Perspective.
ERIC Educational Resources Information Center
Johannsen, Carl Gustav
2000-01-01
Presents theoretical considerations on both similarities and differences between information management and knowledge management and presents a conceptual model of basic knowledge management processes. Discusses total quality management and quality control in the context of information management. (Author/LRW)
A review of distributed parameter groundwater management modeling methods
Gorelick, Steven M.
1983-01-01
Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.
A Review of Distributed Parameter Groundwater Management Modeling Methods
NASA Astrophysics Data System (ADS)
Gorelick, Steven M.
1983-04-01
Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.
Community Multiscale Air Quality Modeling System (CMAQ)
CMAQ is a computational tool used for air quality management. It models air pollutants including ozone, particulate matter and other air toxics to help determine optimum air quality management scenarios.
The Total Quality Management Model Department of Personnel State of Colorado,
A panel of three members will present the Total Quality Management model recently designed for the Department of Personnel, State of Colorado. This model was selected to increase work quality and productivity of the Department and to exemplify Governor Romer’s commitment to quality work within state government.
NASA Astrophysics Data System (ADS)
Jamaluddin, Z.; Razali, A. M.; Mustafa, Z.
2015-02-01
The purpose of this paper is to examine the relationship between the quality management practices (QMPs) and organisational performance for the manufacturing industry in Malaysia. In this study, a QMPs and organisational performance framework is developed according to a comprehensive literature review which cover aspects of hard and soft quality factors in manufacturing process environment. A total of 11 hypotheses have been put forward to test the relationship amongst the six constructs, which are management commitment, training, process management, quality tools, continuous improvement and organisational performance. The model is analysed using Structural Equation Modeling (SEM) with AMOS software version 18.0 using Maximum Likelihood (ML) estimation. A total of 480 questionnaires were distributed, and 210 questionnaires were valid for analysis. The results of the modeling analysis using ML estimation indicate that the fits statistics of QMPs and organisational performance model for manufacturing industry is admissible. From the results, it found that the management commitment have significant impact on the training and process management. Similarly, the training had significant effect to the quality tools, process management and continuous improvement. Furthermore, the quality tools have significant influence on the process management and continuous improvement. Likewise, the process management also has a significant impact to the continuous improvement. In addition the continuous improvement has significant influence the organisational performance. However, the results of the study also found that there is no significant relationship between management commitment and quality tools, and between the management commitment and continuous improvement. The results of the study can be used by managers to prioritize the implementation of QMPs. For instances, those practices that are found to have positive impact on organisational performance can be recommended to managers so that they can allocate resources to improve these practices to get better performance.
Toward a food service quality management system for compliance with the Mediterranean dietary model.
Grigoroudis, Evangelos; Psaroudaki, Antonia; Diakaki, Christina
2013-01-01
The traditional diet of Cretan people in the 1960s is the basis of the Mediterranean dietary model. This article investigates the potential of this model to inspire proposals of meals by food-serving businesses, and suggests a methodology for the development of a quality management system, which will certify the delivery of food service according to this dietary model. The proposed methodology is built upon the principles and structure of the ISO 9001:2008 quality standard to enable integration with other quality, environmental, and food safety management systems.
Data-base development for water-quality modeling of the Patuxent River basin, Maryland
Fisher, G.T.; Summers, R.M.
1987-01-01
Procedures and rationale used to develop a data base and data management system for the Patuxent Watershed Nonpoint Source Water Quality Monitoring and Modeling Program of the Maryland Department of the Environment and the U.S. Geological Survey are described. A detailed data base and data management system has been developed to facilitate modeling of the watershed for water quality planning purposes; statistical analysis; plotting of meteorologic, hydrologic and water quality data; and geographic data analysis. The system is Maryland 's prototype for development of a basinwide water quality management program. A key step in the program is to build a calibrated and verified water quality model of the basin using the Hydrological Simulation Program--FORTRAN (HSPF) hydrologic model, which has been used extensively in large-scale basin modeling. The compilation of the substantial existing data base for preliminary calibration of the basin model, including meteorologic, hydrologic, and water quality data from federal and state data bases and a geographic information system containing digital land use and soils data is described. The data base development is significant in its application of an integrated, uniform approach to data base management and modeling. (Lantz-PTT)
Strategic collaborative quality management and employee job satisfaction
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.
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.
USDA-ARS?s Scientific Manuscript database
Hydrologic/water quality models are increasingly used to explore management and policy alternatives for managing water quality and quantity from intensive silvicultural practices with Best Management Practices (BMPs) in forested watersheds due to the limited number of studies and the cost of conduct...
Increasing the Use of Earth Science Data and Models in Air Quality Management.
Milford, Jana B; Knight, Daniel
2017-04-01
In 2010, the U.S. National Aeronautics and Space Administration (NASA) initiated the Air Quality Applied Science Team (AQAST) as a 5-year, $17.5-million award with 19 principal investigators. AQAST aims to increase the use of Earth science products in air quality-related research and to help meet air quality managers' information needs. We conducted a Web-based survey and a limited number of follow-up interviews to investigate federal, state, tribal, and local air quality managers' perspectives on usefulness of Earth science data and models, and on the impact AQAST has had. The air quality managers we surveyed identified meeting the National Ambient Air Quality Standards for ozone and particulate matter, emissions from mobile sources, and interstate air pollution transport as top challenges in need of improved information. Most survey respondents viewed inadequate coverage or frequency of satellite observations, data uncertainty, and lack of staff time or resources as barriers to increased use of satellite data by their organizations. Managers who have been involved with AQAST indicated that the program has helped build awareness of NASA Earth science products, and assisted their organizations with retrieval and interpretation of satellite data and with application of global chemistry and climate models. AQAST has also helped build a network between researchers and air quality managers with potential for further collaborations. NASA's Air Quality Applied Science Team (AQAST) aims to increase the use of satellite data and global chemistry and climate models for air quality management purposes, by supporting research and tool development projects of interest to both groups. Our survey and interviews of air quality managers indicate they found value in many AQAST projects and particularly appreciated the connections to the research community that the program facilitated. Managers expressed interest in receiving continued support for their organizations' use of satellite data, including assistance in retrieving and interpreting data from future geostationary platforms meant to provide more frequent coverage for air quality and other applications.
Quality Management in Schools: Analysis of Mediating Factors
ERIC Educational Resources Information Center
Díez, Fernando; Iraurgi, Ioseba; Sanchez, Aurelio Villa
2018-01-01
The objective of this study is to contribute to Quality Management Systems (QMS) and their impact on schools in the Basque Country, Spain. Specifically, it analyses two models: the EFQM Excellence Model, which originated in the business world, and the Integrated Quality Project (IQP) Model, which has a humanistic focus and arose from an…
ERIC Educational Resources Information Center
Lu, Xingjiang; Yao, Chen; Zheng, Jianmin
2013-01-01
This paper focuses on the training of undergraduate students' innovation ability. On top of the theoretical framework of the Quality Function Deployment (QFD), we propose a teaching quality management model. Based on this model, we establish a multilevel decomposition indicator system, which integrates innovation ability characterized by four…
NASA Astrophysics Data System (ADS)
Ghodsi, Seyed Hamed; Kerachian, Reza; Estalaki, Siamak Malakpour; Nikoo, Mohammad Reza; Zahmatkesh, Zahra
2016-02-01
In this paper, two deterministic and stochastic multilateral, multi-issue, non-cooperative bargaining methodologies are proposed for urban runoff quality management. In the proposed methodologies, a calibrated Storm Water Management Model (SWMM) is used to simulate stormwater runoff quantity and quality for different urban stormwater runoff management scenarios, which have been defined considering several Low Impact Development (LID) techniques. In the deterministic methodology, the best management scenario, representing location and area of LID controls, is identified using the bargaining model. In the stochastic methodology, uncertainties of some key parameters of SWMM are analyzed using the info-gap theory. For each water quality management scenario, robustness and opportuneness criteria are determined based on utility functions of different stakeholders. Then, to find the best solution, the bargaining model is performed considering a combination of robustness and opportuneness criteria for each scenario based on utility function of each stakeholder. The results of applying the proposed methodology in the Velenjak urban watershed located in the northeastern part of Tehran, the capital city of Iran, illustrate its practical utility for conflict resolution in urban water quantity and quality management. It is shown that the solution obtained using the deterministic model cannot outperform the result of the stochastic model considering the robustness and opportuneness criteria. Therefore, it can be concluded that the stochastic model, which incorporates the main uncertainties, could provide more reliable results.
The Samurai or the Cowboy? Toward an American Model of Quality Management.
ERIC Educational Resources Information Center
Beck, Mark W.
1994-01-01
The Japanese model of business management and Total Quality Management principles being applied to higher education as well as businesses are often ineffective because of the application of packaged ideas without consideration of the subtleties of individual organizations. The cowboy model of teamwork stresses the individual's role and better fits…
Better Insight Into Water Resources Management With Integrated Hydrodynamic And Water Quality Models
NASA Astrophysics Data System (ADS)
Debele, B.; Srinivasan, R.; Parlange, J.
2004-12-01
Models have long been used in water resources management to guide decision making and improve understanding of the system. Numerous models of different scales -spatial and temporal - are available. Yet, very few models manage to bridge simulations of hydrological and water quality parameters from both upland watershed and riverine system. Most water quality models, such as QUAL2E and EPD-RIV1 concentrate on the riverine system while CE-QUAL-W2 and WASP models focus on larger waterbodies, such as lakes and reservoirs. On the other hand, the original SWAT model, HSPF and other upland watershed hydrological models simulate agricultural (diffuse) pollution sources with limited number of processes incorporated to handle point source pollutions that emanate from industrial sectors. Such limitations, which are common in most hydrodynamic and water quality models undermine better understanding that otherwise could be uncovered by employing integrated hydrological and water quality models for both upland watershed and riverine system. The SWAT model is a well documented and verified hydrological and water quality model that has been developed to simulate the effects of various management scenarios on the health of the environment in terms of water quantity and quality. Recently, the SWAT model has been extended to include the simulation of hydrodynamic and water quality parameters in the river system. The extended SWAT model (ESWAT) has been further extended to run using diurnally varying (hourly) weather data and produce outputs at hourly timescales. This and other improvements in the ESWAT model have been documented in the current work. Besides, the results from two case studies in Texas will be reported.
Assessment of the Quality Management Models in Higher Education
ERIC Educational Resources Information Center
Basar, Gulsun; Altinay, Zehra; Dagli, Gokmen; Altinay, Fahriye
2016-01-01
This study involves the assessment of the quality management models in Higher Education by explaining the importance of quality in higher education and by examining the higher education quality assurance system practices in other countries. The qualitative study was carried out with the members of the Higher Education Planning, Evaluation,…
[The organization of system of quality management in large multitype hospital].
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.
The American-Soviet Symposium on Use of Mathematical Models to Optimize Water Quality Management examines methodological questions related to simulation and optimization modeling of processes that determine water quality of river basins. Discussants describe the general state of ...
A methodology model for quality management in a general hospital.
Stern, Z; Naveh, E
1997-01-01
A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.
Management Tools in Engineering Education.
ERIC Educational Resources Information Center
Fehr, M.
1999-01-01
Describes a teaching model that applies management tools such as delegation, total quality management, time management, teamwork, and Deming rules. Promotes the advantages of efficiency, reporting, independent scheduling, and quality. (SK)
An Integrated Decision Support System for Water Quality Management of Songhua River Basin
NASA Astrophysics Data System (ADS)
Zhang, Haiping; Yin, Qiuxiao; Chen, Ling
2010-11-01
In the Songhua River Basin of China, many water resource and water environment conflicts interact. A Decision Support System (DSS) for the water quality management has been established for the Basin. The System is featured by the incorporation of a numerical water quality model system into a conventional water quality management system which usually consists of geographic information system (GIS), WebGIS technology, database system and network technology. The model system is built based on DHI MIKE software comprising of a basin rainfall-runoff module, a basin pollution load evaluation module, a river hydrodynamic module and a river water quality module. The DSS provides a friendly graphical user interface that enables the rapid and transparent calculation of various water quality management scenarios, and also enables the convenient access and interpretation of the modeling results to assist the decision-making.
NASA Astrophysics Data System (ADS)
Honti, Mark; Schuwirth, Nele; Rieckermann, Jörg; Stamm, Christian
2017-03-01
The design and evaluation of solutions for integrated surface water quality management requires an integrated modelling approach. Integrated models have to be comprehensive enough to cover the aspects relevant for management decisions, allowing for mapping of larger-scale processes such as climate change to the regional and local contexts. Besides this, models have to be sufficiently simple and fast to apply proper methods of uncertainty analysis, covering model structure deficits and error propagation through the chain of sub-models. Here, we present a new integrated catchment model satisfying both conditions. The conceptual iWaQa
model was developed to support the integrated management of small streams. It can be used to predict traditional water quality parameters, such as nutrients and a wide set of organic micropollutants (plant and material protection products), by considering all major pollutant pathways in urban and agricultural environments. Due to its simplicity, the model allows for a full, propagative analysis of predictive uncertainty, including certain structural and input errors. The usefulness of the model is demonstrated by predicting future surface water quality in a small catchment with mixed land use in the Swiss Plateau. We consider climate change, population growth or decline, socio-economic development, and the implementation of management strategies to tackle urban and agricultural point and non-point sources of pollution. Our results indicate that input and model structure uncertainties are the most influential factors for certain water quality parameters. In these cases model uncertainty is already high for present conditions. Nevertheless, accounting for today's uncertainty makes management fairly robust to the foreseen range of potential changes in the next decades. The assessment of total predictive uncertainty allows for selecting management strategies that show small sensitivity to poorly known boundary conditions. The identification of important sources of uncertainty helps to guide future monitoring efforts and pinpoints key indicators, whose evolution should be closely followed to adapt management. The possible impact of climate change is clearly demonstrated by water quality substantially changing depending on single climate model chains. However, when all climate trajectories are combined, the human land use and management decisions have a larger influence on water quality against a time horizon of 2050 in the study.
[Quality management in cardiovascular echography].
Gullace, Giuseppe
2002-12-01
The quality management of an organization can be defined as the ability to identify, plan and implement programs of measure, analysis, verification and control that allow to monitor management, resources, activities, processes and output/outcome of the same organization, including the satisfaction of the customers. Whatever the model used, it is demonstrated that the management-quality system, either for professional quality or for organization, turns out to be effective even in the health organizations within and to any level of organizational-structural complexity. The present paper concerns the experience of the Italian Society of Cardiovascular Echography (SIEC) on quality certification, both as a scientific society compared to other health organizations and to cardiovascular echo laboratories, and the definition of minimum requirements for the accreditation of the same laboratories. The model most frequently used for quality management is represented by the ISO 9000: Vision 2000, that is a management model with specific reference to the organization and the customer satisfaction. The model applied to the health structure needs a rapid change in mentality that addresses the operators to define, share and achieve objectives to be brought on by means of an active collaboration, group activity and deep sense of belonging necessary to the attainment of expected objectives. When the model is applied by a scientific society, it is necessary to take into account the different structural and functional organization, the constitution and the operators differing on the point of view of origin, experiences, mentality, and roles. The ISO 9000: Vision 2000 model can be applied also to the cardiovascular echo laboratory which may be compared to a simple organization; for its corrected functioning, SIEC has defined minimal requirements for the accreditation, realization and modalities to carry out and manage quality. The quality system represents a new way of operating of an organization that enhances capability and performance of the operators, stimulates their creativity and facilitates the activities of all, to guarantee both the quality of the product and the satisfaction of operators and customers at the same time.
Bayesian Framework for Water Quality Model Uncertainty Estimation and Risk Management
A formal Bayesian methodology is presented for integrated model calibration and risk-based water quality management using Bayesian Monte Carlo simulation and maximum likelihood estimation (BMCML). The primary focus is on lucid integration of model calibration with risk-based wat...
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.
Quality data collection and management technology of aerospace complex product assembly process
NASA Astrophysics Data System (ADS)
Weng, Gang; Liu, Jianhua; He, Yongxi; Zhuang, Cunbo
2017-04-01
Aiming at solving problems of difficult management and poor traceability for discrete assembly process quality data, a data collection and management method is proposed which take the assembly process and BOM as the core. Data collection method base on workflow technology, data model base on BOM and quality traceability of assembly process is included in the method. Finally, assembly process quality data management system is developed and effective control and management of quality information for complex product assembly process is realized.
Air pollution and public health: a guidance document for risk managers.
Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin
2008-01-01
This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.
Knowledge management systems success in healthcare: Leadership matters.
Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga
2017-01-01
To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Brinkman, J.J.; Griffioen, P.S.; Groot, S.
1987-03-01
The Netherlands have a rather complex water-management system consisting of a number of major rivers, canals, lakes and ditches. Water-quantity management on a regional scale is necessary for an effective water-quality policy. To support water management, a computer model was developed that includes both water quality and water quantity, based on three submodels: ABOPOL for the water movement, DELWAQ for the calculation of water quality variables and BLOOM-II for the phytoplankton growth. The northern province of Friesland was chosen as a test case for the integrated model to be developed, where water quality is highly related to the water distributionmore » and the main trade-off is minimizing the intake of (eutrophicated) alien water in order to minimize external nutrient load and maximizing the intake in order to flush channels and lakes. The results of the application of these models to this and to a number of hypothetical future situations are described.« less
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.…
A Synthesis of a Quality Management Model for Education in Universities
ERIC Educational Resources Information Center
Srikanthan, G.; Dalrymple, John
2004-01-01
The paper attempts to synthesise the features of the model for quality management in education based on the approaches spelt out in four well-articulated methodologies for the practice of quality in higher education. Each methodology contributes to different views of education from the learners' and the institution's perspectives, providing…
The Grand Challenge of Basin-Scale Groundwater Quality Management Modelling
NASA Astrophysics Data System (ADS)
Fogg, G. E.
2017-12-01
The last 50+ years of agricultural, urban and industrial land and water use practices have accelerated the degradation of groundwater quality in the upper portions of many major aquifer systems upon which much of the world relies for water supply. In the deepest and most extensive systems (e.g., sedimentary basins) that typically have the largest groundwater production rates and hold fresh groundwaters on decadal to millennial time scales, most of the groundwater is not yet contaminated. Predicting the long-term future groundwater quality in such basins is a grand scientific challenge. Moreover, determining what changes in land and water use practices would avert future, irreversible degradation of these massive freshwater stores is a grand challenge both scientifically and societally. It is naïve to think that the problem can be solved by eliminating or reducing enough of the contaminant sources, for human exploitation of land and water resources will likely always result in some contamination. The key lies in both reducing the contaminant sources and more proactively managing recharge in terms of both quantity and quality, such that the net influx of contaminants is sufficiently moderate and appropriately distributed in space and time to reverse ongoing groundwater quality degradation. Just as sustainable groundwater quantity management is greatly facilitated with groundwater flow management models, sustainable groundwater quality management will require the use of groundwater quality management models. This is a new genre of hydrologic models do not yet exist, partly because of the lack of modeling tools and the supporting research to model non-reactive as well as reactive transport on large space and time scales. It is essential that the contaminant hydrogeology community, which has heretofore focused almost entirely on point-source plume-scale problems, direct it's efforts toward the development of process-based transport modeling tools and analyses capable of appropriately upscaling advection-dispersion and reactions at the basin scale (10^2 km). A road map for research and development in groundwater quality management modeling and its application toward securing future groundwater resources will be discussed.
Water quality modelling of an impacted semi-arid catchment using flow data from the WEAP model
NASA Astrophysics Data System (ADS)
Slaughter, Andrew R.; Mantel, Sukhmani K.
2018-04-01
The continuous decline in water quality in many regions is forcing a shift from quantity-based water resources management to a greater emphasis on water quality management. Water quality models can act as invaluable tools as they facilitate a conceptual understanding of processes affecting water quality and can be used to investigate the water quality consequences of management scenarios. In South Africa, the Water Quality Systems Assessment Model (WQSAM) was developed as a management-focussed water quality model that is relatively simple to be able to utilise the small amount of available observed data. Importantly, WQSAM explicitly links to systems (yield) models routinely used in water resources management in South Africa by using their flow output to drive water quality simulations. Although WQSAM has been shown to be able to represent the variability of water quality in South African rivers, its focus on management from a South African perspective limits its use to within southern African regions for which specific systems model setups exist. Facilitating the use of WQSAM within catchments outside of southern Africa and within catchments for which these systems model setups to not exist would require WQSAM to be able to link to a simple-to-use and internationally-applied systems model. One such systems model is the Water Evaluation and Planning (WEAP) model, which incorporates a rainfall-runoff component (natural hydrology), and reservoir storage, return flows and abstractions (systems modelling), but within which water quality modelling facilities are rudimentary. The aims of the current study were therefore to: (1) adapt the WQSAM model to be able to use as input the flow outputs of the WEAP model and; (2) provide an initial assessment of how successful this linkage was by application of the WEAP and WQSAM models to the Buffalo River for historical conditions; a small, semi-arid and impacted catchment in the Eastern Cape of South Africa. The simulations of the two models were compared to the available observed data, with the initial focus within WQSAM on a simulation of instream total dissolved solids (TDS) and nutrient concentrations. The WEAP model was able to adequately simulate flow in the Buffalo River catchment, with consideration of human inputs and outputs. WQSAM was adapted to successfully take as input the flow output of the WEAP model, and the simulations of nutrients by WQSAM provided a good representation of the variability of observed nutrient concentrations in the catchment. This study showed that the WQSAM model is able to accept flow inputs from the WEAP model, and that this approach is able to provide satisfactory estimates of both flow and water quality for a small, semi-arid and impacted catchment. It is hoped that this research will encourage the application of WQSAM to an increased number of catchments within southern Africa and beyond.
Extant process-based hydrologic and water quality models are indispensable to water resources planning and environmental management. However, models are only approximations of real systems and often calibrated with incomplete and uncertain data. Reliable estimates, or perhaps f...
Extant process-based hydrologic and water quality models are indispensable to water resources planning and environmental management. However, models are only approximations of real systems and often calibrated with incomplete and uncertain data. Reliable estimates, or perhaps f...
WILDFIRE EMISSION MODELING: INTEGRATING BLUESKY AND SMOKE
Atmospheric chemical transport models are used to simulate historic meteorological episodes for developing air quality management strategies. Wildland fire emissions need to be characterized accurately to achieve these air quality management goals. The temporal and spatial esti...
USDA-ARS?s Scientific Manuscript database
Reducing phosphorus loss from agricultural land is important for improvement and protection of surface water quality. Agricultural models can be used to determine management impacts on P loss and therefore serve as a guide for recommending best management practices. However, the models must be comp...
ERIC Educational Resources Information Center
Kamis-Gould, Edna; And Others
1991-01-01
A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…
NASA Astrophysics Data System (ADS)
González, M. R.; Torres, F.; Yoldi, V.; Arcega, F.; Plaza, I.
2012-04-01
It is proposed an integrated management model for an organization. This model is based on the continuous improvement Plan-Do-Check-Act cycle and it intends to integrate the environmental, risk prevention and ethical aspects as well as research, development and innovation projects management in the general quality management structure proposed by ISO 9001:2008. It aims to fulfill the standards ISO 9001, ISO 14001, OSHAS 18001, SGE 21 y 166002.
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.
Quality management, a directive approach to patient safety.
Ayuso-Murillo, Diego; de Andrés-Gimeno, Begoña; Noriega-Matanza, Concha; López-Suárez, Rafael Jesús; Herrera-Peco, Ivan
Nowadays the implementation of effective quality management systems and external evaluation in healthcare is a necessity to ensure not only transparency in activities related to health but also access to health and patient safety. The key to correctly implementing a quality management system is support from the managers of health facilities, since it is managers who design and communicate to health professionals the strategies of action involved in quality management systems. This article focuses on nursing managers' approach to quality management through the implementation of cycles of continuous improvement, participation of improvement groups, monitoring systems and external evaluation quality models (EFQM, ISO). The implementation of a quality management system will enable preventable adverse effects to be minimized or eliminated, and promote patient safety and safe practice by health professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Development of Innovative Business Model of Modern Manager's Qualities
ERIC Educational Resources Information Center
Yashkova, Elena V.; Sineva, Nadezda L.; Shkunova, Angelika A.; Bystrova, Natalia V.; Smirnova, Zhanna V.; Kolosova, Tatyana V.
2016-01-01
The paper defines a complex of manager's qualities based on theoretical and methodological analysis and synthesis methods, available national and world literature, research papers and publications. The complex approach methodology was used, which provides an innovative view of the development of modern manager's qualities. The methodological…
NASA Astrophysics Data System (ADS)
Fu, Z. H.; Zhao, H. J.; Wang, H.; Lu, W. T.; Wang, J.; Guo, H. C.
2017-11-01
Economic restructuring, water resources management, population planning and environmental protection are subjects to inner uncertainties of a compound system with objectives which are competitive alternatives. Optimization model and water quality model are usually used to solve problems in a certain aspect. To overcome the uncertainty and coupling in reginal planning management, an interval fuzzy program combined with water quality model for regional planning and management has been developed to obtain the absolutely ;optimal; solution in this study. The model is a hybrid methodology of interval parameter programming (IPP), fuzzy programing (FP), and a general one-dimensional water quality model. The method extends on the traditional interval parameter fuzzy programming method by integrating water quality model into the optimization framework. Meanwhile, as an abstract concept, water resources carrying capacity has been transformed into specific and calculable index. Besides, unlike many of the past studies about water resource management, population as a significant factor has been considered. The results suggested that the methodology was applicable for reflecting the complexities of the regional planning and management systems within the planning period. The government policy makers could establish effective industrial structure, water resources utilization patterns and population planning, and to better understand the tradeoffs among economic, water resources, population and environmental objectives.
Code of Federal Regulations, 2011 CFR
2011-04-01
... guidelines in any quality assurance review: (1) ASQC Q9000-1-1994 Quality Management and Quality Assurance... Systems—Model for Quality Assurance in Final Inspection and Test; (5) ASQC Q9004-1-1994 Quality Management... in interpreting testing standards, test methods, evaluating test reports and quality control programs...
Dennis P. Dykstra; Robert A. Monserud
2009-01-01
The purpose of the international conference from which these proceedings are drawn was to explore relationships between forest management activities and timber quality. Sessions were organized to explore models and simulation methodologies that contribute to an understanding of tree development over time and the ways that management and harvesting activities can...
Hudak, R P; Jacoby, I; Meyer, G S; Potter, A L; Hooper, T I; Krakauer, H
1997-01-01
This article describes a training model that focuses on health care management by applying epidemiologic methods to assess and improve the quality of clinical practice. The model's uniqueness is its focus on integrating clinical evidence-based decision making with fundamental principles of resource management to achieve attainable, cost-effective, high-quality health outcomes. The target students are current and prospective clinical and administrative executives who must optimize decision making at the clinical and managerial levels of health care organizations.
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)
[Successful implementation of the EFQM management model at the Department of Ophthalmology in Graz].
Langmann, G; Maier, R; Theisl, A; Bauer, H; Klug, U; Foussek, C; Hödl, R; Wedrich, A; Gliebe, W
2011-04-01
In the context of legal requirements and scarcer resources, the implementation of a quality management (QM) model will provide a competitive advantage or a site warranty for a hospital. For 3 years, the Department of Ophthalmology in Graz has been working with the EFQM model and has now accomplished the first level quality award, namely "Committed to Excellence (C2E)". The project work towards achieving this C2E-award is described below. EFQM stands for European Foundation for Quality Management, an organization that was founded in 1989 by the EU, together with 14 leading enterprises. In the EFQM model, the maturity of an organization in terms of quality is determined through the achievement of a number of quality awards. The C2E award is the first of these awards. At the beginning of our work for the C2E level, the strengths and weaknesses of the Department of Ophthalmology were determined by means of an EFQM questionnaire. Three improvement measures with the highest impact on the performance of the clinic were identified by the questionnaire: 1. The hospitalization of a cataract patient. 2. The lack of information between the various professional parties. 3. The lack of knowledge within the professional groups of the objectives and strategy of the Department of Ophthalmology. These areas requiring improvement were targeted, addressed and improved in a 6-months project work, structured by the EFQM model. The project work as a whole, the results obtained and the corresponding written documentation were evaluated positively in a 1-day assessment by Quality Austria. The EFQM model is a challenging quality management model. After the necessary training of project members or under the supervision of experienced quality managers, the EFQM model may be successfully applied to patient care, teaching and research in a department of ophthalmology.
Quality management in home care: models for today's practice.
Verhey, M P
1996-01-01
In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.
A Review of Surface Water Quality Models
Li, Shibei; Jia, Peng; Qi, Changjun; Ding, Feng
2013-01-01
Surface water quality models can be useful tools to simulate and predict the levels, distributions, and risks of chemical pollutants in a given water body. The modeling results from these models under different pollution scenarios are very important components of environmental impact assessment and can provide a basis and technique support for environmental management agencies to make right decisions. Whether the model results are right or not can impact the reasonability and scientificity of the authorized construct projects and the availability of pollution control measures. We reviewed the development of surface water quality models at three stages and analyzed the suitability, precisions, and methods among different models. Standardization of water quality models can help environmental management agencies guarantee the consistency in application of water quality models for regulatory purposes. We concluded the status of standardization of these models in developed countries and put forward available measures for the standardization of these surface water quality models, especially in developing countries. PMID:23853533
Modeling Cover Crop Effectiveness on Maryland's Eastern Shore
USDA-ARS?s Scientific Manuscript database
The value of watershed-scale, hydrologic/water quality models to ecosystem management is increasingly evident as more programs adopt these tools to evaluate the effectiveness of different management scenarios and their impact on the environment. Quality of precipitation data is critical for appropri...
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.
Managing Quality Improvement of eLearning in a Large, Campus-Based University
ERIC Educational Resources Information Center
Ellis, Robert A.; Jarkey, Nerida; Mahony, Mary Jane; Peat, Mary; Sheely, Stephen
2007-01-01
Purpose: This paper seeks to discuss the characteristics that shape a model to manage eLearning in a large, predominantly campus-based university. It focuses on how such a model can provide a sustainable approach to supporting eLearning for more than 40,000 students while still managing basic quality assurance for the University executive and the…
Code of Federal Regulations, 2010 CFR
2010-07-01
... manager means the Federal agency or the Federal official charged with direct responsibility for management... requirements of the Act. Areawide air quality modeling analysis means an assessment on a scale that includes the entire nonattainment or maintenance area which uses an air quality dispersion model to determine...
Managing water quality under drought conditions in the Llobregat River Basin.
Momblanch, Andrea; Paredes-Arquiola, Javier; Munné, Antoni; Manzano, Andreu; Arnau, Javier; Andreu, Joaquín
2015-01-15
The primary effects of droughts on river basins include both depleted quantity and quality of the available water resources, which can render water resources useless for human needs and simultaneously damage the environment. Isolated water quality analyses limit the action measures that can be proposed. Thus, an integrated evaluation of water management and quality is warranted. In this study, a methodology consisting of two coordinated models is used to combine aspects of water resource allocation and water quality assessment. Water management addresses water allocation issues by considering the storage, transport and consumption elements. Moreover, the water quality model generates time series of concentrations for several pollutants according to the water quality of the runoff and the demand discharges. These two modules are part of the AQUATOOL decision support system shell for water resource management. This tool facilitates the analysis of the effects of water management and quality alternatives and scenarios on the relevant variables in a river basin. This paper illustrates the development of an integrated model for the Llobregat River Basin. The analysis examines the drought from 2004 to 2008, which is an example of a period when the water system was quantitative and qualitatively stressed. The performed simulations encompass a wide variety of water management and water quality measures; the results provide data for making informed decisions. Moreover, the results demonstrated the importance of combining these measures depending on the evolution of a drought event and the state of the water resources system. Copyright © 2014 Elsevier B.V. All rights reserved.
STORM WATER MANAGEMENT MODEL QUALITY ASSURANCE REPORT: DYNAMIC WAVE FLOW ROUTING
The Storm Water Management Model (SWMM) is a computer-based tool for simulating storm water runoff quantity and quality from primarily urban areas. In 2002 the U.S. Environmental Protection Agency’s Water Supply and Water Resources Division partnered with the consulting firm CDM ...
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…
Quality transitivity and traceability system of herbal medicine products based on quality markers.
Liu, Changxiao; Guo, De-An; Liu, Liang
2018-05-15
Due to a variety of factors to affect the herb quality, the existing quality management model is unable to evaluate the process control. The development of the concept of "quality marker" (Q-marker) lays basis for establishing an independent process quality control system for herbal products. To ensure the highest degree of safety, effectiveness and quality process control of herbal products, it is aimed to establish a quality transitivity and traceability system of quality and process control from raw materials to finished herbal products. Based on the key issues and challenges of quality assessment, the current status of quality and process controls from raw materials to herbal medicinal products listed in Pharmacopoeia were analyzed and the research models including discovery and identification of Q-markers, analysis and quality management of risk evaluation were designed. Authors introduced a few new technologies and methodologies, such as DNA barcoding, chromatographic technologies, fingerprint analysis, chemical markers, bio-responses, risk management and solution for quality process control. The quality and process control models for herbal medicinal products were proposed and the transitivity and traceability system from raw materials to the finished products was constructed to improve the herbal quality from the entire supply and production chain. The transitivity and traceability system has been established based on quality markers, especially on how to control the production process under Good Engineering Practices, as well as to implement the risk management for quality and process control in herbal medicine production. Copyright © 2018 Elsevier GmbH. All rights reserved.
Quality Services Management: A Consumer-Oriented Model for Systems Audit and Strategic Intervention.
ERIC Educational Resources Information Center
Baker, Pamela C.
The paper describes Quality Service Management (QSM) as applied to the provision of services to disabled and other special needs persons. QSM is defined as a systems approach to consumer relations based on the belief that quality care may be achieved only within the context of overall services management. Differences among "quality…
Law, Bradley; Caccamo, Gabriele; Roe, Paul; Truskinger, Anthony; Brassil, Traecey; Gonsalves, Leroy; McConville, Anna; Stanton, Matthew
2017-09-01
Species distribution models have great potential to efficiently guide management for threatened species, especially for those that are rare or cryptic. We used MaxEnt to develop a regional-scale model for the koala Phascolarctos cinereus at a resolution (250 m) that could be used to guide management. To ensure the model was fit for purpose, we placed emphasis on validating the model using independently-collected field data. We reduced substantial spatial clustering of records in coastal urban areas using a 2-km spatial filter and by modeling separately two subregions separated by the 500-m elevational contour. A bias file was prepared that accounted for variable survey effort. Frequency of wildfire, soil type, floristics and elevation had the highest relative contribution to the model, while a number of other variables made minor contributions. The model was effective in discriminating different habitat suitability classes when compared with koala records not used in modeling. We validated the MaxEnt model at 65 ground-truth sites using independent data on koala occupancy (acoustic sampling) and habitat quality (browse tree availability). Koala bellows ( n = 276) were analyzed in an occupancy modeling framework, while site habitat quality was indexed based on browse trees. Field validation demonstrated a linear increase in koala occupancy with higher modeled habitat suitability at ground-truth sites. Similarly, a site habitat quality index at ground-truth sites was correlated positively with modeled habitat suitability. The MaxEnt model provided a better fit to estimated koala occupancy than the site-based habitat quality index, probably because many variables were considered simultaneously by the model rather than just browse species. The positive relationship of the model with both site occupancy and habitat quality indicates that the model is fit for application at relevant management scales. Field-validated models of similar resolution would assist in guiding management of conservation-dependent species.
Srinivas, Rallapalli; Singh, Ajit Pratap
2018-03-01
Assessment of water quality status of a river with respect to its discharge has become prerequisite to sustainable river basin management. The present paper develops an integrated model for simulating and evaluating strategies for water quality management in a river basin management by controlling point source pollutant loadings and operations of multi-purpose projects. Water Quality Analysis and Simulation Program (WASP version 8.0) has been used for modeling the transport of pollutant loadings and their impact on water quality in the river. The study presents a novel approach of integrating fuzzy set theory with an "advanced eutrophication" model to simulate the transmission and distribution of several interrelated water quality variables and their bio-physiochemical processes in an effective manner in the Ganges river basin, India. After calibration, simulated values are compared with the observed values to validate the model's robustness. Fuzzy technique of order preference by similarity to ideal solution (F-TOPSIS) has been used to incorporate the uncertainty associated with the water quality simulation results. The model also simulates five different scenarios for pollution reduction, to determine the maximum pollutant loadings during monsoon and dry periods. The final results clearly indicate how modeled reduction in the rate of wastewater discharge has reduced impacts of pollutants in the downstream. Scenarios suggesting a river discharge rate of 1500 m 3 /s during the lean period, in addition to 25 and 50% reduction in the load rate, are found to be the most effective option to restore quality of river Ganges. Thus, the model serves as an important hydrologic tool to the policy makers by suggesting appropriate remediation action plans.
Applying business management models in health care.
Trisolini, Michael G
2002-01-01
Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models.
A Model for the Departmental Quality Management Infrastructure Within an Academic Health System.
Mathews, Simon C; Demski, Renee; Hooper, Jody E; Biddison, Lee Daugherty; Berry, Stephen A; Petty, Brent G; Chen, Allen R; Hill, Peter M; Miller, Marlene R; Witter, Frank R; Allen, Lisa; Wick, Elizabeth C; Stierer, Tracey S; Paine, Lori; Puttgen, Hans A; Tamargo, Rafael J; Pronovost, Peter J
2017-05-01
As quality improvement and patient safety come to play a larger role in health care, academic medical centers and health systems are poised to take a leadership role in addressing these issues. Academic medical centers can leverage their large integrated footprint and have the ability to innovate in this field. However, a robust quality management infrastructure is needed to support these efforts. In this context, quality and safety are often described at the executive level and at the unit level. Yet, the role of individual departments, which are often the dominant functional unit within a hospital, in realizing health system quality and safety goals has not been addressed. Developing a departmental quality management infrastructure is challenging because departments are diverse in composition, size, resources, and needs.In this article, the authors describe the model of departmental quality management infrastructure that has been implemented at the Johns Hopkins Hospital. This model leverages the fractal approach, linking departments horizontally to support peer and organizational learning and connecting departments vertically to support accountability to the hospital, health system, and board of trustees. This model also provides both structure and flexibility to meet individual departmental needs, recognizing that independence and interdependence are needed for large academic medical centers. The authors describe the structure, function, and support system for this model as well as the practical and essential steps for its implementation. They also provide examples of its early success.
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.
NASA Astrophysics Data System (ADS)
Dong, Feifei; Liu, Yong; Wu, Zhen; Chen, Yihui; Guo, Huaicheng
2018-07-01
Targeting nonpoint source (NPS) pollution hot spots is of vital importance for placement of best management practices (BMPs). Although physically-based watershed models have been widely used to estimate nutrient emissions, connections between nutrient abatement and compliance of water quality standards have been rarely considered in NPS hotspot ranking, which may lead to ineffective decision-making. It's critical to develop a strategy to identify priority management areas (PMAs) based on water quality response to nutrient load mitigation. A water quality constrained PMA identification framework was thereby proposed in this study, based on the simulation-optimization approach with ideal load reduction (ILR-SO). It integrates the physically-based Soil and Water Assessment Tool (SWAT) model and an optimization model under constraints of site-specific water quality standards. To our knowledge, it was the first effort to identify PMAs with simulation-based optimization. The SWAT model was established to simulate temporal and spatial nutrient loading and evaluate effectiveness of pollution mitigation. A metamodel was trained to establish a quantitative relationship between sources and water quality. Ranking of priority areas is based on required nutrient load reduction in each sub-watershed targeting to satisfy water quality standards in waterbodies, which was calculated with genetic algorithm (GA). The proposed approach was used for identification of PMAs on the basis of diffuse total phosphorus (TP) in Lake Dianchi Watershed, one of the three most eutrophic large lakes in China. The modeling results demonstrated that 85% of diffuse TP came from 30% of the watershed area. Compared with the two conventional targeting strategies based on overland nutrient loss and instream nutrient loading, the ILR-SO model identified distinct PMAs and narrowed down the coverage of management areas. This study addressed the urgent need to incorporate water quality response into PMA identification and showed that the ILR-SO approach is effective to guide watershed management for aquatic ecosystem restoration.
NASA Astrophysics Data System (ADS)
KIM, M.; Kim, J.; Baek, J.; Kim, C.; Shin, H.
2013-12-01
It has being happened as flush flood or red/green tide in various natural phenomena due to climate change and indiscreet development of river or land. Especially, water being very important to man should be protected and managed from water quality pollution, and in water resources management, real-time watershed monitoring system is being operated with the purpose of keeping watch and managing on rivers. It is especially important to monitor and forecast water quality in watershed. A study area selected Nak_K as one site among TMDL unit watershed in Nakdong River. This study is to develop a water quality forecasting model connected with making full use of observed data of 8 day interval from Nakdong River Environment Research Center. When forecasting models for each of the BOD, DO, COD, and chlorophyll-a are established considering correlation of various water quality factors, it is needed to select water quality factors showing highly considerable correlation with each water quality factor which is BOD, DO, COD, and chlorophyll-a. For analyzing the correlation of the factors (reservoir discharge, precipitation, air temperature, DO, BOD, COD, Tw, TN, TP, chlorophyll-a), in this study, self-organizing map was used and cross correlation analysis method was also used for comparing results drawn. Based on the results, each forecasting model for BOD, DO, COD, and chlorophyll-a was developed during the short period as 8, 16, 24, 32 days at 8 day interval. The each forecasting model is based on neural network with back propagation algorithm. That is, the study is connected with self-organizing map for analyzing correlation among various factors and neural network model for forecasting of water quality. It is considerably effective to manage the water quality in plenty of rivers, then, it specially is possible to monitor a variety of accidents in water quality. It will work well to protect water quality and to prevent destruction of the environment becoming more and more serious before occurring.
Root Zone Water Quality Model (RZWQM2): Model use, calibration, and validation
USDA-ARS?s Scientific Manuscript database
The Root Zone Water Quality Model (RZWQM2) has been used widely for simulating agricultural management effects on crop production and soil and water quality. Although it is a one-dimensional model it has many desirable features for the modeling community. This paper outlines the principles of calibr...
Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber
2015-10-01
Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.
ERIC Educational Resources Information Center
Sahney, Sangeeta
2016-01-01
Purpose: Educational institutes must embrace the principles of total quality management (TQM) if they seek to remain competitive, and survive and succeed in the long run. An educational institution must embrace the principles of quality management and incorporate them into all of their activities. Starting with a theoretical background, the paper…
Ricci-Cabello, Ignacio; Stevens, Sarah; Dalton, Andrew R H; Griffiths, Robert I; Campbell, John L; Valderas, Jose M
2018-02-01
To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction. The relationships between the subdomains were hypothesized in a conceptual model and subsequently tested using structural equation modeling. The model supported two independent paths. In the first path, "access" was associated with "patient-centered care" (β = 0.63), which in turn was strongly associated with "patient satisfaction" (β = 0.88). In the second path, "education and training" was associated with "clinical management" (β = 0.32), which in turn was associated with "intermediate outcomes" (β = 0.69). "Patient-reported health status" was weakly associated with "patient-centered care" (β = -0.05) and "patient satisfaction" (β = 0.09), and not associated with "clinical management" or "intermediate outcomes." This is the first empirical model to simultaneously provide evidence on the independence of intermediate health care outcomes, patient satisfaction, and health status. The explanatory paths via technical quality clinical management and patient centeredness offer specific opportunities for the development of quality improvement initiatives. © Health Research and Educational Trust.
Hu, Wenfa; He, Xinhua
2014-01-01
The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated.
NASA Astrophysics Data System (ADS)
Haris, H.; Chow, M. F.; Usman, F.; Sidek, L. M.; Roseli, Z. A.; Norlida, M. D.
2016-03-01
Urbanization is growing rapidly in Malaysia. Rapid urbanization has known to have several negative impacts towards hydrological cycle due to decreasing of pervious area and deterioration of water quality in stormwater runoff. One of the negative impacts of urbanization is the congestion of the stormwater drainage system and this situation leading to flash flood problem and water quality degradation. There are many urban stormwater management softwares available in the market such as Storm Water Drainage System design and analysis program (DRAINS), Urban Drainage and Sewer Model (MOUSE), InfoWorks River Simulation (InfoWork RS), Hydrological Simulation Program-Fortran (HSPF), Distributed Routing Rainfall-Runoff Model (DR3M), Storm Water Management Model (SWMM), XP Storm Water Management Model (XPSWMM), MIKE-SWMM, Quality-Quantity Simulators (QQS), Storage, Treatment, Overflow, Runoff Model (STORM), and Hydrologic Engineering Centre-Hydrologic Modelling System (HEC-HMS). In this paper, we are going to discuss briefly about several softwares and their functionality, accessibility, characteristics and components in the quantity analysis of the hydrological design software and compare it with MSMA Design Aid and Database. Green Infrastructure (GI) is one of the main topics that has widely been discussed all over the world. Every development in the urban area is related to GI. GI can be defined as green area build in the develop area such as forest, park, wetland or floodway. The role of GI is to improve life standard such as water filtration or flood control. Among the twenty models that have been compared to MSMA SME, ten models were selected to conduct a comprehensive review for this study. These are known to be widely accepted by water resource researchers. These ten tools are further classified into three major categories as models that address the stormwater management ability of GI in terms of quantity and quality, models that have the capability of conducting the economic analysis of GI and models that can address both stormwater management and economic aspects together.
Wang, Li; Cai, Xuejiao; Cheng, Ping
2018-05-30
The management of medical devices is crucial to safe, high-quality surgical care, but has received little attention in the medical literature. This study explored the effect of a sub-specialties management model in the Central Sterile Supply Department (CSSD). A traditional routine management model (control) was applied from September 2015 through April 2016, and a newly developed sub-specialties management model (observation) was applied from July 2016 through February 2017. Health personnel from various clinical departments were randomly selected to participate as the control (n = 86) and observation (n = 90) groups, respectively. The groups were compared for rates of personnel satisfaction, complaints regarding device errors, and damage of medical devices. The satisfaction score of the observation group (95.8 ± 1.2) was significantly higher than that of the control (90.2 ± 2.3; P = 0.000). The rate of complaints of the observation group (3.3%) was significantly lower than that of the control (11.6%; P = 0.035). The quality control regarding recycle and packing was significantly higher during the observation period than the control period, which favorably influenced the scores for satisfaction. The rate of damage to specialist medical devices during the observation period (0.40%) was lower than during the control period (0.61%; P = 0.003). The theoretical knowledge and practical skills of the CSSD professionals improved after application of the sub-specialties management model. A management model that considers the requirements of specialist medical devices can improve quality control in the CSSD.
Freshwater Ecosystem Research in Water Quality Management
ERIC Educational Resources Information Center
Ferris, James J.; And Others
1974-01-01
Describes the use of modeling techniques to contribute to the basic knowledge of ecologic science, and in solving problems of biological production, resource-use planning and management, and environmental quality. (JR)
Evaluative methodology for comprehensive water quality management planning
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dyer, H. L.
Computer-based evaluative methodologies have been developed to provide for the analysis of coupled phenomena associated with natural resource comprehensive planning requirements. Provisions for planner/computer interaction have been included. Each of the simulation models developed is described in terms of its coded procedures. An application of the models for water quality management planning is presented; and the data requirements for each of the models are noted.
Comprehensive nursing case management. An advanced practice model.
Taylor, P
1999-01-01
Under managed care and capitated reimbursement systems, case management is a core strategy for providing high-quality, cost-effective care by decreasing fragmentation, enhancing quality, ensuring efficient use of resources, and containing costs. Although case management is used in various areas of the healthcare arena, it suffers from a lack of consensus regarding its definition, essential components, and appropriate application. The purpose of this paper is to examine the components and limitations of existing case management models, outline the competencies of an effective case manager, and present a model of advanced practice nursing case management that focuses on a continuum of care that integrates medical and psychosocial resources to promote optimal clinical fiscal outcomes and enables patients to work as partners with the healthcare team in facilitating and maintaining their physical and emotional well-being.
Shawler, Celeste; Edward, Jean; Ling, Jiying; Crawford, Tim N; Rayens, Mary Kay
Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure. The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct ("actor") and indirect ("partner") effects of 46 dyads. The mothers' perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters' self-management. Similarly, the daughters' perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers' self-management and HRQOL.
AIR QUALITY SIMULATION MODEL PERFORMANCE FOR ONE-HOUR AVERAGES
If a one-hour standard for sulfur dioxide were promulgated, air quality dispersion modeling in the vicinity of major point sources would be an important air quality management tool. Would currently available dispersion models be suitable for use in demonstrating attainment of suc...
Tracing the influence of land-use change on water quality and coral reefs using a Bayesian model.
Brown, Christopher J; Jupiter, Stacy D; Albert, Simon; Klein, Carissa J; Mangubhai, Sangeeta; Maina, Joseph M; Mumby, Peter; Olley, Jon; Stewart-Koster, Ben; Tulloch, Vivitskaia; Wenger, Amelia
2017-07-06
Coastal ecosystems can be degraded by poor water quality. Tracing the causes of poor water quality back to land-use change is necessary to target catchment management for coastal zone management. However, existing models for tracing the sources of pollution require extensive data-sets which are not available for many of the world's coral reef regions that may have severe water quality issues. Here we develop a hierarchical Bayesian model that uses freely available satellite data to infer the connection between land-uses in catchments and water clarity in coastal oceans. We apply the model to estimate the influence of land-use change on water clarity in Fiji. We tested the model's predictions against underwater surveys, finding that predictions of poor water quality are consistent with observations of high siltation and low coverage of sediment-sensitive coral genera. The model thus provides a means to link land-use change to declines in coastal water quality.
Liu, Yungui; Yao, Ying; Shangguan, Shihao; Gu, Qun; Gao, Wuming; Chen, Yaoshui
2014-05-01
Study the current quality management situation of enterprises marketing corneal contact lens via systemic investigations and explore effective administration countermeasures in the future. The quality management indicators of sixty-two corneal contact lens marketing enterprises in Xuhui district of Shanghai were systematically investigated and enterprises of different operation models was compared and analyzed. Wholesale enterprises and retail chain enterprises are apparently better than independent enterprises almost in all facets. Facilitate market accession of corneal contact lens marketing enterprises, encourage the business model of retail chain, enhance supervision of corneal contact lens marketing enterprises, especially independent franchisors.
Level of quality management in the Municipal Sports Services, contrast trough EFQM Excellence Model.
Martínez-Moreno, Alfonso; Díaz Suárez, Arturo
2016-01-01
The quality management in the Municipal Sports Services is embedded in the servuction provided to the citizens, which are their internal customers who determine the quality improvement ensuring competitiveness with excellence criteria. The Model of the European Foundation for Quality Management enables the evaluation of organization progress towards achieving quality goals, from a structured, measurable and comparable methodology. The aim is to carry out a diagnosis of the level of implementation of quality in the Municipal Sports Services of the Region of Murcia, Spain. The sample of 287 workers of 30 sports services gets a high level of reliability at all scales, with a coefficient of variation of .985 (range .810-.943). The score in the criteria of Policy and Strategy, People Management, Alliances and Resources, Processes and People Results were significantly higher (p < .05) in the Municipalities with more than 25,000 inhabitants when compared with those less than 10,000 and with those from 10,000 to 25,000 inhabitants obtaining global ratings of 571 points, those less than 10,000, 590 points those from 10,000 to 25,000 and those higher than 25,000 reach 636, having a good level of quality in relation to the scale that determines the model.
Storkholm, Marie Höjriis; Mazzocato, Pamela; Savage, Mairi; Savage, Carl
2017-01-31
The "Triple Aim" - provision of a better care experience and improved population health at a lower cost - may be theoretically sound, but paradoxical in practice as it forces together the logics of management and medicine. The aim of this study was to explore how staff and managers understand the change imperative inherent to the Triple Aim and the mental models underlying their understanding. This qualitative study builds on thirty semi-structured interviews conducted with managers, nurses, midwives, medical secretaries, and physicians at a department of Gynecology and Obstetrics in Denmark who successfully cut costs through staff and bed reductions and, from what we can ascertain, maintained care quality. Mental models were articulated from a content analysis of the interviews. Staff and managers identified with the different dimensions of the Triple Aim along classic professional divides, i.e. nurses and midwives focused on patient experience, physicians on health outcomes, and manager on all three. Underlying these, we found four mental models. The understanding of change was guided by a Professional ethos (inner drive to improve care) and a Socio-political discourse (external requirement to become more efficient) mental model. The understanding of economics was guided by a You-get-what-you-pay-for and by a More-bang-for-the-buck mental model. A complex interplay could be discerned between all four, which led staff to see the Triple Aim as a dilemma between quality and economics and a threat to clinical care and quality, whereas managers saw it as a paradox that invited improvement efforts. Despite these differences, managers chose a change strategy in line with staff mental models. The practical challenges inherent to the Triple Aim may be symptomatic of the interactions between the different mental models that guide staff and managers' understanding and choice of change strategies. Pursuit of quality improvement in the face of financial constraints (the essence of the Triple Aim) may be facilitated through conscious exploration of these empirically identified mental models. Managers might do well to translate the socio-political discourse into a change process that resonates with the mental models held by staff.
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.
Quality First in Education... Why Not? Using Quality and Productivity Methods To Improve Schools.
ERIC Educational Resources Information Center
Spanbauer, Stanley J.; Hillman, Jo Ann
A description is provided of the implementation at Fox Valley Technical College (FVTC), Wisconsin, of the Quality First Process Model, which was adapted from a model commonly used in manufacturing and service industries. The model uses private sector quality and productivity procedures and new management styles to serve students more effectively,…
Analysis of air quality management with emphasis on transportation sources
NASA Technical Reports Server (NTRS)
English, T. D.; Divita, E.; Lees, L.
1980-01-01
The current environment and practices of air quality management were examined for three regions: Denver, Phoenix, and the South Coast Air Basin of California. These regions were chosen because the majority of their air pollution emissions are related to mobile sources. The impact of auto exhaust on the air quality management process is characterized and assessed. An examination of the uncertainties in air pollutant measurements, emission inventories, meteorological parameters, atmospheric chemistry, and air quality simulation models is performed. The implications of these uncertainties to current air quality management practices is discussed. A set of corrective actions are recommended to reduce these uncertainties.
Ishii, Lisa; Pronovost, Peter J; Demski, Renee; Wylie, Gill; Zenilman, Michael
2016-06-01
An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations. Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs. Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies. The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.
An Empirical Study of Logistics Organization, Electronic Linkage, and Performance
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
DYNAMIC ELECTRICITY GENERATION FOR ADDRESSING DAILY AIR QUALITY EXCEEDANCES IN THE US
We will design, demonstrate, and evaluate a dynamic management system for managing daily air quality, exploring different elements of the design of this system such as how air quality forecasts can best be used, and decision rules for the electrical dispatch model. We will ...
Ian R. Scott
2009-01-01
Growth models can produce a wealth of detailed information that is often very difficult to perceive because it is frequently presented either as summary tables, stand view or landscape view visualizations. We have developed new tools for use with the Sylvan model (Larsen 1994) that allow the analysis of wood-quality changes as a consequence of forest management....
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.
Virginia R. Tolbert; Carl C. Trettin; Dale W. Johnson; John W. Parsons; Allan E. Houston; David A. Mays
2001-01-01
Ensuring sustainability of intensively managed woody crops requires determining soil and water quality effects using a combination of field data and modeling projections. Plot- and catchrnent-scale research, models, and meta-analyses are addressing nutrient availability, site quality, and measures to increase short-rotation woody crop (SRWC) productivity and site...
ERIC Educational Resources Information Center
Kauppila, Osmo; Mursula, Anu; Harkonen, Janne; Kujala, Jaakko
2015-01-01
The growth in university-industry collaboration has resulted in an increasing demand for methods to evaluate it. This paper presents one way to evaluate an organization's collaborative activities based on the European Foundation of Quality Management excellence model. Success factors of collaboration are derived from literature and compared…
ERIC Educational Resources Information Center
Tsai, Bor-sheng
2002-01-01
Proposes a model called information genetics to elaborate on the origin of information generating. Explains conceptual and data models; and describes a software program that was developed for citation data mining, infomapping, and information repackaging for total quality knowledge management in Web representation. (Contains 112 references.)…
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...
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...
Watershed and stormwater managers need modeling tools to evaluate alternative plans for water quality management and flow abatement techniques in urban and developing areas. A watershed-scale, decision-support framework that is based on cost optimization is needed to support gov...
Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors
Russell, Grant M.; Dahrouge, Simone; Hogg, William; Geneau, Robert; Muldoon, Laura; Tuna, Meltem
2009-01-01
PURPOSE New approaches to chronic disease management emphasize the need to improve the delivery of primary care services to meet the needs of chronically ill patients. This study (1) assessed whether chronic disease management differed among 4 models of primary health care delivery and (2) identified which practice organizational factors were independently associated with high-quality care. METHODS We undertook a cross-sectional survey with nested qualitative case studies (2 practices per model) in 137 randomly selected primary care practices from 4 delivery models in Ontario Canada: fee for service, capitation, blended payment, and community health centers (CHCs). Practice and clinician surveys were based on the Primary Care Assessment Tool. A chart audit assessed evidence-based care delivery for patients with diabetes, congestive heart failure, and coronary artery disease. Intermediate outcomes were calculated for patients with diabetes and hypertension. Multiple linear regression identified those organizational factors independently associated with chronic disease management. RESULTS Chronic disease management was superior in CHCs. Clinicians in CHCs found it easier than those in the other models to promote high-quality care through longer consultations and interprofessional collaboration. Across the whole sample and independent of model, high-quality chronic disease management was associated with the presence of a nurse-practitioner. It was also associated with lower patient-family physician ratios and when practices had 4 or fewer full-time-equivalent family physicians. CONCLUSIONS The study adds to the literature supporting the value of nurse-practitioners within primary care teams and validates the contributions of Ontario’s CHCs. Our observation that quality of care decreased in larger, busier practices suggests that moves toward larger practices and greater patient-physician ratios may have unanticipated negative effects on processes of care quality. PMID:19597168
NASA Astrophysics Data System (ADS)
Faizah, Arbiati; Syafei, Wahyul Amien; Isnanto, R. Rizal
2018-02-01
This research proposed a model combining an approach of Total Quality Management (TQM) and Fuzzy method of Service Quality (SERVQUAL) to asses service quality. TQM implementation was as quality management orienting on customer's satisfaction by involving all stakeholders. SERVQUAL model was used to measure quality service based on five dimensions such as tangible, reliability, responsiveness, assurance, and empathy. Fuzzy set theory was to accommodate subjectivity and ambiguity of quality assessment. Input data consisted of indicator data and quality assessment aspect. Input data was, then, processed to be service quality assessment questionnaires of Pesantren by using Fuzzy method to get service quality score. This process consisted of some steps as follows : inputting dimension and questionnaire data to data base system, filling questionnaire through system, then, system calculated fuzzification, defuzzification, gap of quality expected and received by service receivers, and calculating each dimension rating showing quality refinement priority. Rating of each quality dimension was, then, displayed at dashboard system to enable users to see information. From system having been built, it could be known that tangible dimension had the highest gap, -0.399, thus it needs to be prioritized and gets evaluation and refinement action soon.
The Impact of ISO Quality Management Systems on Primary and Secondary Schools in Spain
ERIC Educational Resources Information Center
Arribas Díaz, Jorge Antonio; Martínez-Mediano, Catalina
2018-01-01
Purpose: The purpose of this study is to evaluate the application of quality management systems (QMS) based on international standards of quality in education (ISO 9001:2008) and ascertain the influence of this quality model on primary and secondary schools in Spain. Design/methodology/approach: The study was conducted in 26 publicly funded,…
2014-01-01
The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated. PMID:24672351
The Effect of Nurse Practitioner Co-Management on the Care of Geriatric Conditions
Reuben, David B.; Ganz, David A.; Roth, Carol P.; McCreath, Heather E.; Ramirez, Karina D.; Wenger, Neil S.
2013-01-01
Background/Objectives The quality of care for geriatric conditions remains poor. The Assessing Care of Vulnerable Elders (ACOVE)-2 model (case finding, delegation of data collection, structured visit notes, physician and patient education, and linkage to community resources) improves the quality of care for geriatric conditions when implemented by primary care physicians (PCPs) or by nurse practitioners (NPs) co-managing care with an academic geriatrician. However, it is unclear whether community-based PCP-NP co-management can achieve similar results. Design Case study. Setting Two community-based primary care practices. Participants Patients > 75 years who screened positive for at least one condition: falls, urinary incontinence (UI), dementia, and depression. Intervention The ACOVE-2 model augmented by NP co-management of conditions. Measurements Quality of care by medical record review using ACOVE-3 quality indicators (QIs). Patients receiving co-management were compared with those who received PCP care alone in the same practices. Results Of 1084 screened patients, 658 (61%) screened positive for > 1 condition; 485 of these patients were randomly selected for chart review and triggered a mean of 7 QIs. A NP saw approximately half (49%) for co-management. Overall, patients received 57% of recommended care. Quality scores for all conditions (falls: 80% versus 34%; UI: 66% versus 19%; dementia: 59% versus 38%) except depression (63% versus 60%) were higher for patients seen by a NP. In analyses adjusted for gender, age of patient, number of conditions, site, and a NP estimate of medical management style, NP co-management remained significantly associated with receiving recommended care (p<0.001), as did the NP estimate of medical management style (p=0.02). Conclusion Compared to usual care using the ACOVE-2 model, NP co-management is associated with better quality of care for geriatric conditions in community-based primary care. PMID:23772723
Assessment of coastal management options by means of multilayered ecosystem models
NASA Astrophysics Data System (ADS)
Nobre, Ana M.; Ferreira, João G.; Nunes, João P.; Yan, Xiaojun; Bricker, Suzanne; Corner, Richard; Groom, Steve; Gu, Haifeng; Hawkins, Anthony J. S.; Hutson, Rory; Lan, Dongzhao; Silva, João D. Lencart e.; Pascoe, Philip; Telfer, Trevor; Zhang, Xuelei; Zhu, Mingyuan
2010-03-01
This paper presents a multilayered ecosystem modelling approach that combines the simulation of the biogeochemistry of a coastal ecosystem with the simulation of the main forcing functions, such as catchment loading and aquaculture activities. This approach was developed as a tool for sustainable management of coastal ecosystems. A key feature is to simulate management scenarios that account for changes in multiple uses and enable assessment of cumulative impacts of coastal activities. The model was applied to a coastal zone in China with large aquaculture production and multiple catchment uses, and where management efforts to improve water quality are under way. Development scenarios designed in conjunction with local managers and aquaculture producers include the reduction of fish cages and treatment of wastewater. Despite the reduction in nutrient loading simulated in three different scenarios, inorganic nutrient concentrations in the bay were predicted to exceed the thresholds for poor quality defined by Chinese seawater quality legislation. For all scenarios there is still a Moderate High to High nutrient loading from the catchment, so further reductions might be enacted, together with additional decreases in fish cage culture. The model predicts that overall, shellfish production decreases by 10%-28% using any of these development scenarios, principally because shellfish growth is being sustained by the substances to be reduced for improvement of water quality. The model outcomes indicate that this may be counteracted by zoning of shellfish aquaculture at the ecosystem level in order to optimize trade-offs between productivity and environmental effects. The present case study exemplifies the value of multilayered ecosystem modelling as a tool for Integrated Coastal Zone Management and for the adoption of ecosystem approaches for marine resource management. This modelling approach can be applied worldwide, and may be particularly useful for the application of coastal management regulation, for instance in the implementation of the European Marine Strategy Framework Directive.
[Basic considerations during outsourcing of clinical data management services].
Shen, Tong; Liu, Yan
2015-11-01
With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.
MUSQA: a CS method to build a multi-standard quality management system
NASA Astrophysics Data System (ADS)
Cros, Elizabeth; Sneed, Isabelle
2002-07-01
CS Communication & Systèmes, through its long quality management experience, has been able to build and evolve its Quality Management System according to clients requirements, norms, standards and models (ISO, DO178, ECSS, CMM, ...), evolving norms (transition from ISO 9001:1994 to ISO 9001:2000) and the TQM approach, being currently deployed. The aim of this paper is to show how, from this enriching and instructive experience, CS has defined and formalised its method: MuSQA (Multi-Standard Quality Approach). This method allows to built a new Quality Management System or simplify and unify an existing one. MuSQA objective is to provide any organisation with an open Quality Management System, which is able to evolve easily and turns to be a useful instrument for everyone, operational as well as non-operational staff.
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...
The Evaluation of Teachers' Job Performance Based on Total Quality Management (TQM)
ERIC Educational Resources Information Center
Shahmohammadi, Nayereh
2017-01-01
This study aimed to evaluate teachers' job performance based on total quality management (TQM) model. This was a descriptive survey study. The target population consisted of all primary school teachers in Karaj (N = 2917). Using Cochran formula and simple random sampling, 340 participants were selected as sample. A total quality management…
Managing Change to a Quality Philosophy: A Partnership Perspective.
ERIC Educational Resources Information Center
Snyder, Karolyn J.; Acker-Hocevar, Michele
Within the past 5 years there has been an international movement to adapt the principles and practices of Total Quality Management work environments to school-restructuring agendas. This paper reports on the development of a model called the Educational Quality System, a benchmark assessment tool for identifying the essential elements of quality…
Water quality modelling of Jadro spring.
Margeta, J; Fistanic, I
2004-01-01
Management of water quality in karst is a specific problem. Water generally moves very fast by infiltration processes but far more by concentrated flows through fissures and openings in karst. This enables the entire surface pollution to be transferred fast and without filtration into groundwater springs. A typical example is the Jadro spring. Changes in water quality at the spring are sudden, but short. Turbidity as a major water quality problem for the karst springs regularly exceeds allowable standards. Former practice in problem solving has been reduced to intensive water disinfection in periods of great turbidity without analyses of disinfection by-products risks for water users. The main prerequisite for water quality control and an optimization of water disinfection is the knowledge of raw water quality and nature of occurrence. The analysis of monitoring data and their functional relationship with hydrological parameters enables establishment of a stochastic model that will help obtain better information on turbidity in different periods of the year. Using the model a great number of average monthly and extreme daily values are generated. By statistical analyses of these data possibility of occurrence of high turbidity in certain months is obtained. This information can be used for designing expert system for water quality management of karst springs. Thus, the time series model becomes a valuable tool in management of drinking water quality of the Jadro spring.
Storm Water Management Model Reference Manual Volume II ...
SWMM is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. The runoff component of SWMM operates on a collection of subcatchment areas that receive precipitation and generate runoff and pollutant loads. The routing portion of SWMM transports this runoff through a system of pipes, channels, storage/treatment devices, pumps, and regulators. SWMM tracks the quantity and quality of runoff generated within each subcatchment, and the flow rate, flow depth, and quality of water in each pipe and channel during a simulation period comprised of multiple time steps. The reference manual for this edition of SWMM is comprised of three volumes. Volume I describes SWMM’s hydrologic models, Volume II its hydraulic models, and Volume III its water quality and low impact development models. This document provides the underlying mathematics for the hydraulic calculations of the Storm Water Management Model (SWMM)
ERIC Educational Resources Information Center
Tsai, Bor-sheng
2003-01-01
Total quality management and knowledge management are merged and used as a conceptual model to direct and develop information landscaping techniques through the coordination of information mapping, charting, querying, and reporting. Goals included: merge citation analysis and data mining, and apply data visualization and information architecture…
AIR QUALITY MODELING AT NEIGHBORHOOD SCALES TO IMPROVE HUMAN EXPOSURE ASSESSMENT
Air quality modeling is an integral component of risk assessment and of subsequent development of effective and efficient management of air quality. Urban areas introduce of fresh sources of pollutants into regional background producing significant spatial variability of the co...
Industrial pollution and the management of river water quality: a model of Kelani River, Sri Lanka.
Gunawardena, Asha; Wijeratne, E M S; White, Ben; Hailu, Atakelty; Pandit, Ram
2017-08-19
Water quality of the Kelani River has become a critical issue in Sri Lanka due to the high cost of maintaining drinking water standards and the market and non-market costs of deteriorating river ecosystem services. By integrating a catchment model with a river model of water quality, we developed a method to estimate the effect of pollution sources on ambient water quality. Using integrated model simulations, we estimate (1) the relative contribution from point (industrial and domestic) and non-point sources (river catchment) to river water quality and (2) pollutant transfer coefficients for zones along the lower section of the river. Transfer coefficients provide the basis for policy analyses in relation to the location of new industries and the setting of priorities for industrial pollution control. They also offer valuable information to design socially optimal economic policy to manage industrialized river catchments.
Sapunar, Damir; Grković, Ivica; Lukšić, Davor; Marušić, Matko
2016-05-01
Our aim was to describe a comprehensive model of internal quality management (QM) at a medical school founded on the business process analysis (BPA) software tool. BPA software tool was used as the core element for description of all working processes in our medical school, and subsequently the system served as the comprehensive model of internal QM. The quality management system at the University of Split School of Medicine included the documentation and analysis of all business processes within the School. The analysis revealed 80 weak points related to one or several business processes. A precise analysis of medical school business processes allows identification of unfinished, unclear and inadequate points in these processes, and subsequently the respective improvements and increase of the QM level and ultimately a rationalization of the institution's work. Our approach offers a potential reference model for development of common QM framework allowing a continuous quality control, i.e. the adjustments and adaptation to contemporary educational needs of medical students. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.
Managing Diversity within South African Technikons: A Strategic Management Approach.
ERIC Educational Resources Information Center
Norris, Brian
1996-01-01
Based on experiences with affirmative action and subsequent management of diversity at five research universities in the United States, a model for strategic management of diversity in South African technical institutes is outlined. The model has six components: organizational culture; organizational/environmental change; Total Quality Management…
[Quality assurance and total quality management in residential home care].
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.
Managing the travel model process : small and medium-sized MPOs. Instructor guide.
DOT National Transportation Integrated Search
2013-09-01
The learning objectives of this course were to: explain fundamental travel model concepts; describe the model development process; identify key inputs and describe the quality control process; and identify and manage resources.
Managing the travel model process : small and medium-sized MPOs. Participant handbook.
DOT National Transportation Integrated Search
2013-09-01
The learning objectives of this course were to: explain fundamental travel model concepts; describe the model development process; identify key inputs and describe the quality control process; and identify and manage resources.
NASA Astrophysics Data System (ADS)
Chang, N. B.
2016-12-01
Many countries concern about development and redevelopment efforts in urban regions to reduce the flood risk by considering hazards such as high-tide events, storm surge, flash floods, stormwater runoff, and impacts of sea level rise. Combining these present and future hazards with vulnerable characteristics found throughout coastal communities such as majority low-lying areas and increasing urban development, create scenarios for increasing exposure of flood hazard. As such, the most vulnerable areas require adaptation strategies and mitigation actions for flood hazard management. In addition, in the U.S., Numeric Nutrient Criteria (NNC) are a critical tool for protecting and restoring the designated uses of a waterbody with regard to nitrogen and phosphorus pollution. Strategies such as low impact development (LID) have been promoted in recent years as an alternative to traditional stormwater management and drainage to control both flooding and water quality impact. LID utilizes decentralized multifunctional site designs and incorporates on-site storm water management practices rather than conventional storm water management approaches that divert flow toward centralized facilities. How to integrate hydrologic and water quality models to achieve the decision support becomes a challenge. The Cross Bayou Watershed of Pinellas County in Tampa Bay, a highly urbanized coastal watershed, is utilized as a case study due to its sensitivity to flood hazards and water quality management within the watershed. This study will aid the County, as a decision maker, to implement its stormwater management policy and honor recent NNC state policy via demonstration of an integrated hydrologic and water quality model, including the Interconnected Channel and Pond Routing Model v.4 (ICPR4) and the BMPTRAIN model as a decision support tool. The ICPR4 can be further coupled with the ADCIRC/SWAN model to reflect the storm surge and seal level rise in coastal regions.
Sustaining self-management in diabetes mellitus.
Mitchell-Brown, Fay
2014-01-01
Successful management of diabetes depends on the individual's ability to manage and control symptoms. Self-management of diabetes is believed to play a significant role in achieving positive outcomes for patients. Adherence to self-management behaviors supports high-quality care, which reduces and delays disease complications, resulting in improved quality of life. Because self-management is so important to diabetes management and involves a lifelong commitment for all patients, health care providers should actively promote ways to maintain and sustain behavior change that support adherence to self-management. A social ecological model of behavior change (McLeroy, Bibeau, Steckler, & Glanz, 1988) helps practitioners provide evidence-based care and optimizes patients' clinical outcomes. This model supports self-management behaviors through multiple interacting interventions that can help sustain behavior change. Diabetes is a complex chronic disease; successful management must use multiple-level interventions.
Development of risk-based air quality management strategies under impacts of climate change.
Liao, Kuo-Jen; Amar, Praveen; Tagaris, Efthimios; Russell, Armistead G
2012-05-01
Climate change is forecast to adversely affect air quality through perturbations in meteorological conditions, photochemical reactions, and precursor emissions. To protect the environment and human health from air pollution, there is an increasing recognition of the necessity of developing effective air quality management strategies under the impacts of climate change. This paper presents a framework for developing risk-based air quality management strategies that can help policy makers improve their decision-making processes in response to current and future climate change about 30-50 years from now. Development of air quality management strategies under the impacts of climate change is fundamentally a risk assessment and risk management process involving four steps: (1) assessment of the impacts of climate change and associated uncertainties; (2) determination of air quality targets; (3) selections of potential air quality management options; and (4) identification of preferred air quality management strategies that minimize control costs, maximize benefits, or limit the adverse effects of climate change on air quality when considering the scarcity of resources. The main challenge relates to the level of uncertainties associated with climate change forecasts and advancements in future control measures, since they will significantly affect the risk assessment results and development of effective air quality management plans. The concept presented in this paper can help decision makers make appropriate responses to climate change, since it provides an integrated approach for climate risk assessment and management when developing air quality management strategies. Development of climate-responsive air quality management strategies is fundamentally a risk assessment and risk management process. The risk assessment process includes quantification of climate change impacts on air quality and associated uncertainties. Risk management for air quality under the impacts of climate change includes determination of air quality targets, selections of potential management options, and identification of effective air quality management strategies through decision-making models. The risk-based decision-making framework can also be applied to develop climate-responsive management strategies for the other environmental dimensions and assess costs and benefits of future environmental management policies.
NASA Astrophysics Data System (ADS)
Lallahem, S.; Hani, A.
2017-02-01
Water sustainability in the lower Seybouse River basin, eastern Algeria, must take into account the importance of water quantity and quality integration. So, there is a need for a better knowledge and understanding of the water quality determinants of groundwater abstraction to meet the municipal and agricultural uses. In this paper, the artificial neural network (ANN) models were used to model and predict the relationship between groundwater abstraction and water quality determinants in the lower Seybouse River basin. The study area chosen is the lower Seybouse River basin and real data were collected from forty five wells for reference year 2006. Results indicate that the feed-forward multilayer perceptron models with back-propagation are useful tools to define and prioritize the important water quality parameters of groundwater abstraction and use. The model evaluation shows that the correlation coefficients are more than 95% for training, verification and testing data. The model aims to link the water quantity and quality with the objective to strengthen the Integrated Water Resources Management approach. It assists water planners and managers to better assess the water quality parameters and progress towards the provision of appropriate quantities of water of suitable quality.
ROLE OF MODELS IN AIR QUALITY MANAGEMENT DECISIONS
Within the frame of the US-India bilateral agreement on environmental cooperation, a team of US scientists have been helping India in designing emission control policies to address urban air quality problems. This presentation discusses how air quality models need to be used for ...
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)
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…
Quality Risk Management. Modernising the Architecture of Quality Assurance
ERIC Educational Resources Information Center
Raban, Colin; Turner, Liz
2006-01-01
Although the world is changing, quality management remains an area of relative calm. Many institutions continue to use elaborated versions of a model that is developed by the Council of Academic Awards and conceived at a time when higher education was not so exposed to market forces, when the policy and regulatory environment was relatively…
Operation quality assessment model for video conference system
NASA Astrophysics Data System (ADS)
Du, Bangshi; Qi, Feng; Shao, Sujie; Wang, Ying; Li, Weijian
2018-01-01
Video conference system has become an important support platform for smart grid operation and management, its operation quality is gradually concerning grid enterprise. First, the evaluation indicator system covering network, business and operation maintenance aspects was established on basis of video conference system's operation statistics. Then, the operation quality assessment model combining genetic algorithm with regularized BP neural network was proposed, which outputs operation quality level of the system within a time period and provides company manager with some optimization advice. The simulation results show that the proposed evaluation model offers the advantages of fast convergence and high prediction accuracy in contrast with regularized BP neural network, and its generalization ability is superior to LM-BP neural network and Bayesian BP neural network.
Innovative Stormwater Quality Tools by SARA for Holistic Watershed Master Planning
NASA Astrophysics Data System (ADS)
Thomas, S. M.; Su, Y. C.; Hummel, P. R.
2016-12-01
Stormwater management strategies such as Best Management Practices (BMP) and Low-Impact Development (LID) have increasingly gained attention in urban runoff control, becoming vital to holistic watershed master plans. These strategies can help address existing water quality impairments and support regulatory compliance, as well as guide planning and management of future development when substantial population growth and urbanization is projected to occur. However, past efforts have been limited to qualitative planning due to the lack of suitable tools to conduct quantitative assessment. The San Antonio River Authority (SARA), with the assistance of Lockwood, Andrews & Newnam, Inc. (LAN) and AQUA TERRA Consultants (a division of RESPEC), developed comprehensive hydrodynamic and water quality models using the Hydrological Simulation Program-FORTRAN (HSPF) for several urban watersheds in the San Antonio River Basin. These models enabled watershed management to look at water quality issues on a more refined temporal and spatial scale than the limited monitoring data. They also provided a means to locate and quantify potential water quality impairments and evaluate the effects of mitigation measures. To support the models, a suite of software tools were developed. including: 1) SARA Timeseries Utility Tool for managing and processing of large model timeseries files, 2) SARA Load Reduction Tool to determine load reductions needed to achieve screening levels for each modeled constituent on a sub-basin basis, and 3) SARA Enhanced BMP Tool to determine the optimal combination of BMP types and units needed to achieve the required load reductions. Using these SARA models and tools, water quality agencies and stormwater professionals can determine the optimal combinations of BMP/LID to accomplish their goals and save substantial stormwater infrastructure and management costs. The tools can also help regulators and permittees evaluate the feasibility of achieving compliance using BMP/LID. The project has gained national attention, being showcased in multiple newsletters, professional magazines, and conference presentations. The project also won the Texas American Council of Engineering Companies (ACEC) Gold Medal Award and the ACEC National Recognition Award in 2016.
Do competition and managed care improve quality?
Sari, Nazmi
2002-10-01
In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts. Copyright 2002 John Wiley & Sons, Ltd.
Water Quality Analysis Simulation Program (WASP)
The Water Quality Analysis Simulation Program (WASP) model helps users interpret and predict water quality responses to natural phenomena and manmade pollution for various pollution management decisions.
Gary L. Achtemeier
2013-01-01
In this paper, conflicting interests in prescribed burn practice and improving air quality in the South are reviewed. Conflicting societal interests and legislative actions threaten to curtail the use of prescribed fire to manage for endangered species and for other land management objectives in the South. This comes at a time when efforts are being made to increase...
Yu, Wen-Kang; Dong, Ling; Pei, Wen-Xuan; Sun, Zhi-Rong; Dai, Jun-Dong; Wang, Yun
2017-12-01
The whole process quality control and management of traditional Chinese medicine (TCM) decoction pieces is a system engineering, involving the base environment, seeds and seedlings, harvesting, processing and other multiple steps, so the accurate identification of factors in TCM production process that may induce the quality risk, as well as reasonable quality control measures are very important. At present, the concept of quality risk is mainly concentrated in the aspects of management and regulations, etc. There is no comprehensive analysis on possible risks in the quality control process of TCM decoction pieces, or analysis summary of effective quality control schemes. A whole process quality control and management system for TCM decoction pieces based on TCM quality tree was proposed in this study. This system effectively combined the process analysis method of TCM quality tree with the quality risk management, and can help managers to make real-time decisions while realizing the whole process quality control of TCM. By providing personalized web interface, this system can realize user-oriented information feedback, and was convenient for users to predict, evaluate and control the quality of TCM. In the application process, the whole process quality control and management system of the TCM decoction pieces can identify the related quality factors such as base environment, cultivation and pieces processing, extend and modify the existing scientific workflow according to their own production conditions, and provide different enterprises with their own quality systems, to achieve the personalized service. As a new quality management model, this paper can provide reference for improving the quality of Chinese medicine production and quality standardization. Copyright© by the Chinese Pharmaceutical Association.
Can Deming's Concept of Total Quality Management Be Applied to Education?
ERIC Educational Resources Information Center
Sevick, Charles
This paper explores the meaning of Total Quality Management (TQM), examines the development of the concept, and assesses the application of TQM to education. In summary, TQM has the following points of relevance for education: (1) The interest and welfare of every student must be a primary concern; (2) the authoritarian management model does not…
Air Quality Response Modeling for Decision Support | Science ...
Air quality management relies on photochemical models to predict the responses of pollutant concentrations to changes in emissions. Such modeling is especially important for secondary pollutants such as ozone and fine particulate matter which vary nonlinearly with changes in emissions. Numerous techniques for probing pollutant-emission relationships within photochemical models have been developed and deployed for a variety of decision support applications. However, atmospheric response modeling remains complicated by the challenge of validating sensitivity results against observable data. This manuscript reviews the state of the science of atmospheric response modeling as well as efforts to characterize the accuracy and uncertainty of sensitivity results. The National Exposure Research Laboratory′s (NERL′s) Atmospheric Modeling and Analysis Division (AMAD) conducts research in support of EPA′s mission to protect human health and the environment. AMAD′s research program is engaged in developing and evaluating predictive atmospheric models on all spatial and temporal scales for forecasting the Nation′s air quality and for assessing changes in air quality and air pollutant exposures, as affected by changes in ecosystem management and regulatory decisions. AMAD is responsible for providing a sound scientific and technical basis for regulatory policies based on air quality models to improve ambient air quality. The models developed by AMAD are being use
Hoshin Kanri: a technique for strategic quality management.
Tennant, C; Roberts, P A
2000-01-01
This paper describes a technique for Strategic Quality Management (SQM), known as Hoshin Kanri, which has been operated as a management system in many Japanese companies since the 1960s. It represents a core aspect of Japanese companies' management systems, and is stated as: the means by which the overall control system and Total Quality Management (TQM) are deployed. Hoshin Kanri is not particularly unique in its concept of establishing and tracking individual goals and objectives, but the manner in which the objectives and the means to achieve them are developed and deployed is. The problem with applying the concept of Strategic Quality Management (SQM) using Hoshin Kanri, is that it can tend to challenge the traditional authoritarian strategic planning models, which have become the paradigms of modern business. Yet Hoshin Kanri provides an appropriate tool for declaration of the strategic vision for the business while integrating goals and targets in a single holistic model. There have been various adaptations of Hoshin Kanri to align the technique to Western thinking and management approaches, yet outside Japan its significance has gone largely unreported. It is proposed that Hoshin Kanri is an effective methodology for SQM, which has a number of benefits over the more conventional planning techniques. The benefits of Hoshin Kanri as a tool for Strategic Quality Management (SQM) compared to conventional planning systems include: integration of strategic objectives with tactical daily management, the application of the plan-do-check-act cycle to business process management, parallel planning and execution methodology, company wide approach, improvements in communication, increased consensus and buy-in to goal setting, and cross-functional-management integration.
Herrler, Claudia; Bramesfeld, Anke; Brodowski, Marc; Prytherch, Helen; Marx, Irmgard; Nafula, Maureen; Richter-Aairijoki, Heide; Musyoka, Lucy; Marx, Michael; Szecsenyi, Joachim
2015-01-01
To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance. The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts. 260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed. Copyright © 2015. Published by Elsevier GmbH.
Managing human resources in healthcare: learning from world class practices--Part I.
Zairi, M
1998-01-01
This paper, which is presented in two parts, is intended to demonstrate that practices related to the area of human resources management, adopted by model organisations that have dominated their markets consistently, can lend themselves very well to the healthcare sector, which is primarily a "people-oriented" sector. As change in a modern business context is set to continue in an unrelenting way, most organisations will be presented with the challenge of developing the necessary skills and areas of expertise to enable them to cope with the demands on them, master technological opportunities at their disposal, learn how to exploit modern management concepts and optimise value to all the stakeholders they intend to serve. This paper draws from best practices using the experiences of quality recognised organisations and many admired names through pioneering human resource policies and practices and through clear demonstrations on the benefits of relying on people as the major "asset". Part I of this article addresses the importance of human resources as revealed through models of management for organisational excellence. In particular, the paper refers to the criteria for excellence in relation to people management using the following prestigious and integrative management models: Deming Prize (Japan); European Quality Award Model (Europe); and Malcolm Baldrige National Quality Award (USA). In addition, this paper illustrates several case studies using organisations known for their pioneering approaches to people management and which led them to win very prestigious quality awards and various international accolades. The paper concludes by reinforcing the point that human resource management in a healthcare context has to be viewed as an integrated set of processes and practices which need to be adhered to from an integrated perspective in order to optimise individuals' performance levels and so that the human potential can be exploited fully.
Role of future scenarios in understanding deep uncertainty in long-term air quality management.
Gamas, Julia; Dodder, Rebecca; Loughlin, Dan; Gage, Cynthia
2015-11-01
The environment and its interactions with human systems, whether economic, social, or political, are complex. Relevant drivers may disrupt system dynamics in unforeseen ways, making it difficult to predict future conditions. This kind of "deep uncertainty" presents a challenge to organizations faced with making decisions about the future, including those involved in air quality management. Scenario Planning is a structured process that involves the development of narratives describing alternative future states of the world, designed to differ with respect to the most critical and uncertain drivers. The resulting scenarios are then used to understand the consequences of those futures and to prepare for them with robust management strategies. We demonstrate a novel air quality management application of Scenario Planning. Through a series of workshops, important air quality drivers were identified. The most critical and uncertain drivers were found to be "technological development" and "change in societal paradigms." These drivers were used as a basis to develop four distinct scenario storylines. The energy and emissions implications of each storyline were then modeled using the MARKAL energy system model. NOx emissions were found to decrease for all scenarios, largely a response to existing air quality regulations, whereas SO2 emissions ranged from 12% greater to 7% lower than 2015 emissions levels. Future-year emissions differed considerably from one scenario to another, however, with key differentiating factors being transition to cleaner fuels and energy demand reductions. Application of scenarios in air quality management provides a structured means of sifting through and understanding the dynamics of the many complex driving forces affecting future air quality. Further, scenarios provide a means to identify opportunities and challenges for future air quality management, as well as a platform for testing the efficacy and robustness of particular management options across wide-ranging conditions.
Air Pollution Data for Model Evaluation and Application
One objective of designing an air pollution monitoring network is to obtain data for evaluating air quality models that are used in the air quality management process and scientific discovery.1.2 A common use is to relate emissions to air quality, including assessing ...
An Integrated Risk Management Model for Source Water Protection Areas
Chiueh, Pei-Te; Shang, Wei-Ting; Lo, Shang-Lien
2012-01-01
Watersheds are recognized as the most effective management unit for the protection of water resources. For surface water supplies that use water from upstream watersheds, evaluating threats to water quality and implementing a watershed management plan are crucial for the maintenance of drinking water safe for humans. The aim of this article is to establish a risk assessment model that provides basic information for identifying critical pollutants and areas at high risk for degraded water quality. In this study, a quantitative risk model that uses hazard quotients for each water quality parameter was combined with a qualitative risk model that uses the relative risk level of potential pollution events in order to characterize the current condition and potential risk of watersheds providing drinking water. In a case study of Taipei Source Water Area in northern Taiwan, total coliforms and total phosphorus were the top two pollutants of concern. Intensive tea-growing and recreational activities around the riparian zone may contribute the greatest pollution to the watershed. Our risk assessment tool may be enhanced by developing, recording, and updating information on pollution sources in the water supply watersheds. Moreover, management authorities could use the resultant information to create watershed risk management plans. PMID:23202770
ERIC Educational Resources Information Center
Kastner, Theodore A.; Walsh, Kevin K.; Criscione, Teri
1997-01-01
Presents a general model of the structure and functioning of managed care and describes elements (provider networks, fiscal elements, risk estimation, case-mix, management information systems, practice parameters, and quality improvement) critical to people with developmental disabilities. Managed care demonstration projects and a hypothetical…
Applying revised gap analysis model in measuring hotel service quality.
Lee, Yu-Cheng; Wang, Yu-Che; Chien, Chih-Hung; Wu, Chia-Huei; Lu, Shu-Chiung; Tsai, Sang-Bing; Dong, Weiwei
2016-01-01
With the number of tourists coming to Taiwan growing by 10-20 % since 2010, the number has increased due to an increasing number of foreign tourists, particularly after deregulation allowed admitting tourist groups, followed later on by foreign individual tourists, from mainland China. The purpose of this study is to propose a revised gap model to evaluate and improve service quality in Taiwanese hotel industry. Thus, service quality could be clearly measured through gap analysis, which was more effective for offering direction in developing and improving service quality. The HOLSERV instrument was used to identify and analyze service gaps from the perceptions of internal and external customers. The sample for this study included three main categories of respondents: tourists, employees, and managers. The results show that five gaps influenced tourists' evaluations of service quality. In particular, the study revealed that Gap 1 (management perceptions vs. customer expectations) and Gap 9 (service provider perceptions of management perceptions vs. service delivery) were more critical than the others in affecting perceived service quality, making service delivery the main area of improvement. This study contributes toward an evaluation of the service quality of the Taiwanese hotel industry from the perspectives of customers, service providers, and managers, which is considerably valuable for hotel managers. It was the aim of this study to explore all of these together in order to better understand the possible gaps in the hotel industry in Taiwan.
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.
A condition metric for Eucalyptus woodland derived from expert evaluations.
Sinclair, Steve J; Bruce, Matthew J; Griffioen, Peter; Dodd, Amanda; White, Matthew D
2018-02-01
The evaluation of ecosystem quality is important for land-management and land-use planning. Evaluation is unavoidably subjective, and robust metrics must be based on consensus and the structured use of observations. We devised a transparent and repeatable process for building and testing ecosystem metrics based on expert data. We gathered quantitative evaluation data on the quality of hypothetical grassy woodland sites from experts. We used these data to train a model (an ensemble of 30 bagged regression trees) capable of predicting the perceived quality of similar hypothetical woodlands based on a set of 13 site variables as inputs (e.g., cover of shrubs, richness of native forbs). These variables can be measured at any site and the model implemented in a spreadsheet as a metric of woodland quality. We also investigated the number of experts required to produce an opinion data set sufficient for the construction of a metric. The model produced evaluations similar to those provided by experts, as shown by assessing the model's quality scores of expert-evaluated test sites not used to train the model. We applied the metric to 13 woodland conservation reserves and asked managers of these sites to independently evaluate their quality. To assess metric performance, we compared the model's evaluation of site quality with the managers' evaluations through multidimensional scaling. The metric performed relatively well, plotting close to the center of the space defined by the evaluators. Given the method provides data-driven consensus and repeatability, which no single human evaluator can provide, we suggest it is a valuable tool for evaluating ecosystem quality in real-world contexts. We believe our approach is applicable to any ecosystem. © 2017 State of Victoria.
An integrated view of data quality in Earth observation
Yang, X.; Blower, J. D.; Bastin, L.; Lush, V.; Zabala, A.; Masó, J.; Cornford, D.; Díaz, P.; Lumsden, J.
2013-01-01
Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research. PMID:23230156
An integrated view of data quality in Earth observation.
Yang, X; Blower, J D; Bastin, L; Lush, V; Zabala, A; Masó, J; Cornford, D; Díaz, P; Lumsden, J
2013-01-28
Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research.
Hu, X H; Li, Y P; Huang, G H; Zhuang, X W; Ding, X W
2016-05-01
In this study, a Bayesian-based two-stage inexact optimization (BTIO) method is developed for supporting water quality management through coupling Bayesian analysis with interval two-stage stochastic programming (ITSP). The BTIO method is capable of addressing uncertainties caused by insufficient inputs in water quality model as well as uncertainties expressed as probabilistic distributions and interval numbers. The BTIO method is applied to a real case of water quality management for the Xiangxi River basin in the Three Gorges Reservoir region to seek optimal water quality management schemes under various uncertainties. Interval solutions for production patterns under a range of probabilistic water quality constraints have been generated. Results obtained demonstrate compromises between the system benefit and the system failure risk due to inherent uncertainties that exist in various system components. Moreover, information about pollutant emission is accomplished, which would help managers to adjust production patterns of regional industry and local policies considering interactions of water quality requirement, economic benefit, and industry structure.
Modeling the Effects of Conservation Tillage on Water Quality at the Field Scale
USDA-ARS?s Scientific Manuscript database
The development and application of predictive tools to quantitatively assess the effects of tillage and related management activities should be carefully tested against high quality field data. This study reports on: 1) the calibration and validation of the Root Zone Water Quality Model (RZWQM) to a...
ERIC Educational Resources Information Center
Kenny, John
This article explores the perennial tension between the demands of management for quality projects that can be used to attract new markets and students and the traditional scholarly approach to learning. Universities are unique environments compared to industry settings. They are unique in that the responsibility for the quality of the teaching…
Schools of Quality: An Introduction to Total Quality Management in Education.
ERIC Educational Resources Information Center
Bonstingl, John Jay
This book offers an introduction to the basic ideas of Total Quality Management (TQM) in education. Chapter 1 contrasts the American model of the bell-shaped curve with the Japanese concept of "kaizen," which is personal dedication to mutual improvement and the heart of TQM philosophy. Chapter 2 provides an overview of the history of the TQ…
A quality improvement management model for renal care.
Vlchek, D L; Day, L M
1991-04-01
The purpose of this article is to explore the potential for applying the theory and tools of quality improvement (total quality management) in the renal care setting. We believe that the coupling of the statistical techniques used in the Deming method of quality improvement, with modern approaches to outcome and process analysis, will provide the renal care community with powerful tools, not only for improved quality (i.e., reduced morbidity and mortality), but also for technology evaluation and resource allocation.
Wolfe, Charles DA; McKevitt, Christopher
2014-01-01
Objectives: Self-management is widely promoted but evidence of effectiveness is limited. Policy encourages health care professionals to support people with long-term conditions to learn self-management skills, yet little is known about the extent to which both parties share a common understanding of self-management. Thus, we compared health care professional and lay understandings of self-management of long-term conditions. Methods: Systematic review and narrative synthesis of qualitative studies identified from relevant electronic databases, hand-searching of references lists, citation tracking and recommendations by experts. Results: In total, 55 studies were included and quality was assessed using a brief quality assessment tool. Three conceptual themes, each with two subthemes were generated: traditional and shifting models of the professional–patient relationship (self-management as a tool to promote compliance; different expectations of responsibility); quality of relationship between health care professional and lay person (self-management as a collaborative partnership; self-management as tailored support) and putting self-management into everyday practice (the lived experience of self-management; self-management as a social practice). Conclusion: Self-management was conceptualised by health care professionals as incorporating both a biomedical model of compliance and individual responsibility. Lay people understood self-management in wider terms, reflecting biomedical, psychological and social domains and different expectations of responsibility. In different ways, both deviated from the dominant model of self-management underpinned by the concept of self-efficacy. Different understandings help to explain how self-management is practised and may help to account for limited evidence of effectiveness of self-management interventions. PMID:26770733
THE STORM WATER MANAGEMENT MODEL (SWMM) AND RELATED WATERSHED TOOLS DEVELOPMENT
The Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. It is the only publicly available model capable of performing a comprehensiv...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Farnham, Irene; Krenzien, Susan
This Quality Assurance Plan (QAP) provides the overall quality assurance (QA) requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Underground Test Area (UGTA) activities. The requirements in this QAP are consistent with DOE Order 414.1C, Quality Assurance (DOE, 2005); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). NNSA/NSO, or designee, must review this QAP every two years. Changes that do not affect the overallmore » scope or requirements will not require an immediate QAP revision but will be incorporated into the next revision cycle after identification. Section 1.0 describes UGTA objectives, participant responsibilities, and administrative and management quality requirements (i.e., training, records, procurement). Section 1.0 also details data management and computer software requirements. Section 2.0 establishes the requirements to ensure newly collected data are valid, existing data uses are appropriate, and environmental-modeling methods are reliable. Section 3.0 provides feedback loops through assessments and reports to management. Section 4.0 provides the framework for corrective actions. Section 5.0 provides references for this document.« less
Improving Water Management Decision Support Tools Using NASA Satellite and Modeling Data
NASA Astrophysics Data System (ADS)
Toll, D. L.; Arsenault, K.; Nigro, J.; Pinheiro, A.; Engman, E. T.; Triggs, J.; Cosgrove, B.; Alonge, C.; Boyle, D.; Allen, R.; Townsend, P.; Ni-Meister, W.
2006-05-01
One of twelve Applications of National priority within NASA's Applied Science Program, the Water Management Program Element addresses concerns and decision making related to water availability, water forecast and water quality. The goal of the Water Management Program Element is to encourage water management organizations to use NASA Earth science data, models products, technology and other capabilities in their decision support tools for problem solving. The Water Management Program Element partners with Federal agencies, academia, private firms, and may include international organizations. This paper further describes the Water Management Program with the objective of informing the applications community of the potential opportunities for using NASA science products for problem solving. We will illustrate some ongoing and application Water Management projects evaluating and benchmarking NASA data with partnering federal agencies and their decision support tools: 1) Environmental Protection Agency for water quality; 2) Bureau of Reclamation for water supply, demand and forecast; and 3) NOAA National Weather Service for improved weather prediction. Examples of the types of NASA contributions to the these agency decision support tools include: 1) satellite observations within models assist to estimate water storage, i.e., snow water equivalent, soil moisture, aquifer volumes, or reservoir storages; 2) model derived products, i.e., evapotranspiration, precipitation, runoff, ground water recharge, and other 4-dimensional data assimilation products; 3) improve water quality, assessments by using improved inputs from NASA models (precipitation, evaporation) and satellite observations (e.g., temperature, turbidity, land cover) to nonpoint source models; and 4) water (i.e., precipitation) and temperature predictions from days to decades over local, regional and global scales.
Terra, Sandra M
2007-01-01
This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of reduction in LOS, improvement in quality, and delivery of care.
A model to evaluate quality and effectiveness of disease management.
Lemmens, K M M; Nieboer, A P; van Schayck, C P; Asin, J D; Huijsman, R
2008-12-01
Disease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control healthcare costs. So far, however, the effects of this strategy remain unclear. Although current models define the concept of disease management, they do not provide a systematic development or an explanatory theory of how disease management affects the outcomes of care. The objective of this paper is to present a framework for valid evaluation of disease-management initiatives. The evaluation model is built on two pillars of disease management: patient-related and professional-directed interventions. The effectiveness of these interventions is thought to be affected by the organisational design of the healthcare system. Disease management requires a multifaceted approach; hence disease-management programme evaluations should focus on the effects of multiple interventions, namely patient-related, professional-directed and organisational interventions. The framework has been built upon the conceptualisation of these disease-management interventions. Analysis of the underlying mechanisms of these interventions revealed that learning and behavioural theories support the core assumptions of disease management. The evaluation model can be used to identify the components of disease-management programmes and the mechanisms behind them, making valid comparison feasible. In addition, this model links the programme interventions to indicators that can be used to evaluate the disease-management programme. Consistent use of this framework will enable comparisons among disease-management programmes and outcomes in evaluation research.
The influence of leadership practices and empowerment on Canadian nurse manager outcomes.
Spence Laschinger, Heather K; Wong, Carol A; Grau, Ashley L; Read, Emily A; Pineau Stam, Lisa M
2012-10-01
To examine the influence of senior nurse leadership practices on middle and first-line nurse managers' experiences of empowerment and organizational support and ultimately on their perceptions of patient care quality and turnover intentions. Empowering leadership has played an important role in staff nurse retention but there is limited research to explain the mechanisms by which leadership influences nurse managers' turnover intentions. This study was a secondary analysis of data collected using non-experimental, predictive mailed survey design. Data from 231 middle and 788 first-line Canadian acute care managers was used to test the hypothesized model using path analysis in each group. The results showed an adequate fit of the hypothesized model in both groups but with an added path between leadership practices and support in the middle line group. Transformational leadership practices of senior nurses empower middle- and first-line nurse managers, leading to increased perceptions of organizational support, quality care and decreased intent to leave. Empowered nurse managers at all levels who feel supported by their organizations are more likely to stay in their roles, remain committed to achieving quality patient care and act as influential role models for potential future leaders. © 2011 Blackwell Publishing Ltd.
Quality of integrated chronic disease care in rural South Africa: user and provider perspectives
Klipstein-Grobusch, Kerstin; D’ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier
2017-01-01
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries. PMID:28207046
Quality of integrated chronic disease care in rural South Africa: user and provider perspectives.
Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier
2017-03-01
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries.
Quality assurance: Importance of systems and standard operating procedures
Manghani, Kishu
2011-01-01
It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company. PMID:21584180
Quality assurance: Importance of systems and standard operating procedures.
Manghani, Kishu
2011-01-01
It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company.
Lüthy, A; Lotze, I; Leiske, M; Rossi, R
2000-01-01
Quality management in hospitals not only includes performance according to international medical standards but also the optimization of processes regarding internal staff as well as external customers. Total Quality Management (TQM) and the Business Excellence Model of the European Foundation of Quality Management (EFQM) require continuous evaluation of customer satisfaction. Specialists and family physician as external customers influence the patient's choice of a hospital. The aim of the present study is to evaluate the satisfaction of admitting physicians of a children's hospital with the help of a questionnaire. The results describe their needs and their level of satisfaction regarding service, information, cooperation and communication within the hospital.
Conceptual Processes for Linking Eutrophication and Network Models
2006-08-01
recommends a general procedure for future endeavors in this area. BACKGROUND: In recent years new ideas for nutrient management to control...network model. Coupling these two models will provide managers a new perspective on how to improve management strategies and help answer questions such...Dorothy H. Tillman, Dr. Carl F. Cerco, and Mr. Mark R. Noel of the Water Quality and Contaminant Modeling Branch, Enviromental Laboratory (EL
Storm Water Management Model Applications Manual
The EPA Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model that computes runoff quantity and quality from primarily urban areas. This manual is a practical application guide for new SWMM users who have already had some previous training in hydrolog...
DEVELOPING EMISSION INVENTORIES FOR BIOMASS BURNING FOR REAL-TIME AND RETROSPECTIVE MODELING
The EPA uses chemical transport models to simulate historic meteorological episodes for developing air quality management strategies. In addition, chemical transport models are now being used operationally to create air quality forecasts. There are currently a number of methods a...
Code of Federal Regulations, 2011 CFR
2011-07-01
... official charged with direct responsibility for management of an area designated as Class I under the Act.... Areawide air quality modeling analysis means an assessment on a scale that includes the entire nonattainment or maintenance area using an air quality dispersion model or photochemical grid model to determine...
Nowlin, Jon O.; Brown, W.M.; Smith, L.H.; Hoffman, R.J.
1980-01-01
The objectives of the Geological Survey 's river-quality assessment in the Truckee and Carson River basins in California and Nevada are to identify the significant resource management problems; to develop techniques to assess the problems; and to effectively communicate results to responsible managers. Six major elements of the assessment to be completed by October 1981 are (1) a detailing of the legal, institutional, and structural development of water resources in the basins and the current problems and conflicts; (2) a compilation and synthesis of the physical hydrology of the basins; (3) development of a special workshop approach to involve local management in the direction and results of the study; (4) development of a comprehensive streamflow model emcompassing both basins to provide a quantitative hydrologic framework for water-quality analysis; (5) development of a water-quality transport model for selected constituents and characteristics on selected reaches of the Truckee River; and (6) a detailed examination of selected fish habitats for specified reaches of the Truckee River. Progress will be periodically reported in reports, maps, computer data files, mathematical models, a bibliography, and public presentations. In building a basic framework to develop techniques, the basins were viewed as a single hydrologic unit because of interconnecting diversion structures. The framework comprises 13 hydrographic subunits to facilitate modeling and sampling. Several significant issues beyond the scope of the assessment were considered as supplementary proposals; water-quality loadings in Truckee and Carson Rivers, urban runoff in Reno and management alternatives, and a model of limnological processes in Lahontan Reservoir. (USGS)
Uncertainty in BMP evaluation and optimization for watershed management
NASA Astrophysics Data System (ADS)
Chaubey, I.; Cibin, R.; Sudheer, K.; Her, Y.
2012-12-01
Use of computer simulation models have increased substantially to make watershed management decisions and to develop strategies for water quality improvements. These models are often used to evaluate potential benefits of various best management practices (BMPs) for reducing losses of pollutants from sources areas into receiving waterbodies. Similarly, use of simulation models in optimizing selection and placement of best management practices under single (maximization of crop production or minimization of pollutant transport) and multiple objective functions has increased recently. One of the limitations of the currently available assessment and optimization approaches is that the BMP strategies are considered deterministic. Uncertainties in input data (e.g. precipitation, streamflow, sediment, nutrient and pesticide losses measured, land use) and model parameters may result in considerable uncertainty in watershed response under various BMP options. We have developed and evaluated options to include uncertainty in BMP evaluation and optimization for watershed management. We have also applied these methods to evaluate uncertainty in ecosystem services from mixed land use watersheds. In this presentation, we will discuss methods to to quantify uncertainties in BMP assessment and optimization solutions due to uncertainties in model inputs and parameters. We have used a watershed model (Soil and Water Assessment Tool or SWAT) to simulate the hydrology and water quality in mixed land use watershed located in Midwest USA. The SWAT model was also used to represent various BMPs in the watershed needed to improve water quality. SWAT model parameters, land use change parameters, and climate change parameters were considered uncertain. It was observed that model parameters, land use and climate changes resulted in considerable uncertainties in BMP performance in reducing P, N, and sediment loads. In addition, climate change scenarios also affected uncertainties in SWAT simulated crop yields. Considerable uncertainties in the net cost and the water quality improvements resulted due to uncertainties in land use, climate change, and model parameter values.
The Educational Consequences of W. Edwards Deming.
ERIC Educational Resources Information Center
Holt, Maurice
1993-01-01
Taylorism (the rational-managerial model) still dominates U.S. education. Deming's quality and improvement concepts cut much deeper than "total quality management" externalities and differ markedly from management by objectives or outcome-based education approaches. The Deming approach is no quick fix but requires a fundamental change in…
Curriculum Transformation through Total Quality Management.
ERIC Educational Resources Information Center
Edwards, Barbara; Algozzine, Bob
1995-01-01
Describes a massive cultural transformation project at two Charlotte, North Carolina, elementary schools that used Deming's total quality management principles to restructure curricula according to Boyer's eight commonalities of learning. Shows how the FADE (focus, analyze, develop, and execute) model was used to develop a well-coordinated,…
HAWQS (Hydrologic and Water Quality System)
A water quantity and quality modeling system to evaluate the impacts of management alternatives, pollution control scenarios, and climate change scenarios on the quantity and quality of water at a national scale.
Water Quality Analysis Simulation
The Water Quality analysis simulation Program, an enhancement of the original WASP. This model helps users interpret and predict water quality responses to natural phenomena and man-made pollution for variious pollution management decisions.
Prototypic automated continuous recreational water quality monitoring of nine Chicago beaches
Dawn Shively,; Nevers, Meredith; Cathy Breitenbach,; Phanikumar, Mantha S.; Kasia Przybyla-Kelly,; Ashley M. Spoljaric,; Richard L. Whitman,
2015-01-01
Predictive empirical modeling is used in many locations worldwide as a rapid, alternative recreational water quality management tool to eliminate delayed notifications associated with traditional fecal indicator bacteria (FIB) culturing (referred to as the persistence model, PM) and to prevent errors in releasing swimming advisories. The goal of this study was to develop a fully automated water quality management system for multiple beaches using predictive empirical models (EM) and state-of-the-art technology. Many recent EMs rely on samples or data collected manually, which adds to analysis time and increases the burden to the beach manager. In this study, data from water quality buoys and weather stations were transmitted through cellular telemetry to a web hosting service. An executable program simultaneously retrieved and aggregated data for regression equations and calculated EM results each morning at 9:30 AM; results were transferred through RSS feed to a website, mapped to each beach, and received by the lifeguards to be posted at the beach. Models were initially developed for five beaches, but by the third year, 21 beaches were managed using refined and validated modeling systems. The adjusted R2 of the regressions relating Escherichia coli to hydrometeorological variables for the EMs were greater than those for the PMs, and ranged from 0.220 to 0.390 (2011) and 0.103 to 0.381 (2012). Validation results in 2013 revealed reduced predictive capabilities; however, three of the originally modeled beaches showed improvement in 2013 compared to 2012. The EMs generally showed higher accuracy and specificity than those of the PMs, and sensitivity was low for both approaches. In 2012 EM accuracy was 70–97%; specificity, 71–100%; and sensitivity, 0–64% and in 2013 accuracy was 68–97%; specificity, 73–100%; and sensitivity 0–36%. Factors that may have affected model capabilities include instrument malfunction, non-point source inputs, and sparse calibration data. The modeling system developed is the most extensive, fully-automated system for recreational water quality developed to date. Key insights for refining and improving large-scale empirical models for beach management have been developed through this multi-year effort.
Watershed modeling and monitoring for assessing nutrient ...
Presentation for the American Water Works Association Water Sustainability Conference. The presentation highlights latest results from water quality trading research conducted by ORD using the East Fork Watershed in Southwestern Ohio as a case study. The watershed has a nutrient enrichment problem that is creating harmful algal blooms in a reservoir used for drinking water and recreation. Innovative modeling and monitoring is combined to understand how to best manage this water quality problem and costs associated with this endeavor. The presentation will provide an overview of the water quality trading feasibility research. The research includes the development and evaluation of innovative modeling and monitoring approaches to manage watersheds for nutrient pollution using a whole systems approach.
The Effect of Stress Management Model in Quality of Life in Breast Cancer Women.
Khodabakhshi Koolaee, Anahita; Falsafinejad, Mohammad Reza; Akbari, Mohammd Esmaeil
2015-08-01
Breast cancer associates with severs severe distress and stress. Since Because of that, the stress management program can train necessary skills to cope with stress; therefore, the current study investigates the effectiveness of stress management on enhancement of quality of life. The aim of the current study is to examine the effectiveness of stress management model in quality of life for breast cancer patients. This research is a quasi-experimental study with pre and post-tests. The 21 subjects were selected from cancer institute of Imam Khomeini in Tehran in 2014. The participants were allocated to two matched groups based on their pre-test scores. They were assigned randomly to the control and experimental groups. Stress management was conducted with the experimental group during 10 sessions. Then the questionnaire was administered at post-test. Statistical analysis was conducted by using the independent t-test and analysis of variance. The research instrument was the core quality of life questionnaire QLQ-C30. The results of the independent t-test showed that there is a significant difference between the pretest and post-test scores in the experimental group (P < 0.05). Also, there is no significant difference between means of quality of life subscales and socio demographic of the patients such as; age, education and disease stage (P < 0.05). The results indicate that stress management can change the irrational and distortion thoughts. So, it enhances the quality of life in breast cancer patients.
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.
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)…
PROJECT SUMMARY: DEVELOPMENT OF THE VIRTUAL BEACH MODEL, PHASE I: AN EMPIRICAL MODEL
Mathematical models based on water-quality and other environmental surrogates may help to provide water quality assessment within a few hours and potentially provide one to three day forecasts, providing beach managers and public-health officials a tool for developing beach-speci...
STORM WATER MANAGEMENT MODEL USER'S MANUAL VERSION 5.0
The EPA Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. SWMM was first developed in 1971 and has undergone several major upgrade...
Li, Yangfan; Li, Yi; Wu, Wei
2016-01-01
The concept of thresholds shows important implications for environmental and resource management. Here we derived potential landscape thresholds which indicated abrupt changes in water quality or the dividing points between exceeding and failing to meet national surface water quality standards for a rapidly urbanizing city on the Eastern Coast in China. The analysis of landscape thresholds was based on regression models linking each of the seven water quality variables to each of the six landscape metrics for this coupled land-water system. We found substantial and accelerating urban sprawl at the suburban areas between 2000 and 2008, and detected significant nonlinear relations between water quality and landscape pattern. This research demonstrated that a simple modeling technique could provide insights on environmental thresholds to support more-informed decision making in land use, water environmental and resilience management. Copyright © 2015 Elsevier Ltd. All rights reserved.
USDA-ARS?s Scientific Manuscript database
The value of watershed-scale, hydrologic/water quality models to ecosystem management is increasingly evident as more programs adopt these tools to evaluate the effectiveness of different management scenarios and their impact on the environment. Quality of precipitation data is critical for appropri...
School Development Applications in Turkey
ERIC Educational Resources Information Center
Hosgörür, Vural
2014-01-01
This study aims to define and explain the establishment, functioning and problems of school development management teams (SDMTs), similar to quality circles used in total quality management practices, for the purposes of continuous development and improvement of schools on the basis of the planned school development model. This is a qualitative…
This webinar describes the use of VELMA, a spatially-distributed ecohydrological model, to identify green infrastructure (GI) best management practices for protecting water quality in intensively managed watersheds. The seminar will include a brief description of VELMA and an ex...
A cropland farm management modeling system for regional air quality and field-scale applications of bi-directional ammonia exchange was presented at ITM XXI. The goal of this research is to improve estimates of nitrogen deposition to terrestrial and aquatic ecosystems and ambien...
Review and comparison of quality standards, guidelines and regulations for laboratories.
Datema, Tjeerd A M; Oskam, Linda; Klatser, Paul R
2012-01-01
The variety and number of laboratory quality standards, guidelines and regulations (hereafter: quality documents) makes it difficult to choose the most suitable one for establishing and maintaining a laboratory quality management system. There is a need to compare the characteristics, suitability and applicability of quality documents in view of the increasing efforts to introduce quality management in laboratories, especially in clinical diagnostic laboratories in low income and middle income countries. This may provide valuable insights for policy makers developing national laboratory policies, and for laboratory managers and quality officers in choosing the most appropriate quality document for upgrading their laboratories. We reviewed the history of quality document development and then selected a subset based on their current use. We analysed these documents following a framework for comparison of quality documents that was adapted from the Clinical Laboratory Standards Institute guideline GP26 Quality management system model for clinical laboratory services . Differences were identified between national and international, and non-clinical and clinical quality documents. The most salient findings were the absence of provisions on occurrence management and customer service in almost all non-clinical quality documents, a low number of safety requirements aimed at protecting laboratory personnel in international quality documents and no requirements regarding ethical behaviour in almost all quality documents. Each laboratory needs to investigate whether national regulatory standards are present. These are preferred as they most closely suit the needs of laboratories in the country. A laboratory should always use both a standard and a guideline: a standard sums up the requirements to a quality management system, a guideline describes how quality management can be integrated in the laboratory processes.
Fuzzy intelligent quality monitoring model for X-ray image processing.
Khalatbari, Azadeh; Jenab, Kouroush
2009-01-01
Today's imaging diagnosis needs to adapt modern techniques of quality engineering to maintain and improve its accuracy and reliability in health care system. One of the main factors that influences diagnostic accuracy of plain film X-ray on detecting pathology is the level of film exposure. If the level of film exposure is not adequate, a normal body structure may be interpretated as pathology and vice versa. This not only influences the patient management but also has an impact on health care cost and patient's quality of life. Therefore, providing an accurate and high quality image is the first step toward an excellent patient management in any health care system. In this paper, we study these techniques and also present a fuzzy intelligent quality monitoring model, which can be used to keep variables from degrading the image quality. The variables derived from chemical activity, cleaning procedures, maintenance, and monitoring may not be sensed, measured, or calculated precisely due to uncertain situations. Therefore, the gamma-level fuzzy Bayesian model for quality monitoring of an image processing is proposed. In order to apply the Bayesian concept, the fuzzy quality characteristics are assumed as fuzzy random variables. Using the fuzzy quality characteristics, the newly developed model calculates the degradation risk for image processing. A numerical example is also presented to demonstrate the application of the model.
Putting people into water quality modelling.
NASA Astrophysics Data System (ADS)
Strickert, G. E.; Hassanzadeh, E.; Noble, B.; Baulch, H. M.; Morales-Marin, L. A.; Lindenschmidt, K. E.
2017-12-01
Water quality in the Qu'Appelle River Basin, Saskatchewan is under pressure due to nutrient pollution entering the river system from major cities, industrial zones and agricultural areas. Among these stressors, agricultural activities are basin-wide; therefore, they are the largest non-point source of water pollution in this region. The dynamics of agricultural impacts on water quality are complex and stem from decisions and activities of two distinct stakeholder groups, namely grain farmers and cattle producers, which have different business plans, values, and attitudes towards water quality. As a result, improving water quality in this basin requires engaging with stakeholders to: (1) understand their perspectives regarding a range of agricultural Beneficial Management Practices (BMPs) that can improve water quality in the region, (2) show them the potential consequences of their selected BMPs, and (3) work with stakeholders to better understand the barriers and incentives to implement the effective BMPs. In this line, we held a series of workshops in the Qu'Appelle River Basin with both groups of stakeholders to understand stakeholders' viewpoints about alternative agricultural BMPs and their impact on water quality. Workshop participants were involved in the statement sorting activity (Q-sorts), group discussions, as well as mapping activity. The workshop outcomes show that stakeholder had four distinct viewpoints about the BMPs that can improve water quality, i.e., flow and erosion control, fertilizer management, cattle site management, as well as mixed cattle and wetland management. Accordingly, to simulate the consequences of stakeholder selected BMPs, a conceptual water quality model was developed using System Dynamics (SD). The model estimates potential changes in water quality at the farm, tributary and regional scale in the Qu'Appelle River Basin under each and/or combination of stakeholder selected BMPs. The SD model was then used for real-time engagement of stakeholders in simulations to demostrate the potential effects of BMPs on water quality. This exercise helped us to better understand the stakeholders' viewpoints to propose effective BMPs and policies that are in-line with stakeholders' values and preferences.
Air quality (AQ) simulation models provide a basis for implementing the National Ambient Air Quality Standards (NAAQS) and are a tool for performing risk-based assessments and for developing environmental management strategies. Fine particulate matter (PM 2.5), its constituent...
Projecting manpower to attain quality
NASA Technical Reports Server (NTRS)
Rone, K. Y.
1983-01-01
The resulting model is useful as a projection tool but must be validated in order to be used as an on-going software cost engineering tool. A procedure is developed to facilitate the tracking of model projections and actual data to allow the model to be tuned. Finally, since the model must be used in an environment of overlapping development activities on a progression of software elements in development and maintenance, a manpower allocation model is developed for use in a steady state development/maintenance environment. In these days of soaring software costs it becomes increasingly important to properly manage a software development project. One element of the management task is the projection and tracking of manpower required to perform the task. In addition, since the total cost of the task is directly related to the initial quality built into the software, it becomes a necessity to project the development manpower in a way to attain that quality. An approach to projecting and tracking manpower with quality in mind is described.
NASA Astrophysics Data System (ADS)
WANG, J.
2017-12-01
In stream water quality control, the total maximum daily load (TMDL) program is very effective. However, the load duration curves (LDC) of TMDL are difficult to be established because no sufficient observed flow and pollutant data can be provided in data-scarce watersheds in which no hydrological stations or consecutively long-term hydrological data are available. Although the point sources or a non-point sources of pollutants can be clarified easily with the aid of LDC, where does the pollutant come from and to where it will be transported in the watershed cannot be traced by LDC. To seek out the best management practices (BMPs) of pollutants in a watershed, and to overcome the limitation of LDC, we proposed to develop LDC based on a distributed hydrological model of SWAT for the water quality management in data scarce river basins. In this study, firstly, the distributed hydrological model of SWAT was established with the scarce-hydrological data. Then, the long-term daily flows were generated with the established SWAT model and rainfall data from the adjacent weather station. Flow duration curves (FDC) was then developed with the aid of generated daily flows by SWAT model. Considering the goal of water quality management, LDC curves of different pollutants can be obtained based on the FDC. With the monitored water quality data and the LDC curves, the water quality problems caused by the point or non-point source pollutants in different seasons can be ascertained. Finally, the distributed hydrological model of SWAT was employed again to tracing the spatial distribution and the origination of the pollutants of coming from what kind of agricultural practices and/or other human activities. A case study was conducted in the Jian-jiang river, a tributary of Yangtze river, of Duyun city, Guizhou province. Results indicate that this kind of method can realize the water quality management based on TMDL and find out the suitable BMPs for reducing pollutant in a watershed.
Improving Quality of Care in Patients with Liver Cirrhosis.
Saberifiroozi, Mehdi
2017-10-01
Liver cirrhosis is a major chronic disease in the field of digestive diseases. It causes more than one million deaths per year. Despite established evidence based guidelines, the adherence to standard of care or quality indicators are variable. Complete adherence to the recommendations of guidelines is less than 50%. To improve the quality of care in patients with cirrhosis, we need a more holistic view. Because of high rate of death due to cardiovascular disease and neoplasms, the care of comorbid conditions and risk factors such as smoking, hypertension, high blood sugar or cholesterol, would be important in addition to the management of primary liver disease. Despite a holistic multidisciplinary approach for this goal, the management of such patients should be patient centered and individualized. The diagnosis of underlying etiology and its appropriate treatment is the most important step. Definition and customizing the quality indicators for quality measure in patients are needed. Because most suggested quality indicators are designed for measuring the quality of care in decompensated liver cirrhosis, we need special quality indicators for compensated and milder forms of chronic liver disease as well. Training the patients for participation in their own management, design of special clinics with dedicated health professionals in a form of chronic disease model, is suggested for improvement of quality of care in this group of patients. Special day care centers by a dedicated gastroenterologist and a trained nurse may be a practical model for better management of such patients.
Domínguez-Mayo, F J; Escalona, M J; Mejías, M; Aragón, G; García-García, J A; Torres, J; Enríquez, J G
2015-01-01
e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.
Escalona, M. J.; Mejías, M.; Aragón, G.; García-García, J. A.; Torres, J.; Enríquez, J. G.
2015-01-01
e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems. PMID:26146656
NASA Astrophysics Data System (ADS)
Boisvert-Chouinard, J.; Halbe, J.; Baig, A. I.; Adamowski, J. F.
2014-12-01
The principles of Integrated Water Resource Management outline the importance of stakeholder participation in water management processes, but in practice, there is a lack of meaningful engagement in water planning and implementation, and participation is often limited to public consultation and education. When models are used to support water planning, stakeholders are usually not involved in their development and use, and the models commonly fail to represent important feedbacks between socio-economic and physical processes. This paper presents the development of holistic models of the Du Chêne basin in Quebec, and the Rechna Doab basin in Pakistan, that simulate socio-economic and physical processes related to, respectively, water quality management, and soil salinity management. The models each consists of two sub-components: a System Dynamics (SD) model, and a physically based model. The SD component was developed in collaboration with key stakeholders in the basins. The Du Chêne SD model was coupled with a Soil and Water Assessment Tool (SWAT) model, while the Rechna Doab SD model was coupled with SahysMod, a soil salinity model. The coupled models were used to assess the environmental and socio-economic impacts of different management scenarios proposed by stakeholders. Results indicate that coupled SD - physically-based models can be used as effective tools for participatory water planning and implementation. The participatory modeling process provides a structure for meaningful stakeholder engagement, and the models themselves can be used to transparently and coherently assess and compare different management options.
Project officer's perspective: quality assurance as a management tool.
Heiby, J
1993-06-01
Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.
Tracking and forecasting the Nation’s water quality - Priorities and strategies for 2013-2023
Rowe, Gary L.; Gilliom, Robert J.; Woodside, Michael D.
2013-01-01
Water-quality issues facing the Nation are growing in number and complexity, and solutions are becoming more challenging and costly. Key factors that affect the quality of our drinking water supplies and ecosystem health include contaminants of human and natural origin in streams and groundwater; excess nutrients and sediment; alteration of natural streamflow; eutrophication of lakes, reservoirs, and coastal estuaries; and changes in surface and groundwater quality associated with changes in climate, land and water use, and management practices. Tracking and forecasting the Nation's water quality in the face of these and other pressing water-quality issues are important goals for 2013-2023, the third decade of the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) program. In consultation with stakeholders and the National Research Council, a new strategic Science Plan has been developed that describes a strategy for building upon and enhancing assessment of the Nation's freshwater quality and aquatic ecosystems. The plan continues strategies that have been central to the NAWQA program's long-term success, but it also makes adjustments to the monitoring and modeling approaches NAWQA will use to address critical data and science information needs identified by stakeholders. This fact sheet describes surface-water and groundwater monitoring and modeling activities that will start in fiscal year 2013. It also provides examples of the types of data and information products planned for the next decade, including (1) restored monitoring for reliable and timely status and trend assessments, (2) maps and models that show the distribution of selected contaminants (such as atrazine, nitrate, and arsenic) in streams and aquifers, and (3) Web-based modeling tools that allow managers to evaluate how water quality may change in response to different scenarios of population growth, climate change, or land-use management.
Gowen, Charles R; Henagan, Stephanie C; McFadden, Kathleen L
2009-01-01
The health care industry has become one of the largest sectors of the U.S. economy and provides the greatest job growth of any industry. With such growth, effective leadership, knowledge management, and quality programs can ameliorate patient safety outcomes and improve organizational performance. This exploratory study examines the efficacy of transformational leadership, knowledge management, and quality initiatives, each of which has been proven effective in health care organizations. The literature has neglected the relationships among these three types of programs, although they are increasingly implemented simultaneously now. This research tests the degree to which knowledge management could act as a mediator of the effects transformational leadership and quality management have on organizational performance for hospitals. Our survey of U.S. hospitals utilizes validated scales from the literature. By calling and e-mailing quality and other department directors, the data set includes responses from all 50 states in our sample of 370 U.S. hospitals. Statistical tests confirmed acceptable regional distribution, interrater reliability, and control variable characteristics for our sample. Structural equation modeling is used to test the research hypotheses. These preliminary results reveal that transformational leadership and quality management improve knowledge management. In addition, transformational leadership is fully mediated by knowledge responsiveness and quality management is partially mediated by knowledge responsiveness for their effects on organizational performance. The unique contribution of this study includes the suggestion that greater transformational leadership skills are important for health care executives to motivate successful knowledge management initiatives. Secondly, continuous improvements in quality management programs have significant positive impacts on knowledge management and organizational outcomes in hospitals. Finally, successful knowledge management initiatives are more closely tied to patient and organizational outcomes through the enhancement of knowledge responsiveness than by knowledge acquisition and dissemination alone.
Modelling raw water quality: development of a drinking water management tool.
Kübeck, Ch; van Berk, W; Bergmann, A
2009-01-01
Ensuring future drinking water supply requires a tough management of groundwater resources. However, recent practices of economic resource control often does not involve aspects of the hydrogeochemical and geohydraulical groundwater system. In respect of analysing the available quantity and quality of future raw water, an effective resource management requires a full understanding of the hydrogeochemical and geohydraulical processes within the aquifer. For example, the knowledge of raw water quality development within the time helps to work out strategies of water treatment as well as planning finance resources. On the other hand, the effectiveness of planed measurements reducing the infiltration of harmful substances such as nitrate can be checked and optimized by using hydrogeochemical modelling. Thus, within the framework of the InnoNet program funded by Federal Ministry of Economics and Technology, a network of research institutes and water suppliers work in close cooperation developing a planning and management tool particularly oriented on water management problems. The tool involves an innovative material flux model that calculates the hydrogeochemical processes under consideration of the dynamics in agricultural land use. The program integrated graphical data evaluation is aligned on the needs of water suppliers.
Performance Evaluation of Resource Management in Cloud Computing Environments.
Batista, Bruno Guazzelli; Estrella, Julio Cezar; Ferreira, Carlos Henrique Gomes; Filho, Dionisio Machado Leite; Nakamura, Luis Hideo Vasconcelos; Reiff-Marganiec, Stephan; Santana, Marcos José; Santana, Regina Helena Carlucci
2015-01-01
Cloud computing is a computational model in which resource providers can offer on-demand services to clients in a transparent way. However, to be able to guarantee quality of service without limiting the number of accepted requests, providers must be able to dynamically manage the available resources so that they can be optimized. This dynamic resource management is not a trivial task, since it involves meeting several challenges related to workload modeling, virtualization, performance modeling, deployment and monitoring of applications on virtualized resources. This paper carries out a performance evaluation of a module for resource management in a cloud environment that includes handling available resources during execution time and ensuring the quality of service defined in the service level agreement. An analysis was conducted of different resource configurations to define which dimension of resource scaling has a real influence on client requests. The results were used to model and implement a simulated cloud system, in which the allocated resource can be changed on-the-fly, with a corresponding change in price. In this way, the proposed module seeks to satisfy both the client by ensuring quality of service, and the provider by ensuring the best use of resources at a fair price.
Performance Evaluation of Resource Management in Cloud Computing Environments
Batista, Bruno Guazzelli; Estrella, Julio Cezar; Ferreira, Carlos Henrique Gomes; Filho, Dionisio Machado Leite; Nakamura, Luis Hideo Vasconcelos; Reiff-Marganiec, Stephan; Santana, Marcos José; Santana, Regina Helena Carlucci
2015-01-01
Cloud computing is a computational model in which resource providers can offer on-demand services to clients in a transparent way. However, to be able to guarantee quality of service without limiting the number of accepted requests, providers must be able to dynamically manage the available resources so that they can be optimized. This dynamic resource management is not a trivial task, since it involves meeting several challenges related to workload modeling, virtualization, performance modeling, deployment and monitoring of applications on virtualized resources. This paper carries out a performance evaluation of a module for resource management in a cloud environment that includes handling available resources during execution time and ensuring the quality of service defined in the service level agreement. An analysis was conducted of different resource configurations to define which dimension of resource scaling has a real influence on client requests. The results were used to model and implement a simulated cloud system, in which the allocated resource can be changed on-the-fly, with a corresponding change in price. In this way, the proposed module seeks to satisfy both the client by ensuring quality of service, and the provider by ensuring the best use of resources at a fair price. PMID:26555730
Frimpter, M.H.; Donohue, J.J.; Rapacz, M.V.; Beye, H.G.
1990-01-01
A mass-balance accounting model can be used to guide the management of septic systems and fertilizers to control the degradation of groundwater quality in zones of an aquifer that contributes water to public supply wells. The nitrate nitrogen concentration of the mixture in the well can be predicted for steady-state conditions by calculating the concentration that results from the total weight of nitrogen and total volume of water entering the zone of contribution to the well. These calculations will allow water-quality managers to predict the nitrate concentrations that would be produced by different types and levels of development, and to plan development accordingly. Computations for different development schemes provide a technical basis for planners and managers to compare water quality effects and to select alternatives that limit nitrate concentration in wells. Appendix A contains tables of nitrate loads and water volumes from common sources for use with the accounting model. Appendix B describes the preparation of a spreadsheet for the nitrate loading calculations with a software package generally available for desktop computers. (USGS)
Kirsch, Florian
2015-01-01
Diabetes is the most expensive chronic disease; therefore, disease management programs (DMPs) were introduced. The aim of this review is to determine whether Markov models are adequate to evaluate the cost-effectiveness of complex interventions such as DMPs. Additionally, the quality of the models was evaluated using Philips and Caro quality appraisals. The five reviewed models incorporated the DMP into the model differently: two models integrated effectiveness rates derived from one clinical trial/meta-analysis and three models combined interventions from different sources into a DMP. The results range from cost savings and a QALY gain to costs of US$85,087 per QALY. The Spearman's rank coefficient assesses no correlation between the quality appraisals. With restrictions to the data selection process, Markov models are adequate to determine the cost-effectiveness of DMPs; however, to allow prioritization of medical services, more flexibility in the models is necessary to enable the evaluation of single additional interventions.
Scotti, Dennis J; Harmon, Joel; Behson, Scott J
2007-01-01
Healthcare managers must deliver high-quality patient services that generate highly satisfied and loyal customers. In this article, we examine how a high-involvement approach to the work environment of healthcare employees may lead to exceptional service quality, satisfied patients, and ultimately to loyal customers. Specifically, we investigate the chain of events through which high-performance work systems (HPWS) and customer orientation influence employee and customer perceptions of service quality and patient satisfaction in a national sample of 113 Veterans Health Administration ambulatory care centers. We present a conceptual model for linking work environment to customer satisfaction and test this model using structural equations modeling. The results suggest that (1) HPWS is linked to employee perceptions of their ability to deliver high-quality customer service, both directly and through their perceptions of customer orientation; (2) employee perceptions of customer service are linked to customer perceptions of high-quality service; and (3) perceived service quality is linked with customer satisfaction. Theoretical and practical implications of our findings, including suggestions of how healthcare managers can implement changes to their work environments, are discussed.
Ameh, Soter; Gómez-Olivé, Francesc Xavier; Kahn, Kathleen; Tollman, Stephen M; Klipstein-Grobusch, Kerstin
2017-03-23
South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care. A cross-sectional study was conducted in 2013 in seven PHC facilities in the Bushbuckridge municipality of Mpumalanga Province, north-east South Africa - an area underpinned by a robust Health and Demographic Surveillance System (HDSS). The patient satisfaction questionnaire (PSQ-18), with measures reflecting structure/process/outcome (SPO) constructs, was adapted and administered to 435 chronic disease patients and the operational managers of all seven PHC facilities. The adapted questionnaire contained 17 dimensions of care, including eight dimensions identified as priority areas in the ICDM model - critical drugs, equipment, referral, defaulter tracing, prepacking of medicines, clinic appointments, waiting time, and coherence. A structural equation model was fit to operationalise Donabedian's theory, using unidirectional, mediation, and reciprocal pathways. The mediation pathway showed that the relationships between structure, process and outcome represented quality systems in the ICDM model. Structure correlated with process (0.40) and outcome (0.75). Given structure, process correlated with outcome (0.88). Of the 17 dimensions of care in the ICDM model, three structure (equipment, critical drugs, accessibility), three process (professionalism, friendliness and attendance to patients) and three outcome (competence, confidence and coherence) dimensions reflected their intended constructs. Of the priority dimensions, referrals, defaulter tracing, prepacking of medicines, appointments, and patient waiting time did not reflect their intended constructs. Donabedian's theoretical framework can be used to provide evidence of quality systems in the ICDM model.
Identification of phosphorus emission hotspots in agricultural catchments
Kovacs, Adam; Honti, Mark; Zessner, Matthias; Eder, Alexander; Clement, Adrienne; Blöschl, Günter
2012-01-01
An enhanced transport-based management approach is presented, which is able to support cost-effective water quality management with respect to diffuse phosphorus pollution. Suspended solids and particulate phosphorus emissions and their transport were modeled in two hilly agricultural watersheds (Wulka River in Austria and Zala River in Hungary) with an improved version of the catchment-scale PhosFate model. Source and transmission areas were ranked by an optimization method in order to provide a priority list of the areas of economically efficient (optimal) management alternatives. The model was calibrated and validated at different gauges and for various years. The spatial distribution of the emissions shows that approximately one third of the catchment area is responsible for the majority of the emissions. However, only a few percent of the source areas can transport fluxes to the catchment outlet. These effective source areas, together with the main transmission areas are potential candidates for improved management practices. In accordance with the critical area concept, it was shown that intervention with better management practices on a properly selected small proportion of the total area (1–3%) is sufficient to reach a remarkable improvement in water quality. If soil nutrient management is also considered in addition to water quality, intervention on 4–12% of the catchment areas can fulfill both aspects. PMID:22771465
Longitudinal analysis on the development of hospital quality management systems in the Netherlands.
Dückers, Michel; Makai, Peter; Vos, Leti; Groenewegen, Peter; Wagner, Cordula
2009-10-01
Many changes have been initiated in the Dutch hospital sector to optimize health-care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment combinations, intensified monitoring of quality and a multi-layered organizational development programme based on quality improvement collaboratives. The objective is to answer the question as to whether these changes were accompanied by a further development of hospital quality management systems and to what extent did the development within the multi-layered programme hospitals differ from that in other hospitals. Longitudinal data were collected in 1995, 2000, 2005 and 2007 using a validated questionnaire. Descriptive analyses and multi-level modelling were applied to test whether: (1) quality management system development stages in hospitals differ over time, (2) development stages and trends differ between hospitals participating or not participating in the multi-layered programme and (3) hospital size has an effect on development stage. Dutch hospital sector between 1995 and 2007. Hospital organizations. Changes through time. Quality management system development stage. Since 1995, hospital quality management systems have reached higher development levels. Programme participants have developed their quality management system more rapidly than have non-participants. However, this effect is confounded by hospital size. Study results suggest that the combination of policy measures at macro level was accompanied by an increase in hospital size and the further development of quality management systems. Hospitals are entering the stage of systematic quality improvement.
Reflections: Management Morphology--How We Got To Be Who We Are.
ERIC Educational Resources Information Center
Hoadley, Irene B.
1999-01-01
Reviews library management issues over the past 25 years. Highlights include library education for managerial skills; on the job training; gender issues; societal factors; Total Quality Management; management changes; and future possibilities, including managerial roles, management models, and organizational structure. (LRW)
Wang, Hongqing; Meselhe, Ehab A.; Waldon, Michael G.; Harwell, Matthew C.; Chen, Chunfang
2012-01-01
The last remaining large remnant of softwater wetlands in the US Florida Everglades lies within the Arthur R. Marshall Loxahatchee National Wildlife Refuge. However, Refuge water quality today is impacted by pumped stormwater inflows to the eutrophic and mineral-enriched 100-km canal, which circumscribes the wetland. Optimal management is a challenge and requires scientifically based predictive tools to assess and forecast the impacts of water management on Refuge water quality. In this research, we developed a compartment-based numerical model of hydrodynamics and water quality for the Refuge. Using the numerical model, we examined the dynamics in stage, water depth, discharge from hydraulic structures along the canal, and exchange flow among canal and marsh compartments. We also investigated the transport of chloride, sulfate and total phosphorus from the canal to the marsh interior driven by hydraulic gradients as well as biological removal of sulfate and total phosphorus. The model was calibrated and validated using long-term stage and water quality data (1995-2007). Statistical analysis indicates that the model is capable of capturing the spatial (from canal to interior marsh) gradients of constituents across the Refuge. Simulations demonstrate that flow from the eutrophic and mineral-enriched canal impacts chloride and sulfate in the interior marsh. In contrast, total phosphorus in the interior marsh shows low sensitivity to intrusion and dispersive transport. We conducted a rainfall-driven scenario test in which the pumped inflow concentrations of chloride, sulfate and total phosphorus were equal to rainfall concentrations (wet deposition). This test shows that pumped inflow is the dominant factor responsible for the substantially increased chloride and sulfate concentrations in the interior marsh. Therefore, the present day Refuge should not be classified as solely a rainfall-driven or ombrotrophic wetland. The model provides an effective screening tool for studying the impacts of various water management alternatives on water quality across the Refuge, and demonstrates the practicality of similarly modeling other wetland systems. As a general rule, modeling provides one component of a multi-faceted effort to provide technical support for ecosystem management decisions.
Li, Haitao; Qian, Dongfu; Griffiths, Sian; Chung, Roger Yat-Nork; Wei, Xiaolin
2015-11-10
There are three major models of primary care providers (Community Health Centers, CHCs) in China, i.e., government managed, hospital managed and privately owned CHCs. We performed a systematic review of structures and health care delivery patterns of the three models of CHCs. Studies from relevant English and Chinese databases for the period of 1997-2011 were searched. Two independent researchers extracted data from the eligible studies using a standardized abstraction form. Methodological quality of included articles was assessed with the Mixed Methods Appraisal Tool (MMAT). A total of 13 studies was included in the final analysis. Compared with the other two models, private CHCs had a smaller health workforce and lower share of government funding in their total revenues. Private CHCs also had fewer training opportunities, were less recognized by health insurance schemes and tended to provide primary care services of poor quality. Hospital managed CHCs attracted patients through their higher quality of clinical care, while private CHCs attracted users through convenience and medical equipment. Our study suggested that government and hospital managed CHCs were more competent and provided better primary care than privately owned CHCs. Further studies are warranted to comprehensively compare performances among different models of CHCs.
NASA Astrophysics Data System (ADS)
Schernewski, Gerald; Hürdler, Jens; Neumann, Thomas; Stybel, Nardine; Venohr, Markus
2010-05-01
Eutrophication management is still a major challenge in the Baltic Sea region. Estuaries or coastal waters linked to large rivers cannot be managed independently. Nutrient loads into these coastal ecosystems depend on processes, utilisation, structure and management in the river basin. In practise this means that we need a large scale approach and integrated models and tools to analyse, assess and evaluate the effects of nutrient loads on coastal water quality as well as the efficiency of river basin management measures on surface waters and especially lagoons and estuaries. The Odra river basin, the Szczecin Lagoon and its coastal waters cover an area of about 150,000 km² and are an eutrophication hot-spot in the Baltic region. To be able to carry out large scale, spatially integrative analyses, we linked the river basin nutrient flux model MONERIS to the coastal 3D-hydrodynamic and ecosystem model ERGOM. Objectives were a) to analyse the eutrophication history in the river basin and the resulting functional changes in the coastal waters between early 1960's and today and b) to analyse the effects of an optimal nitrogen and phosphorus management scenario in the Oder/Odra river basin on coastal water quality. The models show that an optimal river basin management with reduced nutrient loads (e.g. N-load reduction of 35 %) would have positive effects on coastal water quality and algae biomass. The availability of nutrients, N/P ratios and processes like denitrification and nitrogen-fixation would show spatial and temporal changes. It would have positive consequences for ecosystems functions, like the nutrient retention capacity, as well. However, this optimal scenario is by far not sufficient to ensure a good coastal water quality according to the European Water Framework Directive. A "good" water quality in the river will not be sufficient to ensure a "good" water quality in the coastal waters. Further, nitrogen load reductions bear the risk of increased potentially toxic, blue-green algae blooms. The presentation will summarize recent results (Behrendt et al. 2009, Schernewski et al. 2009, Schernewski et al. in press, Schernewski et al. submitted) and give an overview how Climate Change and socio-economic transformation processes in the river basin will effect coastal water quality during the next decades. The opportunities and threats of a changing lagoon ecosystem for tourism and fisheries, the major economic activities, will be shown.
Total Quality Management Practices in Turkish Primary Schools
ERIC Educational Resources Information Center
Toremen, Fatih; Karakus, Mehmet; Yasan, Tezcan
2009-01-01
Purpose: The purpose of this paper is to determine the extent of total quality management (TQM) practices in primary schools based on teachers' perceptions, and how their perceptions are related to different variables. Design/methodology/approach: In this study, a survey based descriptive scanning model was used. This study was carried out in…
Attributing nitrogen (N) in the environment to emissions from agricultural management practices is difficult because of the complex and inter-related chemical and biological reactions associated with N and its cascading effects across land, air and water. Such analyses are criti...
Büchner, Vera Antonia; Schreyögg, Jonas; Schultz, Carsten
2014-01-01
The appropriate governance of hospitals largely depends on effective cooperation between governing boards and hospital management. Governing boards play an important role in strategy-setting as part of their support for hospital management. However, in certain situations, this active strategic role may also generate discord within this relationship. The objective of this study is to investigate the impact of the roles, attributes, and processes of governing boards on hospital performance. We examine the impact of the governing board's strategy-setting role on board-management collaboration quality and on financial performance while also analyzing the interaction effects of board diversity and board activity level. The data are derived from a survey that was sent simultaneously to German hospitals and their associated governing board, combined with objective performance information from annual financial statements and quality reports. We use a structural equation modeling approach to test the model. The results indicate that different board characteristics have a significant impact on hospital performance (R = .37). The strategy-setting role and board-management collaboration quality have a positive effect on hospital performance, whereas the impact of strategy-setting on collaboration quality is negative. We find that the positive effect of strategy-setting on performance increases with decreasing board diversity. When board members have more homogeneous backgrounds and exhibit higher board activity levels, the negative effect of the strategy-setting on collaboration quality also increases. Active strategy-setting by a governing board may generally improve hospital performance. Diverse members of governing boards should be involved in strategy-setting for hospitals. However, high board-management collaboration quality may be compromised if managerial autonomy is too highly restricted. Consequently, hospitals should support board-management collaboration about empowered contrasting board roles.
Musekamp, Gunda; Schuler, Michael; Seekatz, Bettina; Bengel, Jürgen; Faller, Hermann; Meng, Karin
2017-02-15
Heart failure (HF) patient education aims to foster patients' self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. The purpose of this study was to test the hypothesis that change in self-reported self-management skills observed after participation in self-management education predicts changes in physical and mental quality of life and depressive symptoms up to one year thereafter. The sample comprised 342 patients with chronic heart failure, treated in inpatient rehabilitation clinics, who received a heart failure self-management education program. Latent change modelling was used to analyze relationships between both short-term (during inpatient rehabilitation) and intermediate-term (after six months) changes in self-reported self-management skills and both intermediate-term and long-term (after twelve months) changes in physical and mental quality of life and depressive symptoms. Short-term changes in self-reported self-management skills predicted intermediate-term changes in mental quality of life and long-term changes in physical quality of life. Intermediate-term changes in self-reported self-management skills predicted long-term changes in all outcomes. These findings support the assumption that improvements in self-management skills may foster improvements in distal outcomes.
Production system with process quality control: modelling and application
NASA Astrophysics Data System (ADS)
Tsou, Jia-Chi
2010-07-01
Over the past decade, there has been a great deal of research dedicated to the study of quality and the economics of production. In this article, we develop a dynamic model which is based on the hypothesis of a traditional economic production quantity model. Taguchi's cost of poor quality is used to evaluate the cost of poor quality in the dynamic production system. A practical case from the automotive industry, which uses the Six-sigma DMAIC methodology, is discussed to verify the proposed model. This study shows that there is an optimal value of quality investment to make the production system reach a reasonable quality level and minimise the production cost. Based on our model, the management can adjust its investment in quality improvement to generate considerable financial return.
A manufacturing quality assessment model based-on two stages interval type-2 fuzzy logic
NASA Astrophysics Data System (ADS)
Purnomo, Muhammad Ridwan Andi; Helmi Shintya Dewi, Intan
2016-01-01
This paper presents the development of an assessment models for manufacturing quality using Interval Type-2 Fuzzy Logic (IT2-FL). The proposed model is developed based on one of building block in sustainable supply chain management (SSCM), which is benefit of SCM, and focuses more on quality. The proposed model can be used to predict the quality level of production chain in a company. The quality of production will affect to the quality of product. Practically, quality of production is unique for every type of production system. Hence, experts opinion will play major role in developing the assessment model. The model will become more complicated when the data contains ambiguity and uncertainty. In this study, IT2-FL is used to model the ambiguity and uncertainty. A case study taken from a company in Yogyakarta shows that the proposed manufacturing quality assessment model can work well in determining the quality level of production.
USDA-ARS?s Scientific Manuscript database
Water quality models are used to predict effects of conservation practices to mitigate the transport of herbicides to water bodies. We used two models - the Agricultural Policy/Environmental eXtender (APEX) and the Riparian Ecosystem Management Model (REMM) to predict the movement of atrazine from ...
A review of AirQ Models and their applications for forecasting the air pollution health outcomes.
Oliveri Conti, Gea; Heibati, Behzad; Kloog, Itai; Fiore, Maria; Ferrante, Margherita
2017-03-01
Even though clean air is considered as a basic requirement for the maintenance of human health, air pollution continues to pose a significant health threat in developed and developing countries alike. Monitoring and modeling of classic and emerging pollutants is vital to our knowledge of health outcomes in exposed subjects and to our ability to predict them. The ability to anticipate and manage changes in atmospheric pollutant concentrations relies on an accurate representation of the chemical state of the atmosphere. The task of providing the best possible analysis of air pollution thus requires efficient computational tools enabling efficient integration of observational data into models. A number of air quality models have been developed and play an important role in air quality management. Even though a large number of air quality models have been discussed or applied, their heterogeneity makes it difficult to select one approach above the others. This paper provides a brief review on air quality models with respect to several aspects such as prediction of health effects.
NASA Astrophysics Data System (ADS)
Jackson-Blake, L. A.; Sample, J. E.; Wade, A. J.; Helliwell, R. C.; Skeffington, R. A.
2017-07-01
Catchment-scale water quality models are increasingly popular tools for exploring the potential effects of land management, land use change and climate change on water quality. However, the dynamic, catchment-scale nutrient models in common usage are complex, with many uncertain parameters requiring calibration, limiting their usability and robustness. A key question is whether this complexity is justified. To explore this, we developed a parsimonious phosphorus model, SimplyP, incorporating a rainfall-runoff model and a biogeochemical model able to simulate daily streamflow, suspended sediment, and particulate and dissolved phosphorus dynamics. The model's complexity was compared to one popular nutrient model, INCA-P, and the performance of the two models was compared in a small rural catchment in northeast Scotland. For three land use classes, less than six SimplyP parameters must be determined through calibration, the rest may be based on measurements, while INCA-P has around 40 unmeasurable parameters. Despite substantially simpler process-representation, SimplyP performed comparably to INCA-P in both calibration and validation and produced similar long-term projections in response to changes in land management. Results support the hypothesis that INCA-P is overly complex for the study catchment. We hope our findings will help prompt wider model comparison exercises, as well as debate among the water quality modeling community as to whether today's models are fit for purpose. Simpler models such as SimplyP have the potential to be useful management and research tools, building blocks for future model development (prototype code is freely available), or benchmarks against which more complex models could be evaluated.
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
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.
ERIC Educational Resources Information Center
Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan
2015-01-01
The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…
NASA Astrophysics Data System (ADS)
Tan, Pei Kian; Mohd Suradi, Nur Riza; Saludin, Mohamad Nasir
2013-04-01
Service failure frequently occurs. This affects customer expectations which lead to complaint. However, not all dissatisfied customers actually complain. Without customer feedback, it would be impossible for a company to know whether they needed a change for improvement. Thus, complaint management brings a learning experience to organization in order to provide better service. Therefore, it is important to identify customer dissatisfaction through a systematic complaint handling or management. The study proposes a model of systematic complaint management which applied to academic library as a tool of service recovery. As such, the main purpose of this study is to investigate the critical success factors of complaint management towards service quality, customer satisfaction, customer loyalty and the impact to organizational image at academic library. Three academic libraries have been identified and selected for this project, the Library of Tun Sri Lanang, UKM, UTeM and UNIMAS. Using the justice theory, this study investigates the perception of customers on complaint management in terms of outcomes they receive, procedures used by organization and interpersonal treatment. In this study, there are five factors of complaint management identified, which includes speed of recovery, management system, empowerment, culture and psychology and tangible compensation. A questionnaire was designed and used as the data gathering instrument. A total of 600 respondents participated in this study. Ten hypotheses were used to test the relationships between complaint management, service quality, customer satisfaction, customer loyalty and organizational image. To measure the construct relationships, Structural Equation Model (SEM) approach was used. The results show that management system (b = 0.210; p < 0.05) exerts the highest positive impact on service quality. It followed by psychology and culture (b = 0.188; p < 0.05), empowerment (b = 0.179; p < 0.05) and tangible compensation (b = 0.175; p < 0.05). However, the empirical results suggest that speed of recovery (b = -0.009; p > 0.05) do not influence service quality. The second part of this study uses confirmatory factor analysis (CFA) to analyze and confirm the conceptual model proposed in this research. The result shows that all the values obtained in this study fits the data reasonably well.
Uncertainty analyses of the calibrated parameter values of a water quality model
NASA Astrophysics Data System (ADS)
Rode, M.; Suhr, U.; Lindenschmidt, K.-E.
2003-04-01
For river basin management water quality models are increasingly used for the analysis and evaluation of different management measures. However substantial uncertainties exist in parameter values depending on the available calibration data. In this paper an uncertainty analysis for a water quality model is presented, which considers the impact of available model calibration data and the variance of input variables. The investigation was conducted based on four extensive flowtime related longitudinal surveys in the River Elbe in the years 1996 to 1999 with varying discharges and seasonal conditions. For the model calculations the deterministic model QSIM of the BfG (Germany) was used. QSIM is a one dimensional water quality model and uses standard algorithms for hydrodynamics and phytoplankton dynamics in running waters, e.g. Michaelis Menten/Monod kinetics, which are used in a wide range of models. The multi-objective calibration of the model was carried out with the nonlinear parameter estimator PEST. The results show that for individual flow time related measuring surveys very good agreements between model calculation and measured values can be obtained. If these parameters are applied to deviating boundary conditions, substantial errors in model calculation can occur. These uncertainties can be decreased with an increased calibration database. More reliable model parameters can be identified, which supply reasonable results for broader boundary conditions. The extension of the application of the parameter set on a wider range of water quality conditions leads to a slight reduction of the model precision for the specific water quality situation. Moreover the investigations show that highly variable water quality variables like the algal biomass always allow a smaller forecast accuracy than variables with lower coefficients of variation like e.g. nitrate.
NASA Astrophysics Data System (ADS)
Vigouroux, G.; Destouni, G.; Chen, Y.; Bring, A.; Jönsson, A.; Cvetkovic, V.
2017-12-01
Coastal areas link human-driven conditions on land with open sea conditions, and include crucial and vulnerable ecosystems that provide a variety of ecosystem services. Eutrophication is a common problem that is not least observed in the Baltic Sea, where coastal water quality is influenced both by land-based nutrient loading and by partly eutrophic open sea conditions. Robust and adaptive management of coastal systems is essential and necessitates integration of large scale catchment-coastal-marine systems as well as consideration of anthropogenic drivers and impacts, and climate change. To address this coastal challenge, relevant methodological approaches are required for characterization of coupled land, local coastal, and open sea conditions under an adaptive management framework for water quality. In this paper we present a new general and scalable dynamic characterization approach, developed for and applied to the Baltic Sea and its coastal areas. A simple carbon-based water quality model is implemented, dividing the Baltic Sea into main management basins that are linked to corresponding hydrological catchments on land, as well as to each other though aggregated three-dimensional marine hydrodynamics. Relevant hydrodynamic variables and associated water quality results have been validated on the Baltic Sea scale and show good accordance with available observation data and other modelling approaches. Based on its scalability, this methodology is further used on coastal zone scale to investigate the effects of hydrodynamic, hydro-climatic and nutrient load drivers on water quality and management implications for coastal areas in the Baltic Sea.
Jones, Roger; Hunt, Claire; Stevens, Richard; Dalrymple, Jamie; Driscoll, Richard; Sleet, Sarah; Smith, Jonathan Blanchard
2009-01-01
Background Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management. Aim To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome. Design of study Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition. Setting Community-based practice in England, UK. Methods Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines. Results A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease. Conclusion This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions. PMID:19520018
Soulat, J; Picard, B; Léger, S; Monteils, V
2018-06-01
In this study, four prediction models were developed by logistic regression using individual data from 96 heifers. Carcass and sensory rectus abdominis quality clusters were identified then predicted using the rearing factors data. The obtained models from rearing factors applied during the fattening period were compared to those characterising the heifers' whole life. The highest prediction power of carcass and meat quality clusters were obtained from the models considering the whole life, with success rates of 62.8% and 54.9%, respectively. Rearing factors applied during both pre-weaning and fattening periods influenced carcass and meat quality. According to models, carcass traits were improved when heifer's mother was older for first calving, calves ingested concentrates during pasture preceding weaning and heifers were slaughtered older. Meat traits were improved by the genetic of heifers' parents (i.e., calving ease and early muscularity) and when heifers were slaughtered older. A management of carcass and meat quality traits is possible at different periods of the heifers' life. Copyright © 2018 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Lokey, Kenneth R.
The Satellite Technology Demonstration (STD), a project of the Federation of Rocky Mountain States, Inc. (FRMS), employed a project management model for its organizational structure. The organization and management system utilized by the STD was designed to accomplish a predetermined set of objectives with the highest quality possible within a…
Ground-water models for water resources planning
Moore, John E.
1980-01-01
In the past decade hydrologists have emphasized the development of computer-based mathematical models to aid in the understanding of flow, the transport of solutes, transport of heat, and deformation in the groundwater system. These models have been used to provide information and predictions for water managers. Too frequently, groundwater was neglected in water-resource planning because managers believed that it could not be adequately evaluated in terms of availability, quality, and effect of development on surface water supplies. Now, however, with newly developed digital groundwater models, effects of development can be predicted. Such models have been used to predict hydrologic and quality changes under different stresses. These models have grown in complexity over the last 10 years from simple one-layer flow models to three-dimensional simulations of groundwater flow which may include solute transport, heat transport, effects of land subsidence, and encroachment of salt water. This paper illustrates, through case histories, how predictive groundwater models have provided the information needed for the sound planning and management of water resources in the United States. (USGS)
2001-01-01
This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for forming such a "Semantic Web" or "web of trust" among the players active in quality management of health information is that these initiatives make statements about themselves and about each other in a machine-processable language. I present a concrete model on how this collaboration could look, and provide some recommendations on what the role of the World Health Organization (WHO) and other policy makers in this framework could be. PMID:11772549
Eysenbach, G
2001-01-01
This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for forming such a "Semantic Web" or "web of trust" among the players active in quality management of health information is that these initiatives make statements about themselves and about each other in a machine-processable language. I present a concrete model on how this collaboration could look, and provide some recommendations on what the role of the World Health Organization (WHO) and other policy makers in this framework could be.
ERIC Educational Resources Information Center
Ekholm, Mats
1997-01-01
Argues that recent changes in conceptions of state control over schools are due partially to the relaxation of Cold War politics. Shows that new models of management produce fewer changes in school quality than expected. Proposes that the determining factor in change is the mentality inherent in individual schools' working structures. (DSK)
NASA Astrophysics Data System (ADS)
Thomas, A.; Huff, A. K.; Gomori, S. G.; Sadoff, N.
2014-12-01
In order to enhance the capacity for air quality modeling and improve air quality monitoring and management in the SERVIR Mesoamerica region, members of SERVIR's Applied Sciences Team (AST) are developing national numerical air quality models for El Salvador and Costa Rica. We are working with stakeholders from the El Salvador Ministry of the Environment and Natural Resources (MARN); National University of Costa Rica (UNA); the Costa Rica Ministry of the Environment, Energy, and Telecommunications (MINAET); and Costa Rica National Meteorological Institute (IMN), who are leaders in air quality monitoring and management in the Mesoamerica region. Focusing initially on these institutions will build sustainability in regional modeling activities by developing air quality modeling capability that can be shared with other countries in Mesoamerica. The air quality models are based on the Community Multi-scale Air Quality (CMAQ) model and incorporate meteorological inputs from the Weather Research and Forecasting (WRF) model, as well as national emissions inventories from El Salvador and Costa Rica. The models are being optimized for urban air quality, which is a priority of decision-makers in Mesoamerica. Once experimental versions of the modeling systems are complete, they will be transitioned to servers run by stakeholders in El Salvador and Costa Rica. The numerical air quality models will provide decision support for stakeholders to identify 1) high-priority areas for expanding national ambient air monitoring networks, 2) needed revisions to national air quality regulations, and 3) gaps in national emissions inventories. This project illustrates SERVIR's goal of the transition of science to support decision-making through capacity building in Mesoamerica, and it aligns with the Group on Earth Observations' health societal benefit theme. This presentation will describe technical aspects of the development of the models and outline key steps in our successful collaboration with the Mesoamerican stakeholders, including the processes of identifying and engaging decision-makers, understanding their requirements and limitations, communicating status updates on a regular basis, and providing sufficient training for end users to be able to utilize the models in a decision-making context.
Corrao, Carmela Romana Natalina
2011-01-01
The evolution of the national and European legislation has progressively transformed the working environments into organized environments. Specific models for its management are being proposed, which should be integrated into general management strategies. In the case of hospitals this integration should consider the peculiar organizational complexity, where the management of the occupational risk needs to be integrated with clinical risk management and economic risk management. Resources management should also consider that Occupational Medicine has not a direct monetary benefit for the organisation, but only indirect health consequences in terms of reduction of accidents and occupational diseases. The deep and simultaneous analysis of the current general management systems and the current management methods of occupational safety and health protection allows one to hyphotesise a possible integration between them. For both of them the Top Management is the main responsible of the quality management strategies and the use of specific documents in the managerial process, such as the document of risks evaluation in the occupational management and the quality manual in the general management, is of paramount importance. An integrated management has also the scope to pursue a particular kind of quality management, where ethics and job satisfaction are innovative, as established by recent European guidelines, management systems and national legislations.
1992-10-01
System Model for Water Quality Control by Jackson K. Brown ...................................... 119 Management Technique for Long-Term Flow... Modeling Activities for the ARCS Program by David C. Cowgill ...................................... 141 Toxicity and Chemistry Testing of Great Lakes...225 Combined Hydrodynamic and Water Quality Modeling of Lower Green Bay by David J. Mark, Barry W. Bunch, and Norman W. Scheffner
Liu, Hui; Benoit, Gaboury; Liu, Tao; Liu, Yong; Guo, Huaicheng
2015-05-15
A reliable system simulation to relate socioeconomic development with water environment and to comprehensively represent a watershed's dynamic features is important. In this study, after identifying lake watershed system processes, we developed a system dynamics modeling framework for managing lake water quality at the watershed scale. Two reinforcing loops (Development and Investment Promotion) and three balancing loops (Pollution, Resource Consumption, and Pollution Control) were constituted. Based on this work, we constructed Stock and Flow Diagrams that embedded a pollutant load model and a lake water quality model into a socioeconomic system dynamics model. The Dianchi Lake in Yunnan Province, China, which is the sixth largest and among the most severely polluted freshwater lakes in China, was employed as a case study to demonstrate the applicability of the model. Water quality parameters considered in the model included chemical oxygen demand (COD), total nitrogen (TN), and total phosphorus (TP). The business-as-usual (BAU) scenario and three alternative management scenarios on spatial adjustment of industries and population (S1), wastewater treatment capacity construction (S2), and structural adjustment of agriculture (S3), were simulated to assess the effectiveness of certain policies in improving water quality. Results showed that S2 is most effective scenario, and the COD, TN, and TP concentrations in Caohai in 2030 are 52.5, 10.9, and 0.8 mg/L, while those in Waihai are 9.6, 1.2, and 0.08 mg/L, with sustained development in the watershed. Thus, the model can help support the decision making required in development and environmental protection strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.
Variations in Daily Sleep Quality and Type 1 Diabetes Management in Late Adolescents
Queen, Tara L.; Butner, Jonathan; Wiebe, Deborah; Berg, Cynthia A.
2016-01-01
Objective To determine how between- and within-person variability in perceived sleep quality were associated with adolescent diabetes management. Methods A total of 236 older adolescents with type 1 diabetes reported daily for 2 weeks on sleep quality, self-regulatory failures, frequency of blood glucose (BG) checks, and BG values. Average, inconsistent, and daily deviations in sleep quality were examined. Results Hierarchical linear models indicated that poorer average and worse daily perceived sleep quality (compared with one’s average) was each associated with more self-regulatory failures. Sleep quality was not associated with frequency of BG checking. Poorer average sleep quality was related to greater risk of high BG. Furthermore, inconsistent and daily deviations in sleep quality interacted to predict higher BG, with more consistent sleepers benefitting more from a night of high-quality sleep. Conclusions Good, consistent sleep quality during late adolescence may benefit diabetes management by reducing self-regulatory failures and risk of high BG. PMID:26994852
Effect of Workplace Weight Management on Health Care Expenditures and Quality of Life.
Michaud, Tzeyu L; Nyman, John A; Jutkowitz, Eric; Su, Dejun; Dowd, Bryan; Abraham, Jean M
2016-11-01
We examined the effectiveness of the weight management program used by the University of Minnesota in reducing health care expenditures and improving quality of life of its employees, and also in reducing their absenteeism during a 3-year intervention. A differences-in-differences regression approach was used to estimate the effect of weight management participation. We further applied ordinary least squares regression models with fixed effects to estimate the effect in an alternative analysis. Participation in the weight management program significantly reduced health care expenditures by $69 per month for employees, spouses, and dependents, and by $73 for employees only. Quality-of-life weights were 0.0045 points higher for participating employees than for nonparticipating ones. No significant effect was found for absenteeism. The workplace weight management used by the University of Minnesota reduced health care expenditures and improved quality of life.
Ritchey, Jamie; Gay, E Greer; Spencer, Benjamin A; Miller, David C; Wallner, Lauren P; Stewart, Andrew K; Dunn, Rodney L; Litwin, Mark S; Wei, John T
2012-09-01
Given the increased attention to the quality and cost of medical care, the Institute of Medicine and Centers for Medicare and Medicaid Services have called for performance measurement and reporting. The clinical management of prostate cancer has been outlined, yet is not intended to describe quality prostate cancer care. Therefore, RAND researchers developed quality indicators for early stage prostate cancer. The ACoS (American College of Surgeons) used these indicators to perform the first national assessment to our knowledge of the quality of care among men with early stage prostate cancer undergoing expectant management. Information from medical records was abstracted for evidence of compliance with the RAND indicators (structure and process). Weighted and stratified proportions were calculated to assess indicator compliance. Logistic regression models were fit and evaluated by hospital type and patient factors. A weighted and stratified total of 13,876 early stage prostate cancer cases on expectant management in 2000 to 2001 were investigated. Compliance with structural indicators was high (greater than 80%) and compliance with process indicators varied (19% to 87%). Differences in process indicators were observed from models by hospital type and comorbid conditions, but not for age, race or insurance status. Using the RAND quality indicators this study revealed several process areas for quality improvement among men with early stage prostate cancer on expectant management in the United States. Efforts to improve the quality of early stage prostate cancer care need to move beyond the paradigm of age, race and insurance status. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Kanawha River Basin Water Quality Modeling
1986-07-01
was performed by Mr. R. G. Willey with the technical assistance of Mr. Keith Knight. Mr. Don Smith of Resource Management Associates provided advice...during critical parts of the study. The study was managed under the direcLion of Dr. Richard Punnett of the Huntington District who was also responsible...to provide better system water quality analysis capabilities in support of the Corps’ water control management program. The focus of this program is
Lean management systems: creating a culture of continuous quality improvement.
Clark, David M; Silvester, Kate; Knowles, Simon
2013-08-01
This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.
Collaborative problem solving with a total quality model.
Volden, C M; Monnig, R
1993-01-01
A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.
Colonna, Paolo; Pasini, Evasio; Pitocchi, Oreste; Bovenzi, Francesco; Sorino, Margherita; de Luca, Italo
2003-04-01
It is a difficult task to define practical guidelines and a pragmatic achievement for the new document of the Italian Ministry of Health for structures of the national health system obtaining a quality system according to the ISO 9000 standard. The present article illustrates the different steps to accomplish the quality management in our cardiology department, recently internationally certified, and it gives several practical examples of the path followed in the different sections of the department to obtain the best management of all the Operative Units, identifying customer requests and measuring customer satisfaction.
A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan
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
Value-added strategy models to provide quality services in senior health business.
Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin
2017-06-20
The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
ERIC Educational Resources Information Center
Salajan, Florin D.; Welch, Anita G.; Ray, Chris M.; Peterson, Claudette
2015-01-01
This study's primary investigation is the impact of "peer influence" and "perceived quality of teaching" on faculty members' usage of web-based learning management systems within the Technology Acceptance Model (TAM) framework. These factors are entered into an extended TAM as external variables impacting on the core constructs…
Faculty Opinions Regarding the Philosophical Principles of Total Quality Management (TQM).
ERIC Educational Resources Information Center
Aliff, John Vincent
The 14 points of the Total Quality Management (TQM) model can be distilled into the following 5 main guiding principles: establish a moral purpose for the institution, use cooperative efforts instead of individual efforts, stop the use of inspection (testing) to improve students and teachers, continuously improve the system and its products, and…
Simulated yields for managed northern hardwood stands
Dale S. Solomon; William B. Leak; William B. Leak
1986-01-01
Board-foot and cubic-foot yields developed with the forest growth model SlMTlM are presented for northern hardwood stands grown with and without management. SIMTIM has been modified to include more accurate growth rates by species, a new stocking chart, and yields that reflect species values and quality classes. Treatments range from no thinning to intensive quality...
Katz, R
1992-11-01
Cluster management is a management model that fosters decentralization of management, develops leadership potential of staff, and creates ownership of unit-based goals. Unlike shared governance models, there is no formal structure created by committees and it is less threatening for managers. There are two parts to the cluster management model. One is the formation of cluster groups, consisting of all staff and facilitated by a cluster leader. The cluster groups function for communication and problem-solving. The second part of the cluster management model is the creation of task forces. These task forces are designed to work on short-term goals, usually in response to solving one of the unit's goals. Sometimes the task forces are used for quality improvement or system problems. Clusters are groups of not more than five or six staff members, facilitated by a cluster leader. A cluster is made up of individuals who work the same shift. For example, people with job titles who work days would be in a cluster. There would be registered nurses, licensed practical nurses, nursing assistants, and unit clerks in the cluster. The cluster leader is chosen by the manager based on certain criteria and is trained for this specialized role. The concept of cluster management, criteria for choosing leaders, training for leaders, using cluster groups to solve quality improvement issues, and the learning process necessary for manager support are described.
Jin, S W; Li, Y P; Nie, S
2018-05-15
In this study, an interval chance-constrained bi-level programming (ICBP) method is developed for air quality management of municipal energy system under uncertainty. ICBP can deal with uncertainties presented as interval values and probability distributions as well as examine the risk of violating constraints. Besides, a leader-follower decision strategy is incorporated into the optimization process where two decision makers with different goals and preferences are involved. To solve the proposed model, a bi-level interactive algorithm based on satisfactory degree is introduced into the decision-making processes. Then, an ICBP based energy and environmental systems (ICBP-EES) model is formulated for Beijing, in which air quality index (AQI) is used for evaluating the integrated air quality of multiple pollutants. Result analysis can help different stakeholders adjust their tolerances to achieve the overall satisfaction of EES planning for the study city. Results reveal that natural gas is the main source for electricity-generation and heating that could lead to a potentially increment of imported energy for Beijing in future. Results also disclose that PM 10 is the major contributor to AQI. These findings can help decision makers to identify desired alternatives for EES planning and provide useful information for regional air quality management under uncertainty. Copyright © 2018 Elsevier B.V. All rights reserved.
Authentic leadership and nurses' voice behaviour and perceptions of care quality.
Wong, Carol A; Spence Laschinger, Heather K; Cummings, Greta G
2010-11-01
The purpose of the present study was to test a theoretical model linking authentic leadership with staff nurses' trust in their manager, work engagement, voice behaviour and perceived unit care quality. Authentic leadership is a guide for effective leadership needed to build trust and healthier work environments because there is special attention given to honesty, integrity and high ethical standards in the development of leader-follower relationships. A non-experimental, predictive survey design was used to test the hypothesized model in a random sample of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario. The final model fitted the data acceptably (χ(2)=17.24, d.f.=11, P=0.10, IFI=0.99, CFI=0.99, RMSEA=0.045). Authentic leadership significantly and positively influenced staff nurses' trust in their manager and work engagement which in turn predicted voice behaviour and perceived unit care quality. These findings suggest that authentic leadership and trust in the manager play a role in fostering trust, work engagement, voice behaviour and perceived quality of care. Nursing leaders can improve care quality and workplace conditions by paying attention to facilitating genuine and positive relationships with their staff. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
An assessment model for quality management
NASA Astrophysics Data System (ADS)
Völcker, Chr.; Cass, A.; Dorling, A.; Zilioli, P.; Secchi, P.
2002-07-01
SYNSPACE together with InterSPICE and Alenia Spazio is developing an assessment method to determine the capability of an organisation in the area of quality management. The method, sponsored by the European Space Agency (ESA), is called S9kS (SPiCE- 9000 for SPACE). S9kS is based on ISO 9001:2000 with additions from the quality standards issued by the European Committee for Space Standardization (ECSS) and ISO 15504 - Process Assessments. The result is a reference model that supports the expansion of the generic process assessment framework provided by ISO 15504 to nonsoftware areas. In order to be compliant with ISO 15504, requirements from ISO 9001 and ECSS-Q-20 and Q-20-09 have been turned into process definitions in terms of Purpose and Outcomes, supported by a list of detailed indicators such as Practices, Work Products and Work Product Characteristics. In coordination with this project, the capability dimension of ISO 15504 has been revised to be consistent with ISO 9001. As contributions from ISO 9001 and the space quality assurance standards are separable, the stripped down version S9k offers organisations in all industries an assessment model based solely on ISO 9001, and is therefore interesting to all organisations, which intend to improve their quality management system based on ISO 9001.
NASA Astrophysics Data System (ADS)
Liu, Yaoze; Engel, Bernard A.; Flanagan, Dennis C.; Gitau, Margaret W.; McMillan, Sara K.; Chaubey, Indrajeet; Singh, Shweta
2018-05-01
Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water quality models, a high level and forward-looking modeling framework was developed. The components in the framework consist of establishment period efficiency, starting efficiency, efficiency for each storm event, efficiency between maintenance, and efficiency over the life cycle. Combined, they represent long-term efficiency for a specific type of practice and specific environmental concern (runoff/pollutant). An approach for possible implementation of the framework was discussed. The long-term impacts of grass buffer strips (agricultural BMP) and bioretention systems (urban BMP) in reducing total phosphorus were simulated to demonstrate the framework. Data gaps were captured in estimating the long-term performance of the BMPs. A Bayesian method was used to match the simulated distribution of long-term BMP efficiencies with the observed distribution with the assumption that the observed data represented long-term BMP efficiencies. The simulated distribution matched the observed distribution well with only small total predictive uncertainties. With additional data, the same method can be used to further improve the simulation results. The modeling framework and results of this study, which can be adopted in hydrologic/water quality models to better represent long-term BMP effectiveness, can help improve decision support systems for creating long-term stormwater management strategies for watershed management projects.
Storm Water Management Model Reference Manual Volume III – Water Quality
SWMM is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. The runoff component of SWMM operates on a collection of subcatchment areas that receive precipitation and gene...
Leadership versus management: translating pharmacists' abilities into quality performance.
Reeder, C E
2005-03-01
To describe the quality gap in health care as it was referred to in the Institute of Medicine's reports, to try to harness pharmacy's potential to improve the quality of drug therapy, and to provide insight into the elusive leadership, management, and dynamics of change. Current health care is nowhere near ideal. Successful quality initiatives have included establishing a "culture of quality" (promoting a learning organization), having good leadership, and developing strong management. Ideally, all of these concepts must be applied concurrently for the best results because using only one will not spirit medicine across the gap. To close the gap, pharmacists need to understand various types of change and select a change mechanism that will continuously improve care. Optimizing drug therapy is both a great challenge and a great opportunity for pharmacy. AMCP's Framework for Quality Drug Therapy is a continuous quality improvement model that gives us the tools to plan, implement, and evaluate strategies to improve the quality of patient care and cross the "quality chasm."
Modeling factors explaining physicians’ satisfaction with competence
Lepnurm, Rein; Dobson, Roy Thomas; Peña-Sánchez, Juan-Nicolás; Nesdole, Robert
2015-01-01
Objective: Attention to physician wellness has increased as medical practice gains in complexity. Physician satisfaction with practice is critical for quality of care and practice growth. The purpose of this study was to model physicians’ self-reported Satisfaction with Competence as a function of their perceptions of the Quality of Health Services, Distress, Coping, Practice Management, Personal Satisfaction and Professional Equity. Methods: Comprehensive questionnaires were sent to a stratified sample of 5300 physicians across Canada. This cross-sectional study focused on physicians who examined and treated individual patients for a final study population of 2639 physicians. Response bias was negligible. The questionnaires contained measures of Satisfaction with Competence, Quality of Health Services, Distress, Coping, Personal Satisfaction, Practice Management and Professional Equity. Exploring relationships was done using Pearson correlations and one-way analysis of variance. Modeling was by hierarchical regressions. Results: The measures were reliable: Satisfaction with Competence (α = .86), Quality (α = .86), Access (α = .82), Distress (α = .82), Coping (α = .76), Personal Satisfaction (α = .78), Practice Management (α = .89) and the dimensions of Professional Equity (Fulfillment, α = .81; Financial, α = .93; and Recognition, α = .75) with comparative validity. Satisfaction with Competence was positively correlated with Quality (r = .32), Efficiency (r = .37) and Access (r = .32); negatively correlated with Distress (r = −.54); and positively correlated with Coping strategies (r = .43), Personal Satisfaction (r = .57), Practice Management (r = .17), Fulfillment (r = .53), Financial (r = .36) and Recognition (r = .54). Physicians’ perceptions on Quality, Efficiency, Access, Distress, Coping, Personal Satisfaction, Practice Management, Fulfillment, Pay and Recognition explained 60.2% of the variation in Satisfaction with Competence, controlling for years in practice, self-reported health and duties of physicians. Conclusion: Satisfaction with Competence could be affected by excessive accumulation of duties, concerns about quality, efficiency, access, excessive distress, inadequate coping abilities, personal satisfaction with life as a physician, challenges in managing practices and persistent inequities among physicians. PMID:27092256
Modeling factors explaining physicians' satisfaction with competence.
Lepnurm, Rein; Dobson, Roy Thomas; Peña-Sánchez, Juan-Nicolás; Nesdole, Robert
2015-01-01
Attention to physician wellness has increased as medical practice gains in complexity. Physician satisfaction with practice is critical for quality of care and practice growth. The purpose of this study was to model physicians' self-reported Satisfaction with Competence as a function of their perceptions of the Quality of Health Services, Distress, Coping, Practice Management, Personal Satisfaction and Professional Equity. Comprehensive questionnaires were sent to a stratified sample of 5300 physicians across Canada. This cross-sectional study focused on physicians who examined and treated individual patients for a final study population of 2639 physicians. Response bias was negligible. The questionnaires contained measures of Satisfaction with Competence, Quality of Health Services, Distress, Coping, Personal Satisfaction, Practice Management and Professional Equity. Exploring relationships was done using Pearson correlations and one-way analysis of variance. Modeling was by hierarchical regressions. The measures were reliable: Satisfaction with Competence (α = .86), Quality (α = .86), Access (α = .82), Distress (α = .82), Coping (α = .76), Personal Satisfaction (α = .78), Practice Management (α = .89) and the dimensions of Professional Equity (Fulfillment, α = .81; Financial, α = .93; and Recognition, α = .75) with comparative validity. Satisfaction with Competence was positively correlated with Quality (r = .32), Efficiency (r = .37) and Access (r = .32); negatively correlated with Distress (r = -.54); and positively correlated with Coping strategies (r = .43), Personal Satisfaction (r = .57), Practice Management (r = .17), Fulfillment (r = .53), Financial (r = .36) and Recognition (r = .54). Physicians' perceptions on Quality, Efficiency, Access, Distress, Coping, Personal Satisfaction, Practice Management, Fulfillment, Pay and Recognition explained 60.2% of the variation in Satisfaction with Competence, controlling for years in practice, self-reported health and duties of physicians. Satisfaction with Competence could be affected by excessive accumulation of duties, concerns about quality, efficiency, access, excessive distress, inadequate coping abilities, personal satisfaction with life as a physician, challenges in managing practices and persistent inequities among physicians.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Krenzien, Susan; Farnham, Irene
This Quality Assurance Plan (QAP) provides the overall quality assurance (QA) requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) Underground Test Area (UGTA) activities. The requirements in this QAP are consistent with DOE Order 414.1D, Change 1, Quality Assurance (DOE, 2013a); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). If a participant’s requirement document differs from this QAP, the stricter requirement will take precedence.more » NNSA/NFO, or designee, must review this QAP every two years. Changes that do not affect the overall scope or requirements will not require an immediate QAP revision but will be incorporated into the next revision cycle after identification. Section 1.0 describes UGTA objectives, participant responsibilities, and administrative and management quality requirements (i.e., training, records, procurement). Section 1.0 also details data management and computer software requirements. Section 2.0 establishes the requirements to ensure newly collected data are valid, existing data uses are appropriate, and environmental-modeling methods are reliable. Section 3.0 provides feedback loops through assessments and reports to management. Section 4.0 provides the framework for corrective actions. Section 5.0 provides references for this document.« less
NASA Technical Reports Server (NTRS)
Bubenheim, David L.; Schlick, Greg; Genovese, Vanessa; Wilson, Kenneth D.
2018-01-01
Management of aquatic weeds in complex watersheds and river systems present many challenges to assessment, planning and implementation of management practices for floating and submerged aquatic invasive plants. The Delta Region Areawide Aquatic Weed Project (DRAAWP), a USDA sponsored area-wide project, is working to enhance planning, decision-making and operational efficiency in the California Sacramento-San Joaquin Delta. Satellite and airborne remote sensing are used map (area coverage and biomass density), direct operations, and assess management impacts on plant communities. Archived satellite records enable review of results following previous climate and management events and aide in developing long-term strategies. Examples of remote sensing aiding effectiveness of aquatic weed management will be discussed as well as areas for potential technological improvement. Modeling at local and watershed scales using the SWAT modeling tool provides insight into land-use effects on water quality (described by Zhang in same Symposium). Controlled environment growth studies have been conducted to quantify the growth response of invasive aquatic plants to water quality and other environmental factors. Environmental variability occurs across a range of time scales from long-term climate and seasonal trends to short-term water flow mediated variations. Response time for invasive species response are examined at time scales of weeks, day, and hours using a combination of study duration and growth assessment techniques to assess water quality, temperature (air and water), nitrogen, phosphorus, and light effects. These provide response parameters for plant growth models in response to the variation and interact with management and economic models associated with aquatic weed management. Plant growth models are to be informed by remote sensing and applied spatially across the Delta to balance location and type of aquatic plant, growth response to altered environments and phenology. Initial utilization of remote sensing tools developed for mapping of aquatic invasive plants improved operational efficiency in management practices. These assessment methods provide a comprehensive and quantitative view of aquatic invasive plants communities in the California Delta.
NASA Astrophysics Data System (ADS)
Xu, Mengjia; Zou, Changxin; Zhao, Yanwei
2017-04-01
Environmental/ecological models are widely used for lake management as they provide a means to understand physical, chemical and biological processes in highly complex ecosystems. Most research focused on the development of environmental (water quality) and ecological models, separately. Limited studies were developed to couple the two models, and in these limited coupled models, a lake was regarded as a whole for analysis (i.e., considering the lake to be one well-mixed box), which was appropriate for small-scale lakes and was not sufficient to capture spatial variations within middle-scale or large-scale lakes. This paper seeks to establish a zoning-based environmental-ecological-coupled model for a lake. The Baiyangdian Lake, the largest freshwater lake in Northern China, was adopted as the study case. The coupled lake models including a hydrodynamics and water quality model established by MIKE21 and a compartmental ecological model used STELLA software have been established for middle-sized Baiyangdian Lake to realize the simulation of spatial variations of ecological conditions. On the basis of the flow field distribution results generated by MIKE21 hydrodynamics model, four water area zones were used as an example for compartmental ecological model calibration and validation. The results revealed that the developed coupled lake models can reasonably reflected the changes of the key state variables although there remain some state variables that are not well represented by the model due to the low quality of field monitoring data. Monitoring sites in a compartment may not be representative of the water quality and ecological conditions in the entire compartment even though that is the intention of compartment-based model design. There was only one ecological observation from a single monitoring site for some periods. This single-measurement issue may cause large discrepancies particularly when sampled site is not representative of the whole compartment. The coupled models have been applied to simulate the spatial variation trends of ecological condition under ecological water supplement as an example to reflect the application effect in lake restoration and management. The simulation results indicate that the models can provide a useful tool for lake restoration and management. The simulated spatial variation trends can provide a foundation for establishing permissible ranges for a selected set of water quality indices for a series of management measures such as watershed pollution load control and ecological water transfer. Meanwhile, the coupled models can help us to understand processes taking place and the relations of interaction between components in the lake ecosystem and external conditions. Taken together, the proposed models we established show some promising applications as middle-scale or large-scale lake management tools for pollution load control and ecological water transfer. These tools quantify the implications of proposed future water management decisions.
Manufacturing Bms/Iso System Review
NASA Technical Reports Server (NTRS)
Gomez, Yazmin
2004-01-01
The Quality Management System (QMS) is one that recognizes the need to continuously change and improve an organization s products and services as determined by system feedback, and corresponding management decisions. The purpose of a Quality Management System is to minimize quality variability of an organization's products and services. The optimal Quality Management System balances the need for an organization to maintain flexibility in the products and services it provides with the need for providing the appropriate level of discipline and control over the processes used to provide them. The goal of a Quality Management System is to ensure the quality of the products and services while consistently (through minimizing quality variability) meeting or exceeding customer expectations. The GRC Business Management System (BMS) is the foundation of the Center's ISO 9001:2000 registered quality system. ISO 9001 is a quality system model developed by the International Organization for Standardization. BMS supports and promote the Glenn Research Center Quality Policy and wants to ensure the customer satisfaction while also meeting quality standards. My assignment during this summer is to examine the manufacturing processes used to develop research hardware, which in most cases are one of a kind hardware, made with non conventional equipment and materials. During this process of observation I will make a determination, based on my observations of the hardware development processes the best way to meet customer requirements and at the same time achieve the GRC quality standards. The purpose of my task is to review the manufacturing processes identifying opportunities in which to optimize the efficiency of the processes and establish a plan for implementation and continuous improvement.
Water quality management using statistical analysis and time-series prediction model
NASA Astrophysics Data System (ADS)
Parmar, Kulwinder Singh; Bhardwaj, Rashmi
2014-12-01
This paper deals with water quality management using statistical analysis and time-series prediction model. The monthly variation of water quality standards has been used to compare statistical mean, median, mode, standard deviation, kurtosis, skewness, coefficient of variation at Yamuna River. Model validated using R-squared, root mean square error, mean absolute percentage error, maximum absolute percentage error, mean absolute error, maximum absolute error, normalized Bayesian information criterion, Ljung-Box analysis, predicted value and confidence limits. Using auto regressive integrated moving average model, future water quality parameters values have been estimated. It is observed that predictive model is useful at 95 % confidence limits and curve is platykurtic for potential of hydrogen (pH), free ammonia, total Kjeldahl nitrogen, dissolved oxygen, water temperature (WT); leptokurtic for chemical oxygen demand, biochemical oxygen demand. Also, it is observed that predicted series is close to the original series which provides a perfect fit. All parameters except pH and WT cross the prescribed limits of the World Health Organization /United States Environmental Protection Agency, and thus water is not fit for drinking, agriculture and industrial use.
Coon, William F.
2008-01-01
A computer model of hydrologic and water-quality processes of the Onondaga Lake basin in Onondaga County, N.Y., was developed during 2003-07 to assist water-resources managers in making basin-wide management decisions that could affect peak flows and the water quality of tributaries to Onondaga Lake. The model was developed with the Hydrological Simulation Program-Fortran (HSPF) and was designed to allow simulation of proposed or hypothetical land-use changes, best-management practices (BMPs), and instream stormwater-detention basins such that their effects on flows and loads of suspended sediment, orthophosphate, total phosphorus, ammonia, organic nitrogen, and nitrate could be analyzed. Extreme weather conditions, such as intense storms and prolonged droughts, can be simulated through manipulation of the precipitation record. Model results obtained from different scenarios can then be compared and analyzed through an interactive computer program known as Generation and Analysis of Model Simulation Scenarios for Watersheds (GenScn). Background information on HSPF and GenScn is presented to familiarize the user with these two programs. Step-by-step examples are provided on (1) the creation of land-use, BMP, and stormflow-detention scenarios for simulation by the HSPF model, and (2) the analysis of simulation results through GenScn.
Managing diverse occupational therapy resources in a creative, corporate model.
Baptiste, S
1993-10-01
Two occupational therapy departments were amalgamated into a corporate whole and charged with the development of a workable, corporate structure. The departmental model which was developed served to enhance the concepts of quality of working life, employee autonomy, management team and quality circle theory. This paper provides a background from business and organizational literature, and outlines the development of the departmental model, in concert with the adoption of the client-centred model of occupational performance as a department basis for practice. This development was taking place concurrently with larger, institutional changes into a decentralized clinical programme management model. Discussion highlights the level of staff satisfaction with the changes, areas of concern during the development of the system and plans for the future growth. During this period of massive and critical change in the delivery of health care services, there has been a trend in restructuring health care institutions towards decentralized models. This paper will describe the experience of one occupational therapy department in developing an innovative departmental structure involving participatory management amalgamation. It is believed that the experience of the past occupational therapy work units with one viable option for a renewed management model. Staff skill sets can be maximized and optimal potential realized while faced with inevitable resource shrinkage and service reorganization.
Spreadsheet WATERSHED modeling for nonpoint-source pollution management in a Wisconsin basin
Walker, J.F.; Pickard, S.A.; Sonzogni, W.C.
1989-01-01
Although several sophisticated nonpoint pollution models exist, few are available that are easy to use, cover a variety of conditions, and integrate a wide range of information to allow managers and planners to assess different control strategies. Here, a straightforward pollutant input accounting approach is presented in the form of an existing model (WATERSHED) that has been adapted to run on modern electronic spreadsheets. As an application, WATERSHED is used to assess options to improve the quality of highly eutrophic Delavan Lake in Wisconsin. WATERSHED is flexible in that several techniques, such as the Universal Soil Loss Equation or unit-area loadings, can be used to estimate nonpoint-source inputs. Once the model parameters are determined (and calibrated, if possible), the spreadsheet features can be used to conduct a sensitivity analysis of management options. In the case of Delavan Lake, it was concluded that, although some nonpoint controls were cost-effective, the overall reduction in phosphorus would be insufficient to measurably improve water quality.A straightforward pollutant input accounting approach is presented in the form of an existing model (WATERSHED) that has been adapted to run on modern electronic spreadsheets. As an application, WATERSHED is used to assess options to improve the quality of highly eutrophic Delavan Lake in Wisconsin. WATERSHED is flexible in that several techniques, such as the Universal Soil Loss Equation or unit-area loadings, can be used to estimate nonpoint-source inputs. Once the model parameters are determined (and calibrated, if possible), the spreadsheet features can be used to conduct a sensitivity analysis of management options. In the case of Delavan Lake, it was concluded that, although some nonpoint controls were cost-effective, the overall reduction in phosphorus would be insufficient to measurably improve water quality.
Dückers, Michel La; Wagner, Cordula; Vos, Leti; Groenewegen, Peter P
2011-03-09
Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.
Design and Establishment of Quality Model of Fundamental Geographic Information Database
NASA Astrophysics Data System (ADS)
Ma, W.; Zhang, J.; Zhao, Y.; Zhang, P.; Dang, Y.; Zhao, T.
2018-04-01
In order to make the quality evaluation for the Fundamental Geographic Information Databases(FGIDB) more comprehensive, objective and accurate, this paper studies and establishes a quality model of FGIDB, which formed by the standardization of database construction and quality control, the conformity of data set quality and the functionality of database management system, and also designs the overall principles, contents and methods of the quality evaluation for FGIDB, providing the basis and reference for carry out quality control and quality evaluation for FGIDB. This paper designs the quality elements, evaluation items and properties of the Fundamental Geographic Information Database gradually based on the quality model framework. Connected organically, these quality elements and evaluation items constitute the quality model of the Fundamental Geographic Information Database. This model is the foundation for the quality demand stipulation and quality evaluation of the Fundamental Geographic Information Database, and is of great significance on the quality assurance in the design and development stage, the demand formulation in the testing evaluation stage, and the standard system construction for quality evaluation technology of the Fundamental Geographic Information Database.
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.
Turning Search into Knowledge Management.
ERIC Educational Resources Information Center
Kaufman, David
2002-01-01
Discussion of knowledge management for electronic data focuses on creating a high quality similarity ranking algorithm. Topics include similarity ranking and unstructured data management; searching, categorization, and summarization of documents; query evaluation; considering sentences in addition to keywords; and vector models. (LRW)
A Process Management System for Networked Manufacturing
NASA Astrophysics Data System (ADS)
Liu, Tingting; Wang, Huifen; Liu, Linyan
With the development of computer, communication and network, networked manufacturing has become one of the main manufacturing paradigms in the 21st century. Under the networked manufacturing environment, there exist a large number of cooperative tasks susceptible to alterations, conflicts caused by resources and problems of cost and quality. This increases the complexity of administration. Process management is a technology used to design, enact, control, and analyze networked manufacturing processes. It supports efficient execution, effective management, conflict resolution, cost containment and quality control. In this paper we propose an integrated process management system for networked manufacturing. Requirements of process management are analyzed and architecture of the system is presented. And a process model considering process cost and quality is developed. Finally a case study is provided to explain how the system runs efficiently.
Development of water environment information management and water pollution accident response system
NASA Astrophysics Data System (ADS)
Zhang, J.; Ruan, H.
2009-12-01
In recent years, many water pollution accidents occurred with the rapid economical development. In this study, water environment information management and water pollution accident response system are developed based on geographic information system (GIS) techniques. The system integrated spatial database, attribute database, hydraulic model, and water quality model under a user-friendly interface in a GIS environment. System ran in both Client/Server (C/S) and Browser/Server (B/S) platform which focused on model and inquiry respectively. System provided spatial and attribute data inquiry, water quality evaluation, statics, water pollution accident response case management (opening reservoir etc) and 2D and 3D visualization function, and gave assistant information to make decision on water pollution accident response. Polluted plume in Huaihe River were selected to simulate the transport of pollutes.
[Maturity Levels of Quality and Risk Management at the University Hospital Schleswig-Holstein].
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.
Small steps to health: building sustainable partnerships in pediatric obesity care.
Pomietto, Mo; Docter, Alicia Dixon; Van Borkulo, Nicole; Alfonsi, Lorrie; Krieger, James; Liu, Lenna L
2009-06-01
Given the prevalence of childhood obesity and the limited support for preventing and managing obesity in primary care settings, the Seattle Children's Hospital's Children's Obesity Action Team has partnered with Steps to Health King County to develop a pediatric obesity quality-improvement project. Primary care clinics joined year-long quality-improvement collaboratives to integrate obesity prevention and management into the clinic setting by using the chronic-disease model. Sustainability was enhanced through integration at multiple levels by emphasizing small, consistent behavior changes and self-regulation of eating/feeding practices with children, teenagers, and families; building local community partnerships; and encouraging broader advocacy and policy change. Cultural competency and attention to disparities were integrated into quality-improvement efforts. . Participating clinics were able to increase BMI measurement and weight classification; integrate management of overweight/obese children and family and self-management support; and grow community collaborations. Over the course of 4 years, this project grew from a local effort involving 3 clinics to a statewide program recently adopted by the Washington State Department of Health. This model can be used by other states/regions to develop pediatric obesity quality-improvement programs to support the assessment, prevention, and management of childhood obesity. Furthermore, these health care efforts can be integrated into broader community-wide childhood-obesity action plans.
Probability concepts in quality risk management.
Claycamp, H Gregg
2012-01-01
Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management.
Real-time GIS data model and sensor web service platform for environmental data management.
Gong, Jianya; Geng, Jing; Chen, Zeqiang
2015-01-09
Effective environmental data management is meaningful for human health. In the past, environmental data management involved developing a specific environmental data management system, but this method often lacks real-time data retrieving and sharing/interoperating capability. With the development of information technology, a Geospatial Service Web method is proposed that can be employed for environmental data management. The purpose of this study is to determine a method to realize environmental data management under the Geospatial Service Web framework. A real-time GIS (Geographic Information System) data model and a Sensor Web service platform to realize environmental data management under the Geospatial Service Web framework are proposed in this study. The real-time GIS data model manages real-time data. The Sensor Web service platform is applied to support the realization of the real-time GIS data model based on the Sensor Web technologies. To support the realization of the proposed real-time GIS data model, a Sensor Web service platform is implemented. Real-time environmental data, such as meteorological data, air quality data, soil moisture data, soil temperature data, and landslide data, are managed in the Sensor Web service platform. In addition, two use cases of real-time air quality monitoring and real-time soil moisture monitoring based on the real-time GIS data model in the Sensor Web service platform are realized and demonstrated. The total time efficiency of the two experiments is 3.7 s and 9.2 s. The experimental results show that the method integrating real-time GIS data model and Sensor Web Service Platform is an effective way to manage environmental data under the Geospatial Service Web framework.
Quality of care provided in a special needs plan using a nurse care manager model.
Wenger, Neil S; Roth, Carol P; Martin, David; Nickels, Lorraine; Beckman, Robin; Kamberg, Caren; Mach, John; Ganz, David A
2011-10-01
To comprehensively evaluate the quality of care provided in special needs plans (SNPs; Medicare Advantage plans that aim to provide specialized care for complex older adults) and specifically the nurse care management model in the community setting. We adapted 107 process-of-care quality measures across 12 conditions from the Assessing Care of Vulnerable Elders set to obtain a clinically detailed evaluation of the quality of care received by complex older enrollees in a dual eligible Evercare SNP. We abstracted 13 months of primary care medical records to delineate quality of care provided by physicians and whether there was value added from the nurse care manager model. Dual eligible Evercare SNP located in central Florida. Two-hundred thirty-one vulnerable older enrollees in the SNP who had complex disease. Based on physician medical records alone, the 231 high-risk participants (mean age 77, 67% women) received recommended care for 53% of 5,569 evaluated clinical circumstances, ranging from 12% for end-of-life care to 78% for diabetes mellitus. In fewer than 40% of these clinical circumstances was recommended care provided for dementia, falls, and urinary incontinence. In a second analysis accounting for care provided by both the Evercare nurse and the physician, recommended care was provided to patients in 69% of the 5,684 evaluated clinical circumstances. Comprehensive quality measurement applied to vulnerable older adults enrolled in one mature SNP showed that the Evercare nurse model addresses important deficits in physician care for geriatric conditions. Such measurement should be applied to other SNP models and to compare SNP care with that for complex, older, fee-for-service Medicare cohorts. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.
ERIC Educational Resources Information Center
Boronico, Jess; Murdy, Jim; Kong, Xinlu
2014-01-01
This manuscript proposes a mathematical model to address faculty sufficiency requirements towards assuring overall high quality management education at a global university. Constraining elements include full-time faculty coverage by discipline, location, and program, across multiple campus locations subject to stated service quality standards of…
Integrated care: an Information Model for Patient Safety and Vigilance Reporting Systems.
Rodrigues, Jean-Marie; Schulz, Stefan; Souvignet, Julien
2015-01-01
Quality management information systems for safety as a whole or for specific vigilances share the same information types but are not interoperable. An international initiative tries to develop an integrated information model for patient safety and vigilance reporting to support a global approach of heath care quality.
Modeling crop residue burning experiments and assessing the fire impacts on air quality
Prescribed burning is a common land management practice that results in ambient emissions of a variety of primary and secondary pollutants with negative health impacts. The community Multiscale Air Quality (CMAQ) model is used to conduct 2 km grid resolution simulations of prescr...
Quality Management Systems Implementation Compared With Organizational Maturity in Hospital.
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
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
Effect of quality chronic disease management for alcohol and drug dependence on addiction outcomes.
Kim, Theresa W; Saitz, Richard; Cheng, Debbie M; Winter, Michael R; Witas, Julie; Samet, Jeffrey H
2012-12-01
We examined the effect of the quality of primary care-based chronic disease management (CDM) for alcohol and/or other drug (AOD) dependence on addiction outcomes. We assessed quality using (1) a visit frequency based measure and (2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. The self-reported measure of care-when care was at a CDM clinic-was associated with lower drug addiction severity. The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere) was associated with lower alcohol addiction severity and abstinence. These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes. Quality measures based upon alignment with the chronic care model may better capture features of effective CDM care than a visit frequency measure. Copyright © 2012 Elsevier Inc. All rights reserved.
Rounds, Stewart A.; Buccola, Norman L.
2015-01-01
Water-quality models allow water resource professionals to examine conditions under an almost unlimited variety of potential future scenarios. The two-dimensional (longitudinal, vertical) water-quality model CE-QUAL-W2, version 3.7, was enhanced and augmented with new features to help dam operators and managers explore and optimize potential solutions for temperature management downstream of thermally stratified reservoirs. Such temperature management often is accomplished by blending releases from multiple dam outlets that access water of different temperatures at different depths. The modified blending algorithm in version 3.7 of CE-QUAL-W2 allows the user to specify a time-series of target release temperatures, designate from 2 to 10 floating or fixed-elevation outlets for blending, impose minimum and maximum head and flow constraints for any blended outlet, and set priority designations for each outlet that allow the model to choose which outlets to use and how to balance releases among them. The modified model was tested with a variety of examples and against a previously calibrated model of Detroit Lake on the North Santiam River in northwestern Oregon, and the results compared well. These updates to the blending algorithms will allow more complicated dam-operation scenarios to be evaluated somewhat automatically with the model, with decreased need for multiple model runs or preprocessing of model inputs to fully characterize the operational constraints.
[The conceptual bases for an entrepreneurial management of local health systems].
Yepes, F J; Durán-Arenas, L
1994-01-01
Health management has become a fashion and it is now common to talk about strategic or service management, or of total quality management applied to health systems. However, all these elements of business management are being translated to health systems without a previous analysis on the implicit health model and the rationality of the prevalent production functions, which can lead to a higher level of efficiency but with an inadequate use of resources. This paper suggests the importance of integrating the advances in management and health sciences and proposes what are considered to be the conceptual basis for the design of a management tool geared to conduct local health systems with effectiveness, efficiency, quality and equity.
Pascual, Carlos; Luján, Marcos; Mora, José Ramón; Chiva, Vicente; Gamarra, Manuela
2015-01-01
The implantation of total quality management models in clinical departments can better adapt to the 2009 ISO 9004 model. An essential part of implantation of these models is the establishment of processes and their stabilization. There are four types of processes: key, management, support and operative (clinical). Management processes have four parts: process stabilization form, process procedures form, medical activities cost estimation form and, process flow chart. In this paper we will detail the creation of an essential process in a surgical department, such as the process of management of the surgery waiting list.
Boorsma, Marijke; van Hout, Hein PJ; Frijters, Dinnus H; Ribbe, Miel W; Nijpels, Giel
2008-01-01
Background The objective of this article is to describe the design of a study to evaluate the clinical and economic effects of a Disease Management model on functional health, quality of care and quality of life of persons living in homes for the elderly. Methods This study concerns a cluster randomized controlled clinical trial among five intervention homes and five usual care homes in the North-West of the Netherlands with a total of over 500 residents. All persons who are not terminally ill, are able to be interviewed and sign informed consent are included. For cognitively impaired persons family proxies will be approached to provide outcome information. The Disease Management Model consists of several elements: (1) Trained staff carries out a multidimensional assessment of the patients functional health and care needs with the interRAI Long Term Care Facilities instrument (LTCF). Computerization of the LTCF produces immediate identification of problem areas and thereby guides individualized care planning. (2) The assessment outcomes are discussed in a Multidisciplinary Meeting (MM) with the nurse, primary care physician, nursing home physician and Psychotherapist and if necessary other members of the care team. The MM presents individualized care plans to manage or treat modifiable disabilities and risk factors. (3) Consultation by an nursing home physician and psychotherapist is offered to the frailest residents at risk for nursing home admission (according to the interRAI LTCF). Outcome measures are Quality of Care indicators (LTCF based), Quality Adjusted Life Years (Euroqol), Functional health (SF12, COOP-WONCA), Disability (GARS), Patients care satisfaction (QUOTE), hospital and nursing home days and mortality, health care utilization and costs. Discussion This design is unique because no earlier studies were performed to evaluate the effects and costs of this Disease Management Model for disabled persons in homes for the elderly on functional health and quality of care. Trail registration number ISRCTN11076857 PMID:18606020
Boorsma, Marijke; van Hout, Hein P J; Frijters, Dinnus H; Ribbe, Miel W; Nijpels, Giel
2008-07-07
The objective of this article is to describe the design of a study to evaluate the clinical and economic effects of a Disease Management model on functional health, quality of care and quality of life of persons living in homes for the elderly. This study concerns a cluster randomized controlled clinical trial among five intervention homes and five usual care homes in the North-West of the Netherlands with a total of over 500 residents. All persons who are not terminally ill, are able to be interviewed and sign informed consent are included. For cognitively impaired persons family proxies will be approached to provide outcome information. The Disease Management Model consists of several elements: (1) Trained staff carries out a multidimensional assessment of the patients functional health and care needs with the interRAI Long Term Care Facilities instrument (LTCF). Computerization of the LTCF produces immediate identification of problem areas and thereby guides individualized care planning. (2) The assessment outcomes are discussed in a Multidisciplinary Meeting (MM) with the nurse, primary care physician, nursing home physician and Psychotherapist and if necessary other members of the care team. The MM presents individualized care plans to manage or treat modifiable disabilities and risk factors. (3) Consultation by an nursing home physician and psychotherapist is offered to the frailest residents at risk for nursing home admission (according to the interRAI LTCF). Outcome measures are Quality of Care indicators (LTCF based), Quality Adjusted Life Years (Euroqol), Functional health (SF12, COOP-WONCA), Disability (GARS), Patients care satisfaction (QUOTE), hospital and nursing home days and mortality, health care utilization and costs. This design is unique because no earlier studies were performed to evaluate the effects and costs of this Disease Management Model for disabled persons in homes for the elderly on functional health and quality of care. TRAIL REGISTRATION NUMBER: ISRCTN11076857.
Context-aware workflow management of mobile health applications.
Salden, Alfons; Poortinga, Remco
2006-01-01
We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined.
Steuten, L M G; Vrijhoef, H J M; Landewé-Cleuren, S; Schaper, N; Van Merode, G G; Spreeuwenberg, C
2007-10-01
To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets. Single-group, pre-post design with 2-year follow-up in 473 patients. Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL. Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.
ERIC Educational Resources Information Center
Sadler, Lynn Veach
Recommendations for a national educational agenda that is based on tolerance for cultural diversity and real collaboration are presented in this paper with emphasis on the W. E. Deming model of Total Quality Management, or "Demingism." Two problems in American education are academic performance and the failure of disadvantaged schools. Ten…
USDA-ARS?s Scientific Manuscript database
Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water q...
A prescribed fire emission factors database for land management and air quality applications
E. Lincoln; WeiMin Hao; S. Baker; R. J. Yokelson; I. R. Burling; Shawn Urbanski; W. Miller; D. R. Weise; T. J. Johnson
2010-01-01
Prescribed fire is a significant emissions source in the U.S. and that needs to be adequately characterized in atmospheric transport/chemistry models. In addition, the Clean Air Act, its amendments, and air quality regulations require that prescribed fire managers estimate the quantity of emissions that a prescribed fire will produce. Several published papers contain a...
ERIC Educational Resources Information Center
Lehmann, Martin; Fryd, Ole
2008-01-01
Purpose: The purpose of this paper is to describe and discuss the development and the structure of a new international master on the subject of urban quality development and management (UQDM), and explore the potential of the process and the outcome in serving as models adoptable by faculty at other universities. Design/methodology/approach: The…
Evaluating treatment process redesign by applying the EFQM Excellence Model.
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.
Clark, Alistair; Moule, Pam; Topping, Annie; Serpell, Martin
2015-05-01
To review research in the literature on nursing shift scheduling / rescheduling, and to report key issues identified in a consultation exercise with managers in four English National Health Service trusts to inform the development of mathematical tools for rescheduling decision-making. Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives from scheduling. Poor rescheduling decisions can have quality, cost and morale implications. A systematic critical literature review identified rescheduling issues and existing mathematic modelling tools. A consultation exercise with nursing managers examined the complex challenges associated with rescheduling. Minimal research exists on rescheduling compared with scheduling. Poor rescheduling can result in greater disruption to planned nursing shifts and may impact negatively on the quality and cost of patient care, and nurse morale and retention. Very little research examines management challenges or mathematical modelling for rescheduling. Shift rescheduling is a complex and frequent management activity that is more challenging than scheduling. Mathematical modelling may have potential as a tool to support managers to minimise rescheduling disruption. The lack of specific methodological support for rescheduling that takes into account its complexity, increases the likelihood of harm for patients and stress for nursing staff and managers. © 2013 John Wiley & Sons Ltd.
Granata, Randy L; Hamilton, Karen
2015-01-01
Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.
Patient Experience Shows Little Relationship with Hospital Quality Management Strategies
Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa
2015-01-01
Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. Conclusion This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services. PMID:26151864
Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.
Groene, Oliver; Arah, Onyebuchi A; Klazinga, Niek S; Wagner, Cordula; Bartels, Paul D; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa
2015-01-01
Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services.
Stiletto, R; Röthke, M; Schäfer, E; Lefering, R; Waydhas, Ch
2006-10-01
Patient security has become one of the major aspects of clinical management in recent years. The crucial point in research was focused on malpractice. In contradiction to the economic process in non medical fields, the analysis of errors during the in-patient treatment time was neglected. Patient risk management can be defined as a structured procedure in a clinical unit with the aim to reduce harmful events. A risk point model was created based on a Delphi process and founded on the DIVI data register. The risk point model was evaluated in clinically working ICU departments participating in the register data base. The results of the risk point evaluation will be integrated in the next data base update. This might be a step to improve the reliability of the register to measure quality assessment in the ICU.
Process Improvements in Training Device Acceptance Testing: A Study in Total Quality Management
1990-12-12
Quality Management , a small group of Government and industry specialists examined the existing training device acceptance test process for potential improvements. The agreed-to mission of the Air Force/Industry partnership was to continuously identify and promote implementable approaches to minimize the cost and time required for acceptance testing while ensuring that validated performance supports the user training requirements. Application of a Total Quality process improvement model focused on the customers and their requirements, analyzed how work was accomplished, and
2009-04-08
The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q10 Pharmaceutical Quality System." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a model for an effective quality management system for the pharmaceutical industry, referred to as the Pharmaceutical Quality System. The guidance is intended to provide a comprehensive approach to an effective pharmaceutical quality system that is based on International Organization for Standardization (ISO) concepts, includes applicable good manufacturing practice (GMP) regulations and complements ICH guidances on "Q8 Pharmaceutical Development" and "Q9 Quality Risk Management."
Computer modeling of prostate cancer treatment. A paradigm for oncologic management?
Miles, B J; Kattan, M W
1995-04-01
This article discusses the relevance of computer modeling to the management of prostate cancer. Several computer modeling techniques are reviewed and the advantages and disadvantages of each are discussed. An example that uses a computer model to compare alternative strategies for clinically localized prostate cancer is examined in detail. The quality of the data used in computer models is critical, and these models play an important role in medical decision making.
Hopping out of the Swamp: Management of Change in a Downsizing Environment.
ERIC Educational Resources Information Center
Burton, Jennus L.
1993-01-01
Arizona State University has developed a model for managing declining resources in administrative service functions. A variant of Total Quality Management, it involves clarification of administrative unit functions, unit self-examination, establishment of program priorities, environmental scanning, creation of an infrastructure to manage change,…
Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm
2004-12-01
Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.
Comparison of SWAT Model Water Balance Calibration Using NEXRAD and Surface Rain Gauge Data
USDA-ARS?s Scientific Manuscript database
The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...
Development of cropland management dataset to support U.S. SWAT assessments
USDA-ARS?s Scientific Manuscript database
The Soil and Water Assessment Tool (SWAT) is a widely used hydrologic/water quality simulation model in the U.S. Process-based models like SWAT require a great deal of data to accurately represent the natural world, including topography, landuse, soils, weather, and management. With the exception ...
Quality improvement prototype: Johnson Space Center, National Aeronautics and Space Administration
NASA Technical Reports Server (NTRS)
1990-01-01
The Johnson Space Flight Center was recognized by the Office of Management and Budget as a model for its high standards of quality. Included are an executive summary of the center's activities, an organizational overview, techniques for improving quality, the status of the quality effort and a listing of key personnel.
USDA-ARS?s Scientific Manuscript database
Water quality trading (WQT) is a market-based approach that allows point sources of water pollution to meet their water quality obligations by purchasing credits from the reduced discharges from other point or nonpoint sources. Non-permitted animal operations and fields of permitted animal operatio...
Quality in Higher Education: United Arab Emirates Perspective
ERIC Educational Resources Information Center
Soomro, Tariq Rahim; Ahmad, Reyaz
2012-01-01
Quality in higher education is the major concern among researchers. Managing quality in higher education in a multicultural population with different approaches is not only challenging but an uphill task. This paper will focus on quality concern in higher education keeping in view, the United Arab Emirates (UAE) perspectives. A model to maintain…
NASA Astrophysics Data System (ADS)
Zhang, Yan-yu; Wang, Jing; Shi, Yan-xi; Li, Yu-huan; Lv, Chun-yan
2005-10-01
The Crisscross Region of Wind-drift Sand Regions along the Great Wall and Loess Plateau locates in southern Ordos Plateau and northern Chinese Loess Plateau, where wind erosion and water erosion coexist and specified environmental and socio-economic factors, especially human activities induce serious land degradation. However, there are only a few studies provide an overall assessment consequences. Integrated land quality assessment considering impacts of soil, topography, vegetation, environmental hazards, social-economic factors and land managements are imperative to the regional sustainable land managements. A pilot study was made in Hengshan County (Shanxi Province) with the objective of developing comprehensive land quality evaluation model integrating data from farmers' survey and Remote Sensing. Surveys were carried out in 107 households of study area in 2003 and 2004 to get farmers' perceptions of land quality and to collect correlative information. It was found out that farmers evaluated land quality by slope, water availability, soil texture, yields, amount of fertilizer, crop performance, sandy erosion degree and water erosion degree. Scientists' indicators which emphasize on getting information by RS technology were introduced to reflecting above indicators information for the sake of developing a rapid, efficient and local-fitted land quality assessment model including social-economic, environmental and anthropogenic factors. Data from satellite and surveys were integrated with socio-economic statistic data using geographical information system (GIS) and three indexes, namely Production Press Index (PPI), Land State Index (LSI) and Farmer Behavior Index (FBI) were proposed to measure different aspects of land quality. A model was further derived from the three indexes to explore the overall land quality of the study area. Results suggest that local land prevalently had a poor quality. This paper shows that whilst the model was competent for its work in the study area and evaluation results would supply beneficial information for management decisions.
A Risk-based Assessment And Management Framework For Multipollutant Air Quality
Frey, H. Christopher; Hubbell, Bryan
2010-01-01
The National Research Council recommended both a risk- and performance-based multipollutant approach to air quality management. Specifically, management decisions should be based on minimizing the exposure to, and risk of adverse effects from, multiple sources of air pollution and that the success of these decisions should be measured by how well they achieved this objective. We briefly describe risk analysis and its application within the current approach to air quality management. Recommendations are made as to how current practice could evolve to support a fully risk- and performance-based multipollutant air quality management system. The ability to implement a risk assessment framework in a credible and policy-relevant manner depends on the availability of component models and data which are scientifically sound and developed with an understanding of their application in integrated assessments. The same can be said about accountability assessments used to evaluate the outcomes of decisions made using such frameworks. The existing risk analysis framework, although typically applied to individual pollutants, is conceptually well suited for analyzing multipollutant management actions. Many elements of this framework, such as emissions and air quality modeling, already exist with multipollutant characteristics. However, the framework needs to be supported with information on exposure and concentration response relationships that result from multipollutant health studies. Because the causal chain that links management actions to emission reductions, air quality improvements, exposure reductions and health outcomes is parallel between prospective risk analyses and retrospective accountability assessments, both types of assessment should be placed within a single framework with common metrics and indicators where possible. Improvements in risk reductions can be obtained by adopting a multipollutant risk analysis framework within the current air quality management system, e.g. focused on standards for individual pollutants and with separate goals for air toxics and ambient pollutants. However, additional improvements may be possible if goals and actions are defined in terms of risk metrics that are comparable across criteria pollutants and air toxics (hazardous air pollutants), and that encompass both human health and ecological risks. PMID:21209847
Azar, Farbod Ebadifard; Solhi, Mahnaz; Nejhaddadgar, Nazila; Amani, Firoz
2017-08-01
Poor quality of life is common among diabetic patients, and educational intervention is one of the most effective strategies to improve the quality of life for chronic patients. To determine the effect of an educational intervention based on PRECEDE-PROCEED in quality of life of diabetic patients, in 2016. In this quasi-experimental study, 86 patients referred to diabetic centers of Ardabil participated. We used the components PRECEDE-PROCEED model for planning, implementation and evaluation of the program. Data collection tools were Diabetes Quality of Life questionnaire (DQOL) and a researcher-made questionnaire. Eight training sessions were conducted for the intervention group for self-efficiency, self- management, attitude, knowledge, and enabling reinforcing factors. Quality of life was followed one and three months after intervention. Data were analyzed through SPSS 16 software using descriptive and analytical tests. The mean age of patients was 55.88 (±12.1) years. The result showed that before intervention, no significant difference was observed among the mean scores of quality of life, self-management, knowledge, attitude, enabling and reinforcing factors, and self-efficiency in two groups. But one and three months after intervention a significant difference was observed (p<0.001). Educational intervention with PRECEDE-PROCEED model improved the diabetic patient's quality of life.
Korop, Oleg A; Lenskykh, Sergiy V
2018-01-01
Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population. The aim of the work is to provide theoretical grounds for a structural and functional model of quality assurance of radiation diagnostics at all levels of medical care given to the population under the current health care reform in Ukraine. Materials and methods: The object of the study is organizing the operation of the radiation diagnostic service; the information is based on the actual data on the characteristics of radiation diagnosis at different levels of medical care provision. Methods of systematic approach, system analysis and structural and functional analysis of the operating system of radiation diagnostics are used. Review: The basis of the quality assurance model is the cyclical process, which includes the stages of the problem identifition, planning of its solution, organization of the system for implementation of decisions, monitoring the quality management process of the radiation diagnostics, and factors influencing the quality of the radiation diagnostics service. These factors include the quality of the structure, process, results, organization of management and control of current processes and the results of radiation diagnostics management. Conclusions: The advantages of the proposed model for ensuring the quality of the radiation diagnostics service are its systemacy and complexity, elimination of identified defects and deficiencies, and achievement of profitability through modern redistribution and use of existing resources of the health care system. The results of adequate service quality management activities in radiation diagnostics are the improvement of organizational and economic principles along with legislative regulation, the implementation of a modern system of radiation diagnostics in the state health care at the national and regional levels, the increase of the accessibility, quality and efficiency of the radiation diagnostics service.
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.
An index-based robust decision making framework for watershed management in a changing climate.
Kim, Yeonjoo; Chung, Eun-Sung
2014-03-01
This study developed an index-based robust decision making framework for watershed management dealing with water quantity and quality issues in a changing climate. It consists of two parts of management alternative development and analysis. The first part for alternative development consists of six steps: 1) to understand the watershed components and process using HSPF model, 2) to identify the spatial vulnerability ranking using two indices: potential streamflow depletion (PSD) and potential water quality deterioration (PWQD), 3) to quantify the residents' preferences on water management demands and calculate the watershed evaluation index which is the weighted combinations of PSD and PWQD, 4) to set the quantitative targets for water quantity and quality, 5) to develop a list of feasible alternatives and 6) to eliminate the unacceptable alternatives. The second part for alternative analysis has three steps: 7) to analyze all selected alternatives with a hydrologic simulation model considering various climate change scenarios, 8) to quantify the alternative evaluation index including social and hydrologic criteria with utilizing multi-criteria decision analysis methods and 9) to prioritize all options based on a minimax regret strategy for robust decision. This framework considers the uncertainty inherent in climate models and climate change scenarios with utilizing the minimax regret strategy, a decision making strategy under deep uncertainty and thus this procedure derives the robust prioritization based on the multiple utilities of alternatives from various scenarios. In this study, the proposed procedure was applied to the Korean urban watershed, which has suffered from streamflow depletion and water quality deterioration. Our application shows that the framework provides a useful watershed management tool for incorporating quantitative and qualitative information into the evaluation of various policies with regard to water resource planning and management. Copyright © 2013 Elsevier B.V. All rights reserved.
Harlow C. Landphair
1979-01-01
This paper relates the evolution of an empirical model used to predict public response to scenic quality objectively. The text relates the methods used to develop the visual quality index model, explains the terms used in the equation and briefly illustrates how the model is applied and how it is tested. While the technical application of the model relies heavily on...
Technical comments are provided to the Air and waste Management Associations AB-3 committee for potential inclusion into the committee's comments to be made at EPA's 8th Conference on Air Quality Modeling. Computational Fluid Dynamics (CFD) simulations can model specific cases wh...
Cost Estimation of Software Development and the Implications for the Program Manager
1992-06-01
Software Lifecycle Model (SLIM), the Jensen System-4 model, the Software Productivity, Quality, and Reliability Estimator ( SPQR \\20), the Constructive...function models in current use are the Software Productivity, Quality, and Reliability Estimator ( SPQR /20) and the Software Architecture Sizing and...Estimator ( SPQR /20) was developed by T. Capers Jones of Software Productivity Research, Inc., in 1985. The model is intended to estimate the outcome
Modeling discharge, temperature, and water quality in the Tualatin River, Oregon
Rounds, Stewart A.; Wood, Tamara M.; Lynch, Dennis D.
1999-01-01
The discharge, water temperature, and water quality of the Tualatin River in northwestern Oregon was simulated with CE-QUAL-W2, a two-dimensional, laterally averaged model developed by the U.S. Army Corps of Engineers. The model was calibrated for May through October periods of 1991, 1992, and 1993. Nine hypothetical scenarios were tested with the model to provide insight for river managers and regulators.
A guide to calculating habitat-quality metrics to inform conservation of highly mobile species
Bieri, Joanna A.; Sample, Christine; Thogmartin, Wayne E.; Diffendorfer, James E.; Earl, Julia E.; Erickson, Richard A.; Federico, Paula; Flockhart, D. T. Tyler; Nicol, Sam; Semmens, Darius J.; Skraber, T.; Wiederholt, Ruscena; Mattsson, Brady J.
2018-01-01
Many metrics exist for quantifying the relative value of habitats and pathways used by highly mobile species. Properly selecting and applying such metrics requires substantial background in mathematics and understanding the relevant management arena. To address this multidimensional challenge, we demonstrate and compare three measurements of habitat quality: graph-, occupancy-, and demographic-based metrics. Each metric provides insights into system dynamics, at the expense of increasing amounts and complexity of data and models. Our descriptions and comparisons of diverse habitat-quality metrics provide means for practitioners to overcome the modeling challenges associated with management or conservation of such highly mobile species. Whereas previous guidance for applying habitat-quality metrics has been scattered in diversified tracks of literature, we have brought this information together into an approachable format including accessible descriptions and a modeling case study for a typical example that conservation professionals can adapt for their own decision contexts and focal populations.Considerations for Resource ManagersManagement objectives, proposed actions, data availability and quality, and model assumptions are all relevant considerations when applying and interpreting habitat-quality metrics.Graph-based metrics answer questions related to habitat centrality and connectivity, are suitable for populations with any movement pattern, quantify basic spatial and temporal patterns of occupancy and movement, and require the least data.Occupancy-based metrics answer questions about likelihood of persistence or colonization, are suitable for populations that undergo localized extinctions, quantify spatial and temporal patterns of occupancy and movement, and require a moderate amount of data.Demographic-based metrics answer questions about relative or absolute population size, are suitable for populations with any movement pattern, quantify demographic processes and population dynamics, and require the most data.More real-world examples applying occupancy-based, agent-based, and continuous-based metrics to seasonally migratory species are needed to better understand challenges and opportunities for applying these metrics more broadly.
NASA Lewis Wind Tunnel Model Systems Criteria
NASA Technical Reports Server (NTRS)
Soeder, Ronald H.; Haller, Henry C.
1994-01-01
This report describes criteria for the design, analysis, quality assurance, and documentation of models or test articles that are to be tested in the aeropropulsion facilities at the NASA Lewis Research Center. The report presents three methods for computing model allowable stresses on the basis of the yield stress or ultimate stress, and it gives quality assurance criteria for models tested in Lewis' aeropropulsion facilities. Both customer-furnished model systems and in-house model systems are discussed. The functions of the facility manager, project engineer, operations engineer, research engineer, and facility electrical engineer are defined. The format for pretest meetings, prerun safety meetings, and the model criteria review are outlined Then, the format for the model systems report (a requirement for each model that is to be tested at NASA Lewis) is described, the engineers that are responsible for developing the model systems report are listed, and the time table for its delivery to the facility manager is given.
NASA Technical Reports Server (NTRS)
Bubenheim, David; Potter, Christopher; Zhang, Minghua
2016-01-01
The California Sacramento-San Joaquin River Delta is the hub for California's water supply, conveying water from Northern to Southern California agriculture and communities while supporting important ecosystem services, agriculture, and communities in the Delta. Changes in climate, long-term drought, and water quality have all been suspected as playing role in the dramatic expansion of invasive aquatic plants and their impact on ecosystems of the San Francisco Bay / California Delta complex. NASA Ames Research Center, USDA-Agricultural Research Service, the State of California, UC Davis, and local governments have partnered under a USDA sponsored project (DRAAWP) to develop science-based, adaptive-management strategies for invasive aquatic plants in Sacramento-San Joaquin Delta. Critical to developing management strategies is to understand how the Delta is affected by both the magnitude of fluctuations in land-use and climate / drought induced altered environments and how the plants respond to these altered environments. We utilize the Soil Water Assessment Tool (SWAT), a watershed-scale model developed to quantify the impact of land management practices in large and complex watersheds on water quality, as the backbone for a customized Delta model - Delta-SWAT. The model uses land-use, soils, elevation, and hydrologic routing to characterize pesticide and nutrient transport from the Sacramento and San Joaquin rivers watersheds and loading into the Delta. Land-use within the Delta, as well as water extraction to supply those functions, and the resulting return of water to Delta waterways are included in Delta-SWAT. Hydrologic transport within the Delta has required significant attention to address the lack of elevation driven transport processes. Delta-SWAT water quality trend estimates are compared with water quality monitoring conducted throughout the Delta. Aquatic plant response to water quality and other environmental factors is carried out using a customized model component. Plant response to the range of water quality factors, response times, and altered temperature and light regimes of the Delta have required gap-filling studies to provide model parameters. Delta-SWAT provides a tool for evaluating temporal and spatial effects of land-use and altered environments in the Delta and contributing watersheds on aquatic weed growth. Using Delta-SWAT for simulation modeling allows evaluation of historic and current conditions as well as consideration potential climate change and management practice outcomes. Delta-SWAT adds to the scientific understanding of dynamics in the Delta and enhances development of science-informed, management strategies and practices.
Ground-water models for water resource planning
Moore, J.E.
1983-01-01
In the past decade hydrogeologists have emphasized the development of computer-based mathematical models to aid in the understanding of flow, the transport of solutes, transport of heat, and deformation in the ground-water system. These models have been used to provide information and predictions for water managers. Too frequently, ground-water was neglected in water resource planning because managers believed that it could not be adequately evaluated in terms of availability, quality, and effect of development on surface-water supplies. Now, however, with newly developed digital ground-water models, effects of development can be predicted. Such models have been used to predict hydrologic and quality changes under different stresses. These models have grown in complexity over the last ten years from simple one-layer models to three-dimensional simulations of ground-water flow, which may include solute transport, heat transport, effects of land subsidence, and encroachment of saltwater. Case histories illustrate how predictive ground-water models have provided the information needed for the sound planning and management of water resources in the USA. ?? 1983 D. Reidel Publishing Company.
Perceived service quality's effect on patient satisfaction and behavioural compliance.
Mohamed, Bahari; Azizan, Noor Azlinna
2015-01-01
The purpose of this paper is to advance healthcare service quality research using hierarchical component models. This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses. The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS. Only one hospital was evaluated. The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design. Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.
Case Management: Service or Symptom?
ERIC Educational Resources Information Center
Netting, F. Ellen
1992-01-01
Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…
Development of an asthma disease management program in a children's hospital.
Miller, Kelly; Ward-Smith, Peggy; Cox, Karen; Jones, Erika M; Portnoy, Jay M
2003-11-01
The incidence, morbidity, and mortality of asthma have been increasing at an alarming rate, making asthma the most common chronic illness of childhood. An asthma disease management program was developed to improve the care and management of patients with asthma--a comprehensive health care delivery model that was designed to improve the management of patients with asthma was designed and implemented. The goal of the program was to provide high-quality interventions for those children diagnosed with asthma. The asthma disease management program at Children's Mercy Hospital improved the care received, decreased costs, and improved the quality of life for those children with asthma.
NASA Astrophysics Data System (ADS)
Cassagnole, Manon; Ramos, Maria-Helena; Thirel, Guillaume; Gailhard, Joël; Garçon, Rémy
2017-04-01
The improvement of a forecasting system and the evaluation of the quality of its forecasts are recurrent steps in operational practice. However, the evaluation of forecast value or forecast usefulness for better decision-making is, to our knowledge, less frequent, even if it might be essential in many sectors such as hydropower and flood warning. In the hydropower sector, forecast value can be quantified by the economic gain obtained with the optimization of operations or reservoir management rules. Several hydropower operational systems use medium-range forecasts (up to 7-10 days ahead) and energy price predictions to optimize hydropower production. Hence, the operation of hydropower systems, including the management of water in reservoirs, is impacted by weather, climate and hydrologic variability as well as extreme events. In order to assess how the quality of hydrometeorological forecasts impact operations, it is essential to first understand if and how operations and management rules are sensitive to input predictions of different quality. This study investigates how 7-day ahead deterministic and ensemble streamflow forecasts of different quality might impact the economic gains of energy production. It is based on a research model developed by Irstea and EDF to investigate issues relevant to the links between quality and value of forecasts in the optimisation of energy production at the short range. Based on streamflow forecasts and pre-defined management constraints, the model defines the best hours (i.e., the hours with high energy prices) to produce electricity. To highlight the link between forecasts quality and their economic value, we built several synthetic ensemble forecasts based on observed streamflow time series. These inputs are generated in a controlled environment in order to obtain forecasts of different quality in terms of accuracy and reliability. These forecasts are used to assess the sensitivity of the decision model to forecast quality. Relationships between forecast quality and economic value are discussed. This work is part of the IMPREX project, a research project supported by the European Commission under the Horizon 2020 Framework programme, with grant No. 641811 (http://www.imprex.eu)
EFFECT OF QUALITY CHRONIC DISEASE MANAGEMENT FOR ALCOHOL AND DRUG DEPENDENCE ON ADDICTION OUTCOMES
Kim, Theresa W.; Saitz, Richard; Cheng, Debbie M.; Winter, Michael R; Witas, Julie; Samet, Jeffrey H.
2012-01-01
We examinedthe effect ofthe quality of primary care-basedchronic disease management (CDM)for alcohol and/or other drug (AOD) dependenceonaddiction outcomes.We assessed qualityusing 1)avisit frequencybased measure and 2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. Theself-reported measure of care - when care was at a CDM clinic - was associated with lower drug addiction severity.The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere)was associated with lower alcoholaddiction severity and abstinence.These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes.Quality measuresbased upon alignment with the chronic care model may better capture features of effective CDM care than a visitfrequency measure. PMID:22840687
Innovations in projecting emissions for air quality modeling ...
Air quality modeling is used in setting air quality standards and in evaluating their costs and benefits. Historically, modeling applications have projected emissions and the resulting air quality only 5 to 10 years into the future. Recognition that the choice of air quality management strategy has climate change implications is encouraging longer modeling time horizons. However, for multi-decadal time horizons, many questions about future conditions arise. For example, will current population, economic, and land use trends continue, or will we see shifts that may alter the spatial and temporal pattern of emissions? Similarly, will technologies such as building-integrated solar photovoltaics, battery storage, electric vehicles, and CO2 capture emerge as disruptive technologies - shifting how we produce and use energy - or will these technologies achieve only niche markets and have little impact? These are some of the questions that are being evaluated by researchers within the U.S. EPA’s Office of Research and Development. In this presentation, Dr. Loughlin will describe a range of analytical approaches that are being explored. These include: (i) the development of alternative scenarios of the future that can be used to evaluate candidate management strategies over wide-ranging conditions, (ii) the application of energy system models to project emissions decades into the future and to assess the environmental implications of new technologies, (iii) and methodo
Luchins, Daniel
2012-01-01
The quality improvement model currently used in medicine and mental health was adopted from industry, where it developed out of early 20th-century efforts to apply a positivist/quantitative agenda to improving manufacturing. This article questions the application of this model to mental health care. It argues that (1) developing "operational definitions" for something as value-laden as "quality" risks conflating two realms, what we measure with what we value; (2) when measurements that are tied to individuals are aggregated to establish benchmarks and goals, unwarranted mathematical assumptions are made; (3) choosing clinical outcomes is problematic; (4) there is little relationship between process measures and clinical outcomes; and (5) since changes in quality indices do not relate to improved clinical care, management's reliance on such indices provides an illusory sense of control. An alternative model is the older, skill-based/qualitative approach to knowing, which relies on "implicit/ expert" knowledge. These two approaches offer a series of contrasts: quality versus excellence, competence versus expertise, management versus leadership, extrinsic versus intrinsic rewards. The article concludes that we need not totally dispense with the current quality improvement model, but rather should balance quantitative efforts with the older qualitative approach in a mixed methods model.
Evapotranspiration Calculator Desktop Tool
The Evapotranspiration Calculator estimates evapotranspiration time series data for hydrological and water quality models for the Hydrologic Simulation Program - Fortran (HSPF) and the Stormwater Management Model (SWMM).
Bai, Ge; Luo, Li
2013-08-01
This investigation analyzes the management of medical schools merged with comprehensive universities through internet search and research review to reveal management model and effect of the merger. The conclusion is safely reached that governance models are divided into two different patterns: centralized management and decentralized management. Eight universities, representing the two models, were selected and evaluated comprehensively. Among them, the universities that carried out decentralized management have greater development after the merger based on a quality comparison concerning freshmen, faculty, teaching, and research between the two patterns. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.
Defining Strategic and Excellence Bases for the Development of Portuguese Higher Education
ERIC Educational Resources Information Center
Rosa, Maria Joao; Saraiva, Pedro M.; Diz, Henrique
2005-01-01
A self-assessment model was developed for the Portuguese higher education institutions (HEIs) which was based on an empirical study aiming at better understanding their strategic and quality management and innovation practices and tools and on the study of several quality assessment models developed both for HEIs and business organisations. From…
Cao, Bibo; Li, Chuan; Liu, Yan; Zhao, Yue; Sha, Jian; Wang, Yuqiu
2015-05-01
Because water quality monitoring sections or sites could reflect the water quality status of rivers, surface water quality management based on water quality monitoring sections or sites would be effective. For the purpose of improving water quality of rivers, quantifying the contribution ratios of pollutant resources to a specific section is necessary. Because physical and chemical processes of nutrient pollutants are complex in water bodies, it is difficult to quantitatively compute the contribution ratios. However, water quality models have proved to be effective tools to estimate surface water quality. In this project, an enhanced QUAL2Kw model with an added module was applied to the Xin'anjiang Watershed, to obtain water quality information along the river and to assess the contribution ratios of each pollutant source to a certain section (the Jiekou state-controlled section). Model validation indicated that the results were reliable. Then, contribution ratios were analyzed through the added module. Results show that among the pollutant sources, the Lianjiang tributary contributes the largest part of total nitrogen (50.43%), total phosphorus (45.60%), ammonia nitrogen (32.90%), nitrate (nitrite + nitrate) nitrogen (47.73%), and organic nitrogen (37.87%). Furthermore, contribution ratios in different reaches varied along the river. Compared with pollutant loads ratios of different sources in the watershed, an analysis of contribution ratios of pollutant sources for each specific section, which takes the localized chemical and physical processes into consideration, was more suitable for local-regional water quality management. In summary, this method of analyzing the contribution ratios of pollutant sources to a specific section based on the QUAL2Kw model was found to support the improvement of the local environment.
Oikawa, P. Y.; Ge, C.; Wang, J.; Eberwein, J. R.; Liang, L. L.; Allsman, L. A.; Grantz, D. A.; Jenerette, G. D.
2015-01-01
Fertilized soils have large potential for production of soil nitrogen oxide (NOx=NO+NO2), however these emissions are difficult to predict in high-temperature environments. Understanding these emissions may improve air quality modelling as NOx contributes to formation of tropospheric ozone (O3), a powerful air pollutant. Here we identify the environmental and management factors that regulate soil NOx emissions in a high-temperature agricultural region of California. We also investigate whether soil NOx emissions are capable of influencing regional air quality. We report some of the highest soil NOx emissions ever observed. Emissions vary nonlinearly with fertilization, temperature and soil moisture. We find that a regional air chemistry model often underestimates soil NOx emissions and NOx at the surface and in the troposphere. Adjusting the model to match NOx observations leads to elevated tropospheric O3. Our results suggest management can greatly reduce soil NOx emissions, thereby improving air quality. PMID:26556236
Booth, N.L.; Everman, E.J.; Kuo, I.-L.; Sprague, L.; Murphy, L.
2011-01-01
The U.S. Geological Survey National Water Quality Assessment Program has completed a number of water-quality prediction models for nitrogen and phosphorus for the conterminous United States as well as for regional areas of the nation. In addition to estimating water-quality conditions at unmonitored streams, the calibrated SPAtially Referenced Regressions On Watershed attributes (SPARROW) models can be used to produce estimates of yield, flow-weighted concentration, or load of constituents in water under various land-use condition, change, or resource management scenarios. A web-based decision support infrastructure has been developed to provide access to SPARROW simulation results on stream water-quality conditions and to offer sophisticated scenario testing capabilities for research and water-quality planning via a graphical user interface with familiar controls. The SPARROW decision support system (DSS) is delivered through a web browser over an Internet connection, making it widely accessible to the public in a format that allows users to easily display water-quality conditions and to describe, test, and share modeled scenarios of future conditions. SPARROW models currently supported by the DSS are based on the modified digital versions of the 1:500,000-scale River Reach File (RF1) and 1:100,000-scale National Hydrography Dataset (medium-resolution, NHDPlus) stream networks. ?? 2011 American Water Resources Association. This article is a U.S. Government work and is in the public domain in the USA.
NASA Astrophysics Data System (ADS)
Liu, Y.; Zhang, W.; Yan, C.
2012-07-01
Presently, planning and assessment in maintenance, renewal and decision-making for watershed hydrology, water resource management and water quality assessment are evolving toward complex, spatially explicit regional environmental assessments. These problems have to be addressed with object-oriented spatio-temporal data models that can restore, manage, query and visualize various historic and updated basic information concerning with watershed hydrology, water resource management and water quality as well as compute and evaluate the watershed environmental conditions so as to provide online forecasting to police-makers and relevant authorities for supporting decision-making. The extensive data requirements and the difficult task of building input parameter files, however, has long been an obstacle to use of such complex models timely and effectively by resource managers. Success depends on an integrated approach that brings together scientific, education and training advances made across many individual disciplines and modified to fit the needs of the individuals and groups who must write, implement, evaluate, and adjust their watershed management plans. The centre for Hydro-science Research, Nanjing University, in cooperation with the relevant watershed management authorities, has developed a WebGIS management platform to facilitate this complex process. Improve the management of watersheds over the Huaihe basin through the development, promotion and use of a web-based, user-friendly, geospatial watershed management data and decision support system (WMDDSS) involved many difficulties for the development of this complicated System. In terms of the spatial and temporal characteristics of historic and currently available information on meteorological, hydrological, geographical, environmental and other relevant disciplines, we designed an object-oriented spatiotemporal data model that combines spatial, attribute and temporal information to implement the management system. Using this system, we can update, query and analyze environmental information as well as manage historical data, and a visualization tool was provided to help the user interpret results so as to provide scientific support for decision-making. The utility of the system has been demonstrated its values by being used in watershed management and environmental assessments.
Frølich, Anne
2012-02-01
The quality of health care services offered to people suffering from chronic diseases often fails to meet standards in Denmark or internationally. The population consisting of people with chronic diseases is large and accounts for about 70% of total health care expenses. Given that resources are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved. The aim of this dissertation is to describe the effect of determinants, such as organisational structures and management practices including two selected incentives, on the quality of care in chronic diseases. The dissertation is based on four studies with the following purposes: 1) macro- or healthcare system-level identification of organisational structures and principles that affect the quality of health care services, based on a comparison of KP and the Danish health care system; 2) meso- or organisation-level identification of management practices with positive effects on screening rates for hemoglobin A1c and lipid profile in diabetes; 3) evaluation of the effect of the CCM on quality of health care services and continuity of care in a Danish setting; 4) micro- or practice-level evaluation of the effect of financial incentives and public performance reporting on the behaviour of professionals and quality of care. Using secondary data, KP and the Danish health care system were compared in terms of six central dimensions: population, health care professionals, health care organisations, utilization patterns, quality measurements, and costs. Differences existed between the two systems on all dimensions, complicating the interpretation of findings. For instance, observed differences might be due to similar tendencies in the two health care systems that were observed at different times, rather than true structural differences. The expenses in the two health care systems were corrected for differences in the populations served and the purchasing power of currencies. However, no validated methods existed to correct for observed differences in case-mixes of chronic conditions. Data from a population of about half a million patients with diabetes in a large U.S. integrated health care delivery system affiliated with 41 medical centers employing 15 different CCM management practices was the basis for identifying effective management practices. Through the use of statistical modelling, the management practice of provider alerts was identified as most effective for promoting screening for hemoglobin A1c and lipid profile. The CCM was used as a framework for implementing four rehabilitation programs. The model promoted continuity of care and quality of health care services. New management practices were developed in the study, and known practices were further developed. However, the observational nature of the study limited the generalisability of the findings. In a structured literature survey focusing on the effect of financial incentives and public performance reporting on the quality of health care services, few studies documenting an effect were identified. The results varied, and important program aspects or contextual variables were often omitted. A model describing the effects of the two incentives on the conduct of health care professionals and their interaction with the organisations in which they serve was developed. On the macro-level, organisational differences between KP and the Danish health care system related to the primary care sectors, utilization patterns, and the quality of health care services, supporting a hypothesis that KP's focus on primary care is a beneficial form of organisation. On the meso-level, use of the CCM improved quality of health care services, but the effect is complicated and context dependent. The CCM was found to be useful in the Danish health care system, and the model was also further developed in a Danish setting. On the micro-level, quality was improved by financial incentives and disclosure in a complex interplay with other central factors in the work environment of health care professionals.
New Tools for Estimating and Managing Local/Regional Air Quality Impacts of Prescribed Burns
2013-02-01
189 8.1.2 Conference Papers ...the dryer fuels and horizontal burn configuration would result in a more intense fire and provide emission factors closer to those from the flaming...the EPA web site, the CMAQ Model is a powerful computational tool used by EPA and states for air quality management in that it can be used to design
Smoke modeling in support of management of forest landscapes in the eastern United States
Gary L. Achtemeier
2009-01-01
The impact of smoke from forest burning on air quality is a threat to the use of prescribed fire to manage woodlands in the eastern United States. Population shifts from urban centers to the wildland/urban interface have increased human exposures to smoke. Tighter national ambient air quality standards restrict the amount of smoke released over an area. This article...
Álvarez-Romero, Jorge G; Pressey, Robert L; Ban, Natalie C; Brodie, Jon
2015-01-01
Human-induced changes to river loads of nutrients and sediments pose a significant threat to marine ecosystems. Ongoing land-use change can further increase these loads, and amplify the impacts of land-based threats on vulnerable marine ecosystems. Consequently, there is a need to assess these threats and prioritise actions to mitigate their impacts. A key question regarding prioritisation is whether actions in catchments to maintain coastal-marine water quality can be spatially congruent with actions for other management objectives, such as conserving terrestrial biodiversity. In selected catchments draining into the Gulf of California, Mexico, we employed Land Change Modeller to assess the vulnerability of areas with native vegetation to conversion into crops, pasture, and urban areas. We then used SedNet, a catchment modelling tool, to map the sources and estimate pollutant loads delivered to the Gulf by these catchments. Following these analyses, we used modelled river plumes to identify marine areas likely influenced by land-based pollutants. Finally, we prioritised areas for catchment management based on objectives for conservation of terrestrial biodiversity and objectives for water quality that recognised links between pollutant sources and affected marine areas. Our objectives for coastal-marine water quality were to reduce sediment and nutrient discharges from anthropic areas, and minimise future increases in coastal sedimentation and eutrophication. Our objectives for protection of terrestrial biodiversity covered species of vertebrates. We used Marxan, a conservation planning tool, to prioritise interventions and explore spatial differences in priorities for both objectives. Notable differences in the distributions of land values for terrestrial biodiversity and coastal-marine water quality indicated the likely need for trade-offs between catchment management objectives. However, there were priority areas that contributed to both sets of objectives. Our study demonstrates a practical approach to integrating models of catchments, land-use change, and river plumes with conservation planning software to inform prioritisation of catchment management.
Álvarez-Romero, Jorge G.; Pressey, Robert L.; Ban, Natalie C.; Brodie, Jon
2015-01-01
Human-induced changes to river loads of nutrients and sediments pose a significant threat to marine ecosystems. Ongoing land-use change can further increase these loads, and amplify the impacts of land-based threats on vulnerable marine ecosystems. Consequently, there is a need to assess these threats and prioritise actions to mitigate their impacts. A key question regarding prioritisation is whether actions in catchments to maintain coastal-marine water quality can be spatially congruent with actions for other management objectives, such as conserving terrestrial biodiversity. In selected catchments draining into the Gulf of California, Mexico, we employed Land Change Modeller to assess the vulnerability of areas with native vegetation to conversion into crops, pasture, and urban areas. We then used SedNet, a catchment modelling tool, to map the sources and estimate pollutant loads delivered to the Gulf by these catchments. Following these analyses, we used modelled river plumes to identify marine areas likely influenced by land-based pollutants. Finally, we prioritised areas for catchment management based on objectives for conservation of terrestrial biodiversity and objectives for water quality that recognised links between pollutant sources and affected marine areas. Our objectives for coastal-marine water quality were to reduce sediment and nutrient discharges from anthropic areas, and minimise future increases in coastal sedimentation and eutrophication. Our objectives for protection of terrestrial biodiversity covered species of vertebrates. We used Marxan, a conservation planning tool, to prioritise interventions and explore spatial differences in priorities for both objectives. Notable differences in the distributions of land values for terrestrial biodiversity and coastal-marine water quality indicated the likely need for trade-offs between catchment management objectives. However, there were priority areas that contributed to both sets of objectives. Our study demonstrates a practical approach to integrating models of catchments, land-use change, and river plumes with conservation planning software to inform prioritisation of catchment management. PMID:26714166
Agricultural land use and N losses to water: the case study of a fluvial park in northern Italy.
Morari, F; Lugato, E; Borin, M
2003-01-01
An integrated water resource management programme has been under way since 1999 to reduce agricultural water pollution in the River Mincio fluvial park. The experimental part of the programme consisted of: a) a monitoring phase to evaluate the impact of conventional and environmentally sound techniques (Best Management Practices, BMPs) on water quality; this was done on four representative landscape units, where twelve fields were instrumented to monitor the soil, surface and subsurface water quality; b) a modelling phase to extend the results obtained at field scale to the whole territory of the Mincio watershed. For this purpose a GIS developed in the Arc/Info environment was integrated into the CropSyst model. The model had previously been calibrated to test its ability to describe the complexity of the agricultural systems. The first results showed a variable efficiency of the BMPs depending on the interaction between management and pedo-climatic conditions. In general though, the BMPs had positive effects in improving the surface and subsurface water quality. The CropSyst model was able to describe the agricultural systems monitored and its linking with the GIS represented a valuable tool for identifying the vulnerable areas within the watershed.
Two-stage fuzzy-stochastic robust programming: a hybrid model for regional air quality management.
Li, Yongping; Huang, Guo H; Veawab, Amornvadee; Nie, Xianghui; Liu, Lei
2006-08-01
In this study, a hybrid two-stage fuzzy-stochastic robust programming (TFSRP) model is developed and applied to the planning of an air-quality management system. As an extension of existing fuzzy-robust programming and two-stage stochastic programming methods, the TFSRP can explicitly address complexities and uncertainties of the study system without unrealistic simplifications. Uncertain parameters can be expressed as probability density and/or fuzzy membership functions, such that robustness of the optimization efforts can be enhanced. Moreover, economic penalties as corrective measures against any infeasibilities arising from the uncertainties are taken into account. This method can, thus, provide a linkage to predefined policies determined by authorities that have to be respected when a modeling effort is undertaken. In its solution algorithm, the fuzzy decision space can be delimited through specification of the uncertainties using dimensional enlargement of the original fuzzy constraints. The developed model is applied to a case study of regional air quality management. The results indicate that reasonable solutions have been obtained. The solutions can be used for further generating pollution-mitigation alternatives with minimized system costs and for providing a more solid support for sound environmental decisions.
2011-01-01
Background Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. Methods The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. Results MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. Conclusions It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects. PMID:21385467
Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C
2015-11-01
Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.
A Technology Enhanced Learning Model for Quality Education
NASA Astrophysics Data System (ADS)
Sherly, Elizabeth; Uddin, Md. Meraj
Technology Enhanced Learning and Teaching (TELT) Model provides learning through collaborations and interactions with a framework for content development and collaborative knowledge sharing system as a supplementary for learning to improve the quality of education system. TELT deals with a unique pedagogy model for Technology Enhanced Learning System which includes course management system, digital library, multimedia enriched contents and video lectures, open content management system and collaboration and knowledge sharing systems. Open sources like Moodle and Wiki for content development, video on demand solution with a low cost mid range system, an exhaustive digital library are provided in a portal system. The paper depicts a case study of e-learning initiatives with TELT model at IIITM-K and how effectively implemented.
Managers’ Compensation in a Mixed Ownership Industry: Evidence from Nursing Homes
Huang, Sean Shenghsiu; Hirth, Richard A.; Smith, Dean G.
2016-01-01
An extensive literature is devoted to differences between for-profit and non-profit health-care providers’ prices, utilization, and quality. Less is known about for-profit and non-profit managers’ compensation and its relationship with financial and quality performance. The aim of this study is to examine whether for-profit and non-profit nursing homes place differential weights on financial and quality performance in determining managers’ compensation. Using a unique 8-year dataset on Ohio nursing homes, fixed-effect regression models of managers’ compensation include financial and quality performance as well as other explanatory variables concerning firm and market characteristics and manager qualifications. Among for-profit nursing homes, compensation of owner-managers and non-owner managers are compared. Compensation of for-profit managers is significantly positively associated with profit margin and return-on-assets, while compensation of non-profit managers does not exhibit any consistent relationship with financial measures. Compensation of neither for-profit nor non-profit managers is significantly related to quality measures. Nursing home size and managers’ years of experience are the only consistent determinants of compensation. Owner-managers earn significantly higher compensation than non-owner managers and their compensation is less related to nursing home performance. Finding that home size and experience are strong determinants of compensation, and the association with ownership and financial performance for for-profit nursing homes are as expected. The insignificant relationship between compensation and quality performance is potentially troublesome. PMID:28083528
ERIC Educational Resources Information Center
Pradabpech, Pipat; Chantarasombat, Chalard; Sriampai, Anan
2015-01-01
This research for: 1) to study the current situation and problem in KM, 2) to develop the KM Model, and 3) to evaluate the finding usage of the KM Model for developing the Internal Quality Assurance of Educational Opportunity Expansion Schools. There were 3 Phases of research implementation. Phase 1: the current situation and problem in KM, was…
NASA Astrophysics Data System (ADS)
Hong, E.; Park, Y.; Muirhead, R.; Jeong, J.; Pachepsky, Y. A.
2017-12-01
Pathogenic microorganisms in recreational and irrigation waters remain the subject of concern. Water quality models are used to estimate microbial quality of water sources, to evaluate microbial contamination-related risks, to guide the microbial water quality monitoring, and to evaluate the effect of agricultural management on the microbial water quality. The Agricultural Policy/Environmental eXtender (APEX) is the watershed-scale water quality model that includes highly detailed representation of agricultural management. The APEX currently does not have microbial fate and transport simulation capabilities. The objective of this work was to develop the first APEX microbial fate and transport module that could use the APEX conceptual model of manure removal together with recently introduced conceptualizations of the in-stream microbial fate and transport. The module utilizes manure erosion rates found in the APEX. Bacteria survival in soil-manure mixing layer was simulated with the two-stage survival model. Individual survival patterns were simulated for each manure application date. Simulated in-stream microbial fate and transport processes included the reach-scale passive release of bacteria with resuspended bottom sediment during high flow events, the transport of bacteria from bottom sediment due to the hyporheic exchange during low flow periods, the deposition with settling sediment, and the two-stage survival. Default parameter values were available from recently published databases. The APEX model with the newly developed microbial fate and transport module was applied to simulate seven years of monitoring data for the Toenepi watershed in New Zealand. Based on calibration and testing results, the APEX with the microbe module reproduced well the monitored pattern of E. coli concentrations at the watershed outlet. The APEX with the microbial fate and transport module will be utilized for predicting microbial quality of water under various agricultural practices, evaluating monitoring protocols, and supporting the selection of management practices based on regulations that rely on fecal indicator bacteria concentrations.
The 3D Elevation Program: summary for Texas
Carswell, William J.
2013-01-01
Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Texas, elevation data are critical for natural resources conservation; wildfire management, planning, and response; flood risk management; agriculture and precision farming; infrastructure and construction management; water supply and quality; and other business uses. Today, high-quality light detection and ranging (lidar) data are the source for creating elevation models and other elevation datasets. Federal, State, and local agencies work in partnership to (1) replace data, on a national basis, that are (on average) 30 years old and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data. The new 3D Elevation Program (3DEP) initiative, managed by the U.S. Geological Survey (USGS), responds to the growing need for high-quality topographic data and a wide range of other three-dimensional representations of the Nation’s natural and constructed features.
The 3D Elevation Program: summary for Minnesota
Carswell, William J.
2013-01-01
Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Minnesota, elevation data are critical for agriculture and precision farming, natural resources conservation, flood risk management, infrastructure and construction management, water supply and quality, coastal zone management, and other business uses. Today, high-quality light detection and ranging (lidar) data are the sources for creating elevation models and other elevation datasets. Federal, State, and local agencies work in partnership to (1) replace data, on a national basis, that are (on average) 30 years old and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data. The new 3D Elevation Program (3DEP) initiative, managed by the U.S. Geological Survey (USGS), responds to the growing need for high-quality topographic data and a wide range of other three-dimensional representations of the Nation’s natural and constructed features.
NASA Astrophysics Data System (ADS)
D'Elia, I.; Bencardino, M.; Ciancarella, L.; Contaldi, M.; Vialetto, G.
2009-12-01
The Italian Air Quality legislation underwent sweeping changes with the implementation of the 1996 European Air Quality Framework Directive when the Italian administrative Regions were entrusted with air quality management tasks. The most recent Regional Air Quality Management Plans (AQMPs) highlighted the importance of Non-Technical Measures (NTMs), in addition to Technical Measures (TMs), in meeting environmental targets. The aim of the present work is to compile a list of all the TMs and NTMs taken into account in the Italian Regional AQMPs and to give in the target year, 2010, an estimation of SO 2, NO x and PM 10 emission reductions, of PM 10 concentration and of the health impact of PM 2.5 concentrations in terms of Life Expectancy Reduction. In order to do that, RAINS-Italy, as part of the National Integrated Modeling system for International Negotiation on atmospheric pollution (MINNI), has been applied. The management of TMs and NTMs inside RAINS have often obliged both the introduction of exogenous driving force scenarios and the control strategy modification. This has inspired a revision of the many NTM definitions and a clear choice of the definition adopted. It was finally highlighted that only few TMs and NTMs implemented in the AQMPs represent effective measures in reaching the environmental targets.
Quality Attribute Techniques Framework
NASA Astrophysics Data System (ADS)
Chiam, Yin Kia; Zhu, Liming; Staples, Mark
The quality of software is achieved during its development. Development teams use various techniques to investigate, evaluate and control potential quality problems in their systems. These “Quality Attribute Techniques” target specific product qualities such as safety or security. This paper proposes a framework to capture important characteristics of these techniques. The framework is intended to support process tailoring, by facilitating the selection of techniques for inclusion into process models that target specific product qualities. We use risk management as a theory to accommodate techniques for many product qualities and lifecycle phases. Safety techniques have motivated the framework, and safety and performance techniques have been used to evaluate the framework. The evaluation demonstrates the ability of quality risk management to cover the development lifecycle and to accommodate two different product qualities. We identify advantages and limitations of the framework, and discuss future research on the framework.
Short-term forecasting tools for agricultural nutrient management
USDA-ARS?s Scientific Manuscript database
The advent of real time/short term farm management tools is motivated by the need to protect water quality above and beyond the general guidance offered by existing nutrient management plans. Advances in high performance computing and hydrologic/climate modeling have enabled rapid dissemination of ...
Modelling the Loktak Lake Basin to Assess Human Impact on Water Resources
NASA Astrophysics Data System (ADS)
Eliza, K.
2015-12-01
Loktak Lake is an internationally important, Ramsar designated, fresh water wetland system in the state of Manipur, India. The lake was also listed under Montreux Record on account of the ecological modifications that the lake system has witnessed over time. A characteristic feature of this lake is the extensive occurrence of coalesced, naturally or otherwise, vegetative masses floating over it. A contiguous 40 km2 area of Phumdis, as these vegetative masses are locally referred to, also constitutes the only natural home of the endemic and endangered species of Manipur's brow-antlered deer popularly known as Sangai. Appropriately notified as Keibul Lamjao National Park by Government of India, this natural feature is known to be the world's largest floating park. Water quality and sediment deposition on account of soil erosion in its catchments are some of the emerging concerns along with a reported enhanced frequency and duration of flooding of the shore areas, reduced fish catch within a visibly deteriorated overall natural ecosystem. Disturbances of watershed processes, command area management practices, ineffective as indeed largely absent, waste management practices and management interventions linked to the Loktak Hydroelectric Project are often cited as the principal triggers that are seen to be responsible for the damage. An effective management protocol for the Lake requires a rigorous understanding of its hydrobiology and eco-hydrodynamics. The present study is carried out to establish such a characterization of the various rivers systems draining directly into the Lake using MIKE SHE, MIKE 11 HD and MIKE 11 ECO Lab modelling platforms. Water quality modelling was limited to dissolved oxygen (DO), biological oxygen demand (BOD) and water temperature. Model calibration was done using the available measured water quality data. The derived results were then investigated for causal correlation with anthropogenic influences to assess human impact on water resource as a primary step towards the eventual goal to design effective conservation and management practices for the entire Loktak eco-system. Keywords: Water quality modelling, hydrodynamic modelling, rainfall- runoff model, hydrobiology
Nurse managed occupational health services: a primary care model in practice.
Childre, F
1997-10-01
1. Managed care focus on delivering health care which values prevention, early intervention, continuity of care, commitment to quality care, and outcomes, as well as client satisfaction. Occupational health nurses routinely integrate these values into their practice. 2. An on-site model of primary health care delivery, incorporating the fundamentals of occupational health nursing, can bring significant savings to the organization in health related costs. 3. Case management may provide the greatest potential for growth in occupational health nursing. It is a method that can be used together with managed care to maximize quality health care services. 4. Viewing health related costs as an investment as opposed to part of a benefit plan, influences employees to make positive choices. It also impacts the delivery of health care services on a systematic, global level, which affects total health care costs.
The development of an audit technique to assess the quality of safety barrier management.
Guldenmund, Frank; Hale, Andrew; Goossens, Louis; Betten, Jeroen; Duijm, Nijs Jan
2006-03-31
This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed.
ERIC Educational Resources Information Center
Cameron, Kim; And Others
This study attempted to develop a reliable and valid instrument for assessing work environment and continuous quality improvement efforts in the non-academic sectors of colleges and universities particularly those institutions who have adopted Total Quality Management programs. A model of a work environment for continuous quality improvement was…
Josh Hyde; Eva K. Strand; Andrew T. Hudak; Dale Hamilton
2015-01-01
The use of fire as a land management tool is well recognized for its ecological benefits in many natural systems. To continue to use fire while complying with air quality regulations, land managers are often tasked with modeling emissions from fire during the planning process. To populate such models, the Landscape Fire and Resource Management Planning Tools (...
Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae; Choi, In Young
2013-06-01
Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. THE EVALUATION AREAS OF THE CRM SYSTEM INCLUDES THREE AREAS: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems.
Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae
2013-01-01
Objectives Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. Methods The evaluation areas of the CRM system includes three areas: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Results Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. Conclusions This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems. PMID:23882416
Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Biron, Pierre; Philip, Irène; Perrier, Lionel
2017-06-01
Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including the promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the quality of care management in acute care hospitals throughout France. This retrospective study was based on data derived from three national databases for the year 2011: IPAQSS (indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. Several multivariate models were used to examine the association between the use of EHRs and specific EHR features with four quality indicators: the quality of patient record, the delay in sending information at hospital discharge, the pain status evaluation, and the nutritional status evaluation, while also adjusting for hospital characteristics. The models revealed a significant positive impact of EHR use on the four quality indicators. Additionally, they showed a differential impact according to the functionality of the element of the health record that was computerized. All four quality indicators were also impacted by the type of hospital, the geographical region, and the severity of the pathology. These results suggest that, to improve the quality of care management in hospitals, EHR adoption represents an important lever. They complete previous work dealing with EHR and the organizational performance of hospital surgical units. Copyright © 2017 Elsevier B.V. All rights reserved.
Visions, Strategic Planning, and Quality--More than Hype.
ERIC Educational Resources Information Center
Kaufman, Roger
1996-01-01
Discusses the need to shift from the old models for organizational development to the new methods of quality management and continuous improvement, visions and visioning, and strategic planning, despite inappropriate criticisms they receive. (AEF)
Asthma Self-Management Model: Randomized Controlled Trial
ERIC Educational Resources Information Center
Olivera, Carolina M. X.; Vianna, Elcio Oliveira; Bonizio, Roni C.; de Menezes, Marcelo B.; Ferraz, Erica; Cetlin, Andrea A.; Valdevite, Laura M.; Almeida, Gustavo A.; Araujo, Ana S.; Simoneti, Christian S.; de Freitas, Amanda; Lizzi, Elisangela A.; Borges, Marcos C.; de Freitas, Osvaldo
2016-01-01
Information for patients provided by the pharmacist is reflected in adhesion to treatment, clinical results and patient quality of life. The objective of this study was to assess an asthma self-management model for rational medicine use. This was a randomized controlled trial with 60 asthmatic patients assigned to attend five modules presented by…
Charter Management Organizations: An Emerging Approach to Scaling up What Works
ERIC Educational Resources Information Center
Farrell, Caitlin; Wohlstetter, Priscilla; Smith, Joanna
2012-01-01
Policymakers have shown increasing interest in replicating high-quality education models as a way to improve chronically underperforming schools. Charter management organizations (CMOs) have been touted as one organizational model poised to be such a vehicle for reform. CMOs are nonprofit organizations that operate a network of charter schools…
This 2-page factsheet describes an enhanced version (2.0) of the VELMA eco-hydrological model. VELMA – Visualizing Ecosystem Land Management Assessments – has been redesigned to assist communities, land managers, policy makers and other decision makers in evaluataing the effecti...
NASA Astrophysics Data System (ADS)
Witarsyah Jacob, Deden; Fudzee, Mohd Farhan Md; Aizi Salamat, Mohamad; Kasim, Shahreen; Mahdin, Hairulnizam; Azhar Ramli, Azizul
2017-08-01
Many governments around the world increasingly use internet technologies such as electronic government to provide public services. These services range from providing the most basic informational website to deploying sophisticated tools for managing interactions between government agencies and beyond government. Electronic government (e-government) aims to provide a more accurate, easily accessible, cost-effective and time saving for the community. In this study, we develop a new model of e-government adoption service by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) through the incorporation of some variables such as System Quality, Information Quality and Trust. The model is then tested using a large-scale, multi-site survey research of 237 Indonesian citizens. This model will be validated by using Structural Equation Modeling (SEM). The result indicates that System Quality, Information Quality and Trust variables proven to effect user behavior. This study extends the current understanding on the influence of System Quality, Information Quality and Trust factors to researchers, practitioners, and policy makers.
A Multi Agent Based Approach for Prehospital Emergency Management.
Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh
2017-07-01
To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities. The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement.
Sabatelli, L; Seppälä, U; Sastre, J; Crater, G
Fractional exhaled nitric oxide (FeNO) is a marker for type 2 airway inflammation. The objective of this study was to evaluate the cost-effectiveness and budget impact of FeNO monitoring for management of adult asthma in Spain. A cost-effectiveness analysis model was used to evaluate the effect on costs of adding FeNO monitoring to asthma management. Over a 1-year period, the model estimated the incremental cost per quality-adjusted life year and incremental number of exacerbations avoided when FeNO monitoring was added to standard guideline-driven asthma care compared with standard care alone. Univariate and multivariate sensitivity analyses were applied to explore uncertainty in the model. A budget impact model was used to examine the impact of FeNO monitoring on primary care costs across the Spanish health system. The results showed that adding FeNO to standard asthma care saved €62.53 per patient-year in the adult population and improved quality-adjusted life years by 0.026 per patient-year. The budget impact analysis revealed a potential net yearly saving of €129 million if FeNO monitoring had been used in primary care settings in Spain. The present economic model shows that adding FeNO to the treatment algorithm can considerably reduce costs and improve quality of life when used to manage asthma in combination with current treatment guidelines.
A Multi Agent Based Approach for Prehospital Emergency Management
Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh
2017-01-01
Objective: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Methods: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Results: Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities. The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. Conclusion: In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement. PMID:28795061
Gurney, Georgina G.; Melbourne-Thomas, Jessica; Geronimo, Rollan C.; Aliño, Perry M.; Johnson, Craig R.
2013-01-01
Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef systems. PMID:24260347
Gurney, Georgina G; Melbourne-Thomas, Jessica; Geronimo, Rollan C; Aliño, Perry M; Johnson, Craig R
2013-01-01
Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef systems.
Wu, James X; Sacks, Greg D; Dawes, Aaron J; DeUgarte, Daniel; Lee, Steven L
2017-07-01
Several studies have demonstrated the safety and short-term success of nonoperative management in children with acute, uncomplicated appendicitis. Nonoperative management spares the patients and their family the upfront cost and discomfort of surgery, but also risks recurrent appendicitis. Using decision-tree software, we evaluated the cost-effectiveness of nonoperative management versus routine laparoscopic appendectomy. Model variables were abstracted from a review of the literature, Healthcare Cost and Utilization Project, and Medicare Physician Fee schedule. Model uncertainty was assessed using both one-way and probabilistic sensitivity analyses. We used a $100,000 per quality adjusted life year (QALY) threshold for cost-effectiveness. Operative management cost $11,119 and yielded 23.56 quality-adjusted life months (QALMs). Nonoperative management cost $2277 less than operative management, but yielded 0.03 fewer QALMs. The incremental cost-to-effectiveness ratio of routine laparoscopic appendectomy was $910,800 per QALY gained. This greatly exceeds the $100,000/QALY threshold and was not cost-effective. One-way sensitivity analysis found that operative management would become cost-effective if the 1-year recurrence rate of acute appendicitis exceeded 39.8%. Probabilistic sensitivity analysis indicated that nonoperative management was cost-effective in 92% of simulations. Based on our model, nonoperative management is more cost-effective than routine laparoscopic appendectomy for children with acute, uncomplicated appendicitis. Cost-Effectiveness Study: Level II. Published by Elsevier Inc.
Code of Federal Regulations, 2010 CFR
2010-07-01
... official charged with direct responsibility for management of an area designated as Class I under the Act... 301(d) of the Act and which implements the relevant requirements of the Act. Areawide air quality... which uses an air quality dispersion model to determine the effects of emissions on air quality. Cause...
Modeling Effects of Groundwater Basin Closure, and Reversal of Closure, on Groundwater Quality
NASA Astrophysics Data System (ADS)
Pauloo, R.; Guo, Z.; Fogg, G. E.
2017-12-01
Population growth, the expansion of agriculture, and climate uncertainties have accelerated groundwater pumping and overdraft in aquifers worldwide. In many agricultural basins, a water budget may be stable or not in overdraft, yet disconnected ground and surface water bodies can contribute to the formation of a "closed" basin, where water principally exits the basin as evapotranspiration. Although decreasing water quality associated with increases in Total Dissolved Solids (TDS) have been documented in aquifers across the United States in the past half century, connections between water quality declines and significant changes in hydrologic budgets leading to closed basin formation remain poorly understood. Preliminary results from an analysis with a regional-scale mixing model of the Tulare Lake Basin in California indicate that groundwater salinization resulting from open to closed basin conversion can operate on a decades-to-century long time scale. The only way to reverse groundwater salinization caused by basin closure is to refill the basin and change the hydrologic budget sufficiently for natural groundwater discharge to resume. 3D flow and transport modeling, including the effects of heterogeneity based on a hydrostratigraphic facies model, is used to explore rates and time scales of groundwater salinization and its reversal under different water and land management scenarios. The modeling is also used to ascertain the extent to which local and regional heterogeneity need to be included in order to appropriately upscale the advection-dispersion equation in a basin scale groundwater quality management model. Results imply that persistent managed aquifer recharge may slow groundwater salinization, and complete reversal may be possible at sufficiently high water tables.
Lin, Hailong; Zhou, Shiyan; Zhang, Dongxiu; Huang, Leting
2016-11-01
To evaluate a nurse-led management model of adolescent acute lymphoblastic leukemia (ALL) patients and improve their psychological care and quality of life. Seventy-three adolescent ALL patients participated in an open, controlled clinical trial and were randomized into a nurse-led management model group (n=36) and a doctor-led management model group (n=37). Two assessment questionnaires were administered to assess and compare the 2 models during a 1.5-year follow-up period: the hospital anxiety and depression scale (HADS) questionnaire was administered at 6 different time points, and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) at 3 different time points. There were no differences in anxiety and depression between the groups according to the first-administered questionnaire (the mean anxiety and depression scores of the nurse-led group were 14.2±4.1 and 10.8±2.7, respectively; those of the doctor-led group were 13.8±3.8 and 10.6±2.2, respectively). However, repeated measures analysis of variance detected differences in subsequent HADS-based scores as a function of time between the 2 groups (p<0.05). Moreover, the Holm-Sidak's multiple comparisons tests showed that patients of the nurse-led group had significantly decreased mean anxiety scores compared to those in the doctor-led group at the third and subsequent sessions, as well as in mean depression scores from the second session onwards (all p<0.05). According to the last-administered EORTC QLQ-C30 questionnaire, there were statistical differences in cognitive, emotional, social, and quality of life scales between the 2 groups (all p<0.05), but not in role and physical scales (all p>0.05). It is necessary to offer unique cognitive, psychological, and behavioral management models to adolescent ALL patients that are tailored toward their age group. Strengthening such management is more conducive to alleviating or even reversing psychological problems, and to improving patients' quality of life while ensuring complication-free follow-up periods. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Mlakar, Mitja
2016-01-01
Abstract Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. Methods A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. Results The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. Conclusion The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation. PMID:27703537
Petek, Davorina; Mlakar, Mitja
2016-09-01
A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.
Terrado, Marta; Sabater, Sergi; Chaplin-Kramer, Becky; Mandle, Lisa; Ziv, Guy; Acuña, Vicenç
2016-01-01
There is a growing pressure of human activities on natural habitats, which leads to biodiversity losses. To mitigate the impact of human activities, environmental policies are developed and implemented, but their effects are commonly not well understood because of the lack of tools to predict the effects of conservation policies on habitat quality and/or diversity. We present a straightforward model for the simultaneous assessment of terrestrial and aquatic habitat quality in river basins as a function of land use and anthropogenic threats to habitat that could be applied under different management scenarios to help understand the trade-offs of conservation actions. We modify the InVEST model for the assessment of terrestrial habitat quality and extend it to freshwater habitats. We assess the reliability of the model in a severely impaired basin by comparing modeled results to observed terrestrial and aquatic biodiversity data. Estimated habitat quality is significantly correlated with observed terrestrial vascular plant richness (R(2)=0.76) and diversity of aquatic macroinvertebrates (R(2)=0.34), as well as with ecosystem functions such as in-stream phosphorus retention (R(2)=0.45). After that, we analyze different scenarios to assess the suitability of the model to inform changes in habitat quality under different conservation strategies. We believe that the developed model can be useful to assess potential levels of biodiversity, and to support conservation planning given its capacity to forecast the effects of management actions in river basins. Copyright © 2015 Elsevier B.V. All rights reserved.
ERIC Educational Resources Information Center
Cartmell, Jonathan; Binsardi, Ben; McLean, Alexis
2011-01-01
This seminal study investigates the use of the EFQM Excellence Model[R] in the UK Further Education sector. Following initial interviews with Senior Managers and Quality Consultants, an online survey was sent to Principals and Senior Managers in all Colleges across the UK to critically investigate the relationship between the use of the Model and…
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.
Application of receptor models on water quality data in source apportionment in Kuantan River Basin
2012-01-01
Recent techniques in the management of surface river water have been expanding the demand on the method that can provide more representative of multivariate data set. A proper technique of the architecture of artificial neural network (ANN) model and multiple linear regression (MLR) provides an advance tool for surface water modeling and forecasting. The development of receptor model was applied in order to determine the major sources of pollutants at Kuantan River Basin, Malaysia. Thirteen water quality parameters were used in principal component analysis (PCA) and new variables of fertilizer waste, surface runoff, anthropogenic input, chemical and mineral changes and erosion are successfully developed for modeling purposes. Two models were compared in terms of efficiency and goodness-of-fit for water quality index (WQI) prediction. The results show that APCS-ANN model gives better performance with high R2 value (0.9680) and small root mean square error (RMSE) value (2.6409) compared to APCS-MLR model. Meanwhile from the sensitivity analysis, fertilizer waste acts as the dominant pollutant contributor (59.82%) to the basin studied followed by anthropogenic input (22.48%), surface runoff (13.42%), erosion (2.33%) and lastly chemical and mineral changes (1.95%). Thus, this study concluded that receptor modeling of APCS-ANN can be used to solve various constraints in environmental problem that exist between water distribution variables toward appropriate water quality management. PMID:23369363
[Discussion on logistics management of medical consumables].
Deng, Sutong; Wang, Miao; Jiang, Xiali
2011-09-01
Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.
[Disease management for chronic heart failure patient].
Bläuer, Cornelia; Pfister, Otmar; Bächtold, Christa; Junker, Therese; Spirig, Rebecca
2011-02-01
Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.
Albuquerque De Almeida, Fernando; Al, Maiwenn; Koymans, Ron; Caliskan, Kadir; Kerstens, Ankie; Severens, Johan L
2018-04-01
Describing the general and methodological characteristics of decision-analytical models used in the economic evaluation of early warning systems for the management of chronic heart failure patients and performing a quality assessment of their methodological characteristics is expected to provide concise and useful insight to inform the future development of decision-analytical models in the field of heart failure management. Areas covered: The literature on decision-analytical models for the economic evaluation of early warning systems for the management of chronic heart failure patients was systematically reviewed. Nine electronic databases were searched through the combination of synonyms for heart failure and sensitive filters for cost-effectiveness and early warning systems. Expert commentary: The retrieved models show some variability with regards to their general study characteristics. Overall, they display satisfactory methodological quality, even though some points could be improved, namely on the consideration and discussion of any competing theories regarding model structure and disease progression, identification of key parameters and the use of expert opinion, and uncertainty analyses. A comprehensive definition of early warning systems and further research under this label should be pursued. To improve the transparency of economic evaluation publications, authors should make available detailed technical information regarding the published models.
Fields, Dail; Roman, Paul M; Blum, Terry C
2012-06-01
To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.
Fields, Dail; Roman, Paul M; Blum, Terry C
2012-01-01
Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342
Short and long term improvements in quality of chronic care delivery predict program sustainability.
Cramm, Jane Murray; Nieboer, Anna Petra
2014-01-01
Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (p<0.001) and quality changes in the first (p<0.001) and second (p<0.01) years predicted program sustainability. In conclusion this study showed that disease-management programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Integrated Hydrographical Basin Management. Study Case - Crasna River Basin
NASA Astrophysics Data System (ADS)
Visescu, Mircea; Beilicci, Erika; Beilicci, Robert
2017-10-01
Hydrographical basins are important from hydrological, economic and ecological points of view. They receive and channel the runoff from rainfall and snowmelt which, when adequate managed, can provide fresh water necessary for water supply, irrigation, food industry, animal husbandry, hydrotechnical arrangements and recreation. Hydrographical basin planning and management follows the efficient use of available water resources in order to satisfy environmental, economic and social necessities and constraints. This can be facilitated by a decision support system that links hydrological, meteorological, engineering, water quality, agriculture, environmental, and other information in an integrated framework. In the last few decades different modelling tools for resolving problems regarding water quantity and quality were developed, respectively water resources management. Watershed models have been developed to the understanding of water cycle and pollution dynamics, and used to evaluate the impacts of hydrotechnical arrangements and land use management options on water quantity, quality, mitigation measures and possible global changes. Models have been used for planning monitoring network and to develop plans for intervention in case of hydrological disasters: floods, flash floods, drought and pollution. MIKE HYDRO Basin is a multi-purpose, map-centric decision support tool for integrated hydrographical basin analysis, planning and management. MIKE HYDRO Basin is designed for analyzing water sharing issues at international, national and local hydrographical basin level. MIKE HYDRO Basin uses a simplified mathematical representation of the hydrographical basin including the configuration of river and reservoir systems, catchment hydrology and existing and potential water user schemes with their various demands including a rigorous irrigation scheme module. This paper analyzes the importance and principles of integrated hydrographical basin management and develop a case study for Crasna river basin, with the use of MIKE HYDRO Basin advanced hydroinformatic tool for integrated hydrographical basin analysis, planning and management.
USDA-ARS?s Scientific Manuscript database
Well-tested agricultural system models can improve our understanding of the water quality effects of management practices under different conditions. The Root Zone Water Quality Model (RZWQM) has been tested under a variety of conditions. However, the current model’s ability to simulate pesticide tr...
Growing high quality hardwoods: Plantation trials of mixed hardwood species in Tennessee
Christopher M. Oswalt; Wayne K. Clatterbuck
2011-01-01
Hardwood plantations are becoming increasingly important in the United States. To date, many foresters have relied on a conifer plantation model as the basis of establishing and managing hardwood plantations. The monospecific approach suggested by the conifer plantation model does not appear to provide for the development of quality hardwood logs similar to those found...
ERIC Educational Resources Information Center
Leask, Marilyn; Younie, Sarah
2013-01-01
If teacher quality is the most critical factor in improving educational outcomes, then why is so little attention drawn to the knowledge and evidence base available to support teachers in improving the quality of their professional knowledge? This paper draws together findings from a range of sources to propose national models for continuing…
Ghodsi, Seyed Hamed; Kerachian, Reza; Zahmatkesh, Zahra
2016-04-15
In this paper, an integrated framework is proposed for urban runoff management. To control and improve runoff quality and quantity, Low Impact Development (LID) practices are utilized. In order to determine the LIDs' areas and locations, the Non-dominated Sorting Genetic Algorithm-II (NSGA-II), which considers three objective functions of minimizing runoff volume, runoff pollution and implementation cost of LIDs, is utilized. In this framework, the Storm Water Management Model (SWMM) is used for stream flow simulation. The non-dominated solutions provided by the NSGA-II are considered as management scenarios. To select the most preferred scenario, interactions among the main stakeholders in the study area with conflicting utilities are incorporated by utilizing bargaining models including a non-cooperative game, Nash model and social choice procedures of Borda count and approval voting. Moreover, a new social choice procedure, named pairwise voting method, is proposed and applied. Based on each conflict resolution approach, a scenario is identified as the ideal solution providing the LIDs' areas, locations and implementation cost. The proposed framework is applied for urban water quality and quantity management in the northern part of Tehran metropolitan city, Iran. Results show that the proposed pairwise voting method tends to select a scenario with a higher percentage of reduction in TSS (Total Suspended Solid) load and runoff volume, in comparison with the Borda count and approval voting methods. Besides, the Nash method presents a management scenario with the highest cost for LIDs' implementation and the maximum values for percentage of runoff volume reduction and TSS removal. The results also signify that selection of an appropriate management scenario by stakeholders in the study area depends on the available financial resources and the relative importance of runoff quality improvement in comparison with reducing the runoff volume. Copyright © 2016 Elsevier B.V. All rights reserved.
NASA Technical Reports Server (NTRS)
Connelly, L. C.
1977-01-01
The mission planning processor is a user oriented tool for consumables management and is part of the total consumables subsystem management concept. The approach to be used in developing a working model of the mission planning processor is documented. The approach includes top-down design, structured programming techniques, and application of NASA approved software development standards. This development approach: (1) promotes cost effective software development, (2) enhances the quality and reliability of the working model, (3) encourages the sharing of the working model through a standard approach, and (4) promotes portability of the working model to other computer systems.
Liu, Jing; Li, Yongping; Huang, Guohe; Fu, Haiyan; Zhang, Junlong; Cheng, Guanhui
2017-06-01
In this study, a multi-level-factorial risk-inference-based possibilistic-probabilistic programming (MRPP) method is proposed for supporting water quality management under multiple uncertainties. The MRPP method can handle uncertainties expressed as fuzzy-random-boundary intervals, probability distributions, and interval numbers, and analyze the effects of uncertainties as well as their interactions on modeling outputs. It is applied to plan water quality management in the Xiangxihe watershed. Results reveal that a lower probability of satisfying the objective function (θ) as well as a higher probability of violating environmental constraints (q i ) would correspond to a higher system benefit with an increased risk of violating system feasibility. Chemical plants are the major contributors to biological oxygen demand (BOD) and total phosphorus (TP) discharges; total nitrogen (TN) would be mainly discharged by crop farming. It is also discovered that optimistic decision makers should pay more attention to the interactions between chemical plant and water supply, while decision makers who possess a risk-averse attitude would focus on the interactive effect of q i and benefit of water supply. The findings can help enhance the model's applicability and identify a suitable water quality management policy for environmental sustainability according to the practical situations.
A Hybrid Interval-Robust Optimization Model for Water Quality Management.
Xu, Jieyu; Li, Yongping; Huang, Guohe
2013-05-01
In water quality management problems, uncertainties may exist in many system components and pollution-related processes ( i.e. , random nature of hydrodynamic conditions, variability in physicochemical processes, dynamic interactions between pollutant loading and receiving water bodies, and indeterminacy of available water and treated wastewater). These complexities lead to difficulties in formulating and solving the resulting nonlinear optimization problems. In this study, a hybrid interval-robust optimization (HIRO) method was developed through coupling stochastic robust optimization and interval linear programming. HIRO can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original chemical oxygen demand (COD) discharge constraints, HIRO enhances the robustness of the optimization processes and resulting solutions. This method was applied to planning of industry development in association with river-water pollution concern in New Binhai District of Tianjin, China. Results demonstrated that the proposed optimization model can effectively communicate uncertainties into the optimization process and generate a spectrum of potential inexact solutions supporting local decision makers in managing benefit-effective water quality management schemes. HIRO is helpful for analysis of policy scenarios related to different levels of economic penalties, while also providing insight into the tradeoff between system benefits and environmental requirements.
Application of a theoretical model to evaluate COPD disease management.
Lemmens, Karin M M; Nieboer, Anna P; Rutten-Van Mölken, Maureen P M H; van Schayck, Constant P; Asin, Javier D; Dirven, Jos A M; Huijsman, Robbert
2010-03-26
Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.
Application of a theoretical model to evaluate COPD disease management
2010-01-01
Background Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. Methods A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Results Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. Conclusions The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care. PMID:20346135
Chambers, D W
1998-01-01
This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.
Hanna, R. Blair; Campbell, Sharon G.
2000-01-01
This report describes the water quality model developed for the Klamath River System Impact Assessment Model (SIAM). The Klamath River SIAM is a decision support system developed by the authors and other US Geological Survey (USGS), Midcontinent Ecological Science Center staff to study the effects of basin-wide water management decisions on anadromous fish in the Klamath River. The Army Corps of Engineersa?? HEC5Q water quality modeling software was used to simulate water temperature, dissolved oxygen and conductivity in 100 miles of the Klamath River Basin in Oregon and California. The water quality model simulated three reservoirs and the mainstem Klamath River influenced by the Shasta and Scott River tributaries. Model development, calibration and two validation exercises are described as well as the integration of the water quality model into the SIAM decision support system software. Within SIAM, data are exchanged between the water quantity model (MODSIM), the water quality model (HEC5Q), the salmon population model (SALMOD) and methods for evaluating ecosystem health. The overall predictive ability of the water quality model is described in the context of calibration and validation error statistics. Applications of SIAM and the water quality model are described.
1990-12-01
studies for the continuing education of managers new to the TQM approach , for informing vendors of their responsibilities under a changed process, and...Department of Defense (DoD) is adopting a management approach known as Total Quality Management (TQM) in an effort to improve quality and productivity...individuals selected be highly knowledgeable about the operations in their shop or unit. The main function of PATs is to collect and summarize process data for
Álvarez-Romero, Jorge G; Wilkinson, Scott N; Pressey, Robert L; Ban, Natalie C; Kool, Johnathan; Brodie, Jon
2014-12-15
Human-induced changes in flows of water, nutrients, and sediments have impacts on marine ecosystems. Quantifying these changes to systematically allocate management actions is a priority for many areas worldwide. Modeling nutrient and sediment loads and contributions from subcatchments can inform prioritization of management interventions to mitigate the impacts of land-based pollution on marine ecosystems. Among the catchment models appropriate for large-scale applications, N-SPECT and SedNet have been used to prioritize areas for management of water quality in coastal-marine ecosystems. However, an assessment of their relative performance, parameterization, and utility for regional-scale planning is needed. We examined how these considerations can influence the choice between the two models and the areas identified as priorities for management actions. We assessed their application in selected catchments of the Gulf of California, where managing land-based threats to marine ecosystems is a priority. We found important differences in performance between models. SedNet consistently estimated spatial variations in runoff with higher accuracy than N-SPECT and modeled suspended sediment (TSS) loads mostly within the range of variation in observed loads. N-SPECT overestimated TSS loads by orders of magnitude when using the spatially-distributed sediment delivery ratio (SDR), but outperformed SedNet when using a calibrated SDR. Differences in subcatchments' contribution to pollutant loads were principally due to explicit representation of sediment sinks and particulate nutrients by SedNet. Improving the floodplain extent model, and constraining erosion estimates by local data including gully erosion in SedNet, would improve results of this model and help identify effective management responses. Differences between models in the patterns of modeled pollutant supply were modest, but significantly influenced the prioritization of subcatchments for management. Copyright © 2014 Elsevier Ltd. All rights reserved.
Testing a pharmacist-patient relationship quality model among older persons with diabetes.
Worley, Marcia M
2006-03-01
Considering recent changes to the Medicare program, pharmacists will have unique opportunities to be reimbursed for providing Medication Therapy Management Services to older persons with diabetes. A high-quality pharmacist-patient relationship can lay the foundation for effective provision of Medication Therapy Management Services and improved care in this cohort. To test a pharmacist-patient relationship quality model in a group of older persons with diabetes from the patient's perspective. Antecedents to relationship quality were pharmacist participative behavior/patient-centeredness of relationship, patient participative behavior, and pharmacist-patient interpersonal communication. Pharmacist-patient relationship commitment was the outcome of relationship quality studied. Data were collected via mailed questionnaire from a random sample of 600 community-dwelling adults in the United States who (1) were 65 years of age and older, (2) had type 1 or type 2 diabetes, (3) used at least one prescription medication to treat their diabetes, and (4) used some type of nonmail order pharmacy as their primary source of obtaining prescription medications. Model relationships were tested using path analysis. The adjusted response rate was 41.6% (221/531). The models explained 47% and 49% of the variance in relationship quality and relationship commitment, respectively. In the relationship quality model, pharmacist participative behavior/patient-centeredness of relationship (beta=.51, P<.001) and pharmacist-patient interpersonal communication (beta=.17, P=.008) had direct effects on relationship quality. In the relationship commitment model, relationship quality had a direct effect on relationship commitment (beta=.60, P<.001). Pharmacist participative behavior/patient-centeredness and pharmacist-patient interpersonal communication had indirect effects on relationship commitment through their effects on relationship quality, which is a mediator in the model. Results affirm findings from previous research showing that patients' perceptions of pharmacist participative behavior/patient-centeredness of relationship and pharmacist-patient interpersonal communication are positively related to perceptions of relationship quality. Also, relationship quality is a strong mediator between pharmacist participative behavior/patient-centeredness of relationship and relationship commitment, as well as between pharmacist-patient interpersonal communication and relationship commitment.
NASA Astrophysics Data System (ADS)
Hassanzadeh, Y.; Vidon, P.; Gold, A.; Pradhanang, S. M.; Addy, K.
2017-12-01
Vegetated riparian zones are often considered for use as best management practices to mitigate the impacts of agriculture on water quality. However, riparian zones can also be a source of greenhouse gases and their influence on water quality varies depending on landscape hydrogeomorphic characteristics and climate. Methods used to evaluate riparian zone functions include conceptual models, and spatially explicit and process based models (REMM), but very few attempts have been made to connect riparian zone characteristics with function using easily accessible landscape scale data. Here, we present comprehensive statistical models that can be used to assess riparian zone functions with easily obtainable landscape-scale hydrogeomorphic attributes and climate data. Models were developed from a database spanning 88 years and 36 sites. Statistical methods including principal component analysis and stepwise regression were used to reduced data dimensionality and identify significant predictors. Models were validated using additional data collected from scientific literature. The 8 models developed connect landscape characteristics to nitrogen and phosphorus concentration and removal (1-4), greenhouse gas emissions (5-7), and water table depth (8). Results show the range of influence that various climate and landscape characteristics have on riparian zone functions, and the tradeoffs that exist with regards to nitrogen, phosphorous, and greenhouse gases. These models will help reduce the need for extensive field measurements and help scientists and land managers make more informed decisions regarding the use of riparian zones for water quality management.
NASA Astrophysics Data System (ADS)
Dolan, Tom; Pullan, Stephanie; Whelan, Mick; Parsons, David
2013-04-01
Diffuse inputs from agriculture are commonly the main source of pesticide contamination in surface water and may have implications for the quality of treated drinking water. After privatisation in 1991, UK water companies primarily focused on the provision of sufficient water treatment to reduce the risk of non-compliance with the European Drinking Water Directive (DWD), under which all pesticide concentrations must be below 0.1µg/l and UK Water Supply Regulations for the potable water they supply. Since 2000, Article 7 of the Water Framework Directive (WFD) has begun to drive a prevention-led approach to compliance with the DWD. As a consequence water companies are now more interested in the quality of 'raw' (untreated) water at the point of abstraction. Modelling (based upon best available estimates of cropping, pesticide use, weather conditions, pesticide characteristics, and catchment characteristics) and monitoring of raw water quality can both help to determine the compliance risks associated with the quality of this 'raw' water resource. This knowledge allows water companies to prioritise active substances for action in their catchments, and is currently used in many cases to support the design of monitoring programmes for pesticide active substances. Additional value can be provided if models are able to help to identify the type and scale of catchment management interventions required to achieve DWD compliance for pesticide active substances through pollution prevention at source or along transport pathways. These questions were explored using a simple catchment-scale pesticide fate and transport model. The model employs a daily time-step and is semi-lumped with calculations performed for soil type and crop combinations, weighted by their proportions within the catchment. Soil properties are derived from the national soil database and the model can, therefore, be applied to any catchment in England and Wales. Various realistic catchment management intervention scenarios were explored (including changes to land use and pesticide usage) with the aim of providing a useful input to the debate between water companies, their regulators and pesticide users over the scale of catchment management required to support both DWD and WFD Article 7 compliance.
Validating archetypes for the Multiple Sclerosis Functional Composite.
Braun, Michael; Brandt, Alexander Ulrich; Schulz, Stefan; Boeker, Martin
2014-08-03
Numerous information models for electronic health records, such as openEHR archetypes are available. The quality of such clinical models is important to guarantee standardised semantics and to facilitate their interoperability. However, validation aspects are not regarded sufficiently yet. The objective of this report is to investigate the feasibility of archetype development and its community-based validation process, presuming that this review process is a practical way to ensure high-quality information models amending the formal reference model definitions. A standard archetype development approach was applied on a case set of three clinical tests for multiple sclerosis assessment: After an analysis of the tests, the obtained data elements were organised and structured. The appropriate archetype class was selected and the data elements were implemented in an iterative refinement process. Clinical and information modelling experts validated the models in a structured review process. Four new archetypes were developed and publicly deployed in the openEHR Clinical Knowledge Manager, an online platform provided by the openEHR Foundation. Afterwards, these four archetypes were validated by domain experts in a team review. The review was a formalised process, organised in the Clinical Knowledge Manager. Both, development and review process turned out to be time-consuming tasks, mostly due to difficult selection processes between alternative modelling approaches. The archetype review was a straightforward team process with the goal to validate archetypes pragmatically. The quality of medical information models is crucial to guarantee standardised semantic representation in order to improve interoperability. The validation process is a practical way to better harmonise models that diverge due to necessary flexibility left open by the underlying formal reference model definitions.This case study provides evidence that both community- and tool-enabled review processes, structured in the Clinical Knowledge Manager, ensure archetype quality. It offers a pragmatic but feasible way to reduce variation in the representation of clinical information models towards a more unified and interoperable model.
Validating archetypes for the Multiple Sclerosis Functional Composite
2014-01-01
Background Numerous information models for electronic health records, such as openEHR archetypes are available. The quality of such clinical models is important to guarantee standardised semantics and to facilitate their interoperability. However, validation aspects are not regarded sufficiently yet. The objective of this report is to investigate the feasibility of archetype development and its community-based validation process, presuming that this review process is a practical way to ensure high-quality information models amending the formal reference model definitions. Methods A standard archetype development approach was applied on a case set of three clinical tests for multiple sclerosis assessment: After an analysis of the tests, the obtained data elements were organised and structured. The appropriate archetype class was selected and the data elements were implemented in an iterative refinement process. Clinical and information modelling experts validated the models in a structured review process. Results Four new archetypes were developed and publicly deployed in the openEHR Clinical Knowledge Manager, an online platform provided by the openEHR Foundation. Afterwards, these four archetypes were validated by domain experts in a team review. The review was a formalised process, organised in the Clinical Knowledge Manager. Both, development and review process turned out to be time-consuming tasks, mostly due to difficult selection processes between alternative modelling approaches. The archetype review was a straightforward team process with the goal to validate archetypes pragmatically. Conclusions The quality of medical information models is crucial to guarantee standardised semantic representation in order to improve interoperability. The validation process is a practical way to better harmonise models that diverge due to necessary flexibility left open by the underlying formal reference model definitions. This case study provides evidence that both community- and tool-enabled review processes, structured in the Clinical Knowledge Manager, ensure archetype quality. It offers a pragmatic but feasible way to reduce variation in the representation of clinical information models towards a more unified and interoperable model. PMID:25087081
ERIC Educational Resources Information Center
Miller, John A.
2017-01-01
The purpose of this article is to describe an experiential course designed to overcome the specific problems inherent in working with undergraduate students in introductory management courses. The article grew out of discussions among faculty at the 1988 Academy of Management meetings who shared deep concerns about the quality of undergraduate…
Cramm, Jane Murray; Nieboer, Anna Petra
2013-01-01
Background This cross-sectional study aimed to identify the relationship between quality of chronic care delivery, self-management abilities, and wellbeing among patients with chronic obstructive pulmonary disease (COPD). Methods The study was conducted in 2012 and included 548 (out of 1303; 42% response rate) patients with COPD enrolled in a COPD care program in the region of Noord-Kennemerland in The Netherlands. We employed a multilevel random-effects model (548 patients nested in 47 healthcare practices) to investigate the relationship between quality of chronic care delivery, self-management abilities, and patients’ wellbeing. In the multilevel analyses we controlled for patients’ background characteristics and health behaviors. Results Multilevel analyses clearly showed a significant relationship between quality of chronic care delivery and wellbeing of patients with COPD (P ≤ 0.001). When self-management abilities were included in the equation while controlling for background characteristics, health behaviors, and quality of chronic care delivery, these abilities were found to have a strong positive relationship with patients’ wellbeing (P ≤ 0.001). Low educational level, single marital status, and physical exercise were not significantly associated with wellbeing when self-management abilities were included in the equation. Conclusion Self-management abilities and the quality of chronic care delivery are important for the wellbeing of patients with COPD. Furthermore, self-management abilities acted as mediators between wellbeing and low educational level, single status, and physical exercise among these patients. PMID:23641152
Milando, Chad W.; Martenies, Sheena E.; Batterman, Stuart A.
2017-01-01
In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest the potential for FRESH-EST to identify pollution control alternatives for air quality management planning. PMID:27318620
Zhang, Ruibin; Qian, Xin; Yuan, Xingcheng; Ye, Rui; Xia, Bisheng; Wang, Yulei
2012-12-07
In recent years, water quality degradation associated with rapid socio-economic development in the Taihu Lake Basin, China, has attracted increasing attention from both the public and the Chinese government. The primary sources of pollution in Taihu Lake are its inflow rivers and their tributaries. Effective water environmental management strategies need to be implemented in these rivers to improve the water quality of Taihu Lake, and to ensure sustainable development in the region. The aim of this study was to provide a basis for water environmental management decision-making. In this study, the QUAL2K model for river and stream water quality was applied to predict the water quality and environmental capacity of the Hongqi River, which is a polluted tributary in the Taihu Lake Basin. The model parameters were calibrated by trial and error until the simulated results agreed well with the observed data. The calibrated QUAL2K model was used to calculate the water environmental capacity of the Hongqi River, and the water environmental capacities of COD(Cr) NH(3)-N, TN, and TP were 17.51 t, 1.52 t, 2.74 t and 0.37 t, respectively. The results showed that the NH(3)-N, TN, and TP pollution loads of the studied river need to be reduced by 50.96%, 44.11%, and 22.92%, respectively to satisfy the water quality objectives. Thus, additional water pollution control measures are needed to control and reduce the pollution loads in the Hongqi River watershed. The method applied in this study should provide a basis for water environmental management decision-making.
30 CFR 285.659 - What requirements must I include in my SAP, COP, or GAP regarding air quality?
Code of Federal Regulations, 2010 CFR
2010-07-01
..., or GAP regarding air quality? 285.659 Section 285.659 Mineral Resources MINERALS MANAGEMENT SERVICE... must I include in my SAP, COP, or GAP regarding air quality? (a) You must comply with the Clean Air Act...) For air quality modeling that you perform in support of the activities proposed in your plan, you...
Zhang, Ruibin; Qian, Xin; Yuan, Xingcheng; Ye, Rui; Xia, Bisheng; Wang, Yulei
2012-01-01
In recent years, water quality degradation associated with rapid socio-economic development in the Taihu Lake Basin, China, has attracted increasing attention from both the public and the Chinese government. The primary sources of pollution in Taihu Lake are its inflow rivers and their tributaries. Effective water environmental management strategies need to be implemented in these rivers to improve the water quality of Taihu Lake, and to ensure sustainable development in the region. The aim of this study was to provide a basis for water environmental management decision-making. In this study, the QUAL2K model for river and stream water quality was applied to predict the water quality and environmental capacity of the Hongqi River, which is a polluted tributary in the Taihu Lake Basin. The model parameters were calibrated by trial and error until the simulated results agreed well with the observed data. The calibrated QUAL2K model was used to calculate the water environmental capacity of the Hongqi River, and the water environmental capacities of CODCr NH3-N, TN, and TP were 17.51 t, 1.52 t, 2.74 t and 0.37 t, respectively. The results showed that the NH3-N, TN, and TP pollution loads of the studied river need to be reduced by 50.96%, 44.11%, and 22.92%, respectively to satisfy the water quality objectives. Thus, additional water pollution control measures are needed to control and reduce the pollution loads in the Hongqi River watershed. The method applied in this study should provide a basis for water environmental management decision-making. PMID:23222206
Towards Automatic Validation and Healing of Citygml Models for Geometric and Semantic Consistency
NASA Astrophysics Data System (ADS)
Alam, N.; Wagner, D.; Wewetzer, M.; von Falkenhausen, J.; Coors, V.; Pries, M.
2013-09-01
A steadily growing number of application fields for large 3D city models have emerged in recent years. Like in many other domains, data quality is recognized as a key factor for successful business. Quality management is mandatory in the production chain nowadays. Automated domain-specific tools are widely used for validation of business-critical data but still common standards defining correct geometric modeling are not precise enough to define a sound base for data validation of 3D city models. Although the workflow for 3D city models is well-established from data acquisition to processing, analysis and visualization, quality management is not yet a standard during this workflow. Processing data sets with unclear specification leads to erroneous results and application defects. We show that this problem persists even if data are standard compliant. Validation results of real-world city models are presented to demonstrate the potential of the approach. A tool to repair the errors detected during the validation process is under development; first results are presented and discussed. The goal is to heal defects of the models automatically and export a corrected CityGML model.
NASA Astrophysics Data System (ADS)
Sutherland, D. A.; Kim, C.; Marsik, M.; Spiridonov, G.; Toft, J.; Ruckelshaus, M.; Guerry, A.; Plummer, M.
2011-12-01
Humans obtain numerous benefits from marine ecosystems, including fish to eat; mitigation of storm damage; nutrient and water cycling and primary production; and cultural, aesthetic and recreational values. However, managing these benefits, or ecosystem services, in the marine world relies on an integrated approach that accounts for both marine and watershed activities. Here we present the results of a set of simple, physically-based, and spatially-explicit models that quantify the effects of terrestrial activities on marine ecosystem services. Specifically, we model the circulation and water quality of Hood Canal, WA, USA, a fjord system in Puget Sound where multiple human uses of the nearshore ecosystem (e.g., shellfish aquaculture, recreational Dungeness crab and shellfish harvest) can be compromised when water quality is poor (e.g., hypoxia, excessive non-point source pollution). Linked to the estuarine water quality model is a terrestrial hydrology model that simulates streamflow and nutrient loading, so land cover and climate changes in watersheds can be reflected in the marine environment. In addition, a shellfish aquaculture model is linked to the water quality model to test the sensitivity of the ecosystem service and its value to both terrestrial and marine activities. The modeling framework is general and will be publicly available, allowing easy comparisons of watershed impacts on marine ecosystem services across multiple scales and regions.
A dynamic model for costing disaster mitigation policies.
Altay, Nezih; Prasad, Sameer; Tata, Jasmine
2013-07-01
The optimal level of investment in mitigation strategies is usually difficult to ascertain in the context of disaster planning. This research develops a model to provide such direction by relying on cost of quality literature. This paper begins by introducing a static approach inspired by Joseph M. Juran's cost of quality management model (Juran, 1951) to demonstrate the non-linear trade-offs in disaster management expenditure. Next it presents a dynamic model that includes the impact of dynamic interactions of the changing level of risk, the cost of living, and the learning/investments that may alter over time. It illustrates that there is an optimal point that minimises the total cost of disaster management, and that this optimal point moves as governments learn from experience or as states get richer. It is hoped that the propositions contained herein will help policymakers to plan, evaluate, and justify voluntary disaster mitigation expenditures. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.
The role of hospital managers in quality and patient safety: a systematic review
Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles
2014-01-01
Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance. PMID:25192876
Modeling soil erosion and transport on forest landscape
Ge Sun; Steven G McNulty
1998-01-01
Century-long studies on the impacts of forest management in North America suggest sediment can cause major reduction on stream water quality. Soil erosion patterns in forest watersheds are patchy and heterogeneous. Therefore, patterns of soil erosion are difficult to model and predict. The objective of this study is to develop a user friendly management tool for land...
Pay-for-performance in disease management: a systematic review of the literature.
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
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
NASA Astrophysics Data System (ADS)
Gronewold, A. D.; Wolpert, R. L.; Reckhow, K. H.
2007-12-01
Most probable number (MPN) and colony-forming-unit (CFU) are two estimates of fecal coliform bacteria concentration commonly used as measures of water quality in United States shellfish harvesting waters. The MPN is the maximum likelihood estimate (or MLE) of the true fecal coliform concentration based on counts of non-sterile tubes in serial dilution of a sample aliquot, indicating bacterial metabolic activity. The CFU is the MLE of the true fecal coliform concentration based on the number of bacteria colonies emerging on a growth plate after inoculation from a sample aliquot. Each estimating procedure has intrinsic variability and is subject to additional uncertainty arising from minor variations in experimental protocol. Several versions of each procedure (using different sized aliquots or different numbers of tubes, for example) are in common use, each with its own levels of probabilistic and experimental error and uncertainty. It has been observed empirically that the MPN procedure is more variable than the CFU procedure, and that MPN estimates are somewhat higher on average than CFU estimates, on split samples from the same water bodies. We construct a probabilistic model that provides a clear theoretical explanation for the observed variability in, and discrepancy between, MPN and CFU measurements. We then explore how this variability and uncertainty might propagate into shellfish harvesting area management decisions through a two-phased modeling strategy. First, we apply our probabilistic model in a simulation-based analysis of future water quality standard violation frequencies under alternative land use scenarios, such as those evaluated under guidelines of the total maximum daily load (TMDL) program. Second, we apply our model to water quality data from shellfish harvesting areas which at present are closed (either conditionally or permanently) to shellfishing, to determine if alternative laboratory analysis procedures might have led to different management decisions. Our research results indicate that the (often large) observed differences between MPN and CFU values for the same water body are well within the ranges predicted by our probabilistic model. Our research also indicates that the probability of violating current water quality guidelines at specified true fecal coliform concentrations depends on the laboratory procedure used. As a result, quality-based management decisions, such as opening or closing a shellfishing area, may also depend on the laboratory procedure used.
Linking the Scales of Scientific inquiry and Watershed Management: A Focus on Green Infrastructure
NASA Astrophysics Data System (ADS)
Golden, H. E.; Hoghooghi, N.
2017-12-01
Urbanization modifies the hydrologic cycle, resulting in potentially deleterious downstream water quality and quantity effects. However, the cumulative interacting effects of water storage, transport, and biogeochemical processes occurring within other land cover and use types of the same watershed can render management explicitly targeted to limit the negative outcomes from urbanization ineffective. For example, evidence indicates that green infrastructure, or low impact development (LID), practices can attenuate the adverse water quality and quantity effects of urbanizing systems. However, the research providing this evidence has been conducted at local scales (e.g., plots, small homogeneous urban catchments) that isolate the measurable effects of such approaches. Hence, a distinct disconnect exists between the scale of scientific inquiry and the scale of management and decision-making practices. Here we explore the oft-discussed yet rarely directly addressed scientific and management conundrum: How do we scale our well-documented scientific knowledge of the water quantity and quality responses to LID practices measured and modeled at local scales to that of "actual" management scales? We begin by focusing on LID practices in mixed land cover watersheds. We present key concepts that have emerged from LID research at the local scale, considerations for scaling this research to watersheds, recent advances and findings in scaling the effects of LID practices on water quality and quantity at watershed scales, and the use of combined novel measurements and models for these scaling efforts. We underscore these concepts with a case study that evaluates the effects of three LID practices using simulation modeling across a mixed land cover watershed. This synthesis and case study highlight that scientists are making progress toward successfully tailoring fundamental research questions with decision-making goals in mind, yet we still have a long road ahead.
Cramm, Jane Murray; Nieboer, Anna Petra
2012-11-01
Disease management programs based on the Chronic Care Model are expected to improve the quality of chronic care delivery. However, evidence to date for such improvement and how it is achieved is scarce. In 2010 and again in 2011, we surveyed professionals in twenty-two primary care practices in the Netherlands that had implemented the Chronic Care Model of disease management beginning in 2009. The responses showed that, over time, chronic illness care delivery improved to advanced levels. The gains were attributed primarily to improved relational coordination-that is, raising the quality of communication and task integration among professionals from diverse disciplines who share common objectives. These findings may have implications for other disease management efforts by collaborative care teams, in that they suggest that diverse health care professionals must be strongly connected to provide effective, holistic care.
Zajac, Zuzanna; Stith, Bradley M.; Bowling, Andrea C.; Langtimm, Catherine A.; Swain, Eric D.
2015-01-01
Habitat suitability index (HSI) models are commonly used to predict habitat quality and species distributions and are used to develop biological surveys, assess reserve and management priorities, and anticipate possible change under different management or climate change scenarios. Important management decisions may be based on model results, often without a clear understanding of the level of uncertainty associated with model outputs. We present an integrated methodology to assess the propagation of uncertainty from both inputs and structure of the HSI models on model outputs (uncertainty analysis: UA) and relative importance of uncertain model inputs and their interactions on the model output uncertainty (global sensitivity analysis: GSA). We illustrate the GSA/UA framework using simulated hydrology input data from a hydrodynamic model representing sea level changes and HSI models for two species of submerged aquatic vegetation (SAV) in southwest Everglades National Park: Vallisneria americana (tape grass) and Halodule wrightii (shoal grass). We found considerable spatial variation in uncertainty for both species, but distributions of HSI scores still allowed discrimination of sites with good versus poor conditions. Ranking of input parameter sensitivities also varied spatially for both species, with high habitat quality sites showing higher sensitivity to different parameters than low-quality sites. HSI models may be especially useful when species distribution data are unavailable, providing means of exploiting widely available environmental datasets to model past, current, and future habitat conditions. The GSA/UA approach provides a general method for better understanding HSI model dynamics, the spatial and temporal variation in uncertainties, and the parameters that contribute most to model uncertainty. Including an uncertainty and sensitivity analysis in modeling efforts as part of the decision-making framework will result in better-informed, more robust decisions.
Leadership and globalization: research in health management education.
West, Daniel J; Ramirez, Bernardo; Filerman, Gary
2012-01-01
The impact of globalization on graduate health care management education is evident, yet challenging to quantify. The Commission on Healthcare Management Education (CAHME) recently authorized two research studies to gather specific information and answer important questions about accredited graduate programs in the USA and Canada. Two surveys provided the most comprehensive data impacting international health management education efforts by 70 programs. An inventory was made of 22 countries; information was compiled on 21 accrediting or quality improvement organizations. Observations on leadership and the demand for qualified health care professionals is discussed in terms of accreditation, certification, competency models, outcome assessment, improving quality, and the impact of globalization on higher education.
Musekamp, Gunda; Bengel, Jürgen; Schuler, Michael; Faller, Hermann
2016-08-01
Self-management programs aim to improve patients' skills to manage their chronic condition in everyday life. Improvement in self-management is assumed to bring about improvements in more distal outcomes, such as quality of life. This study aimed to test the hypothesis that changes in self-reported self-management skills observed after participation in self-management programs predict changes in both quality of life and depressive symptoms three months later. Using latent change modeling, the relationship between changes in latent variables over three time points (start and end of rehabilitation, after three months) was analysed. The sample comprised 580 patients with different chronic conditions treated in inpatient rehabilitation clinics. The influence of additional predictor variables (age, sex, perceived social support) and type of disorder as a moderator variable was also tested. Changes in self-reported self-management skills after rehabilitation predicted changes in both quality of life and depressive symptoms at the end of rehabilitation and the 3 months follow-up. These relationships remained significant after the inclusion of other predictor variables and were similar across disorders. The findings provide support for the hypothesis that improvements in proximal outcomes of self-management programs may foster improvements in distal outcomes. Further studies should investigate treatment mechanisms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Perspectives on User Satisfaction Surveys.
ERIC Educational Resources Information Center
Cullen, Rowena
2001-01-01
Discusses academic libraries, digital environments, increasing competition, the relationship between service quality and user satisfaction, and user surveys. Describes the SERVQUAL model that measures service quality and user satisfaction in academic libraries; considers gaps between user expectations and managers' perceptions of user…
Reforming funding for chronic illness: Medicare-CDM.
Swerissen, Hal; Taylor, Michael J
2008-02-01
Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.
Klemenc-Ketis, Zalika; Poplas-Susič, Antonija
2017-12-01
To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients. We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements. © 2017 John Wiley & Sons Ltd.
Wang, Hongqing; Chen, Qin; Hu, Kelin; LaPeyre, Megan K.
2017-01-01
Freshwater and sediment management in estuaries affects water quality, particularly in deltaic estuaries. Furthermore, climate change-induced sea-level rise (SLR) and land subsidence also affect estuarine water quality by changing salinity, circulation, stratification, sedimentation, erosion, residence time, and other physical and ecological processes. However, little is known about how the magnitudes and spatial and temporal patterns in estuarine water quality variables will change in response to freshwater and sediment management in the context of future SLR. In this study, we applied the Delft3D model that couples hydrodynamics and water quality processes to examine the spatial and temporal variations of salinity, total suspended solids, and chlorophyll-α concentration in response to small (142 m3 s−1) and large (7080 m3 s−1) Mississippi River (MR) diversions under low (0.38 m) and high (1.44 m) relative SLR (RSLR = eustatic SLR + subsidence) scenarios in the Breton Sound Estuary, Louisiana, USA. The hydrodynamics and water quality model were calibrated and validated via field observations at multiple stations across the estuary. Model results indicate that the large MR diversion would significantly affect the magnitude and spatial and temporal patterns of the studied water quality variables across the entire estuary, whereas the small diversion tends to influence water quality only in small areas near the diversion. RSLR would also play a significant role on the spatial heterogeneity in estuary water quality by acting as an opposite force to river diversions; however, RSLR plays a greater role than the small-scale diversion on the magnitude and spatial pattern of the water quality parameters in this deltaic estuary.
NASA Astrophysics Data System (ADS)
Gidey, Amanuel
2018-06-01
Determining suitability and vulnerability of groundwater quality for irrigation use is a key alarm and first aid for careful management of groundwater resources to diminish the impacts on irrigation. This study was conducted to determine the overall suitability of groundwater quality for irrigation use and to generate their spatial distribution maps in Elala catchment, Northern Ethiopia. Thirty-nine groundwater samples were collected to analyze and map the water quality variables. Atomic absorption spectrophotometer, ultraviolet spectrophotometer, titration and calculation methods were used for laboratory groundwater quality analysis. Arc GIS, geospatial analysis tools, semivariogram model types and interpolation methods were used to generate geospatial distribution maps. Twelve and eight water quality variables were used to produce weighted overlay and irrigation water quality index models, respectively. Root-mean-square error, mean square error, absolute square error, mean error, root-mean-square standardized error, measured values versus predicted values were used for cross-validation. The overall weighted overlay model result showed that 146 km2 areas are highly suitable, 135 km2 moderately suitable and 60 km2 area unsuitable for irrigation use. The result of irrigation water quality index confirms 10.26% with no restriction, 23.08% with low restriction, 20.51% with moderate restriction, 15.38% with high restriction and 30.76% with the severe restriction for irrigation use. GIS and irrigation water quality index are better methods for irrigation water resources management to achieve a full yield irrigation production to improve food security and to sustain it for a long period, to avoid the possibility of increasing environmental problems for the future generation.
Quality Leadership and the Professional School Counselor.
ERIC Educational Resources Information Center
Burgess, David G., Ed; Dedmond, Rebecca M., Ed.
Schools are not what they used to be because our society is not what it used to be. The articles appearing here discuss ways that schools can supply future societal need. The articles include: (1) "The Educational Quality Improvement Process Model" (David G. Burgess); (2) "Total Quality Management: How It Works in Schools"…
ERIC Educational Resources Information Center
Azkiyah, Siti Nurul; Mukminin, Amirul
2017-01-01
This study was intended to investigate the teaching quality of student teachers when they conducted their teaching practicum. Teaching quality is conceptualised based on eight classroom factors (orientation, structuring, modelling, application, questioning, building classroom as a learning environment, assessment, and time management) of the…
Eley, Diann S; Patterson, Elizabeth; Young, Jacqui; Fahey, Paul P; Del Mar, Chris B; Hegney, Desley G; Synnott, Robyn L; Mahomed, Rosemary; Baker, Peter G; Scuffham, Paul A
2013-01-01
The Australian government's commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model's feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients' stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.
NASA Astrophysics Data System (ADS)
Lerner, R. N.; Lerner, D. N.; Surridge, B.; Paetzold, A.; Harris, B.; Anderson, C. W.
2005-12-01
In Europe, the Water Framework Directive (WFD) is providing a powerful regulatory driver to adopt integrated catchment management, and so pressurizing researchers to build suitable supporting tools. The WFD requires agencies to drive towards `good ecological quality' by 2015. After the initial step of characterising water bodies and the pressures on them, the next substantive step is the preparation of river basin management plans and proposed programmes of measures by 2009. Ecological quality is a complex concept and poorly defined, unless it is taken as a simple measure such as the abundance of a particular species of organism. There is clearly substantial work to do to build a practical but sound definition of ecological quality; practical in the sense of being easy to measure and explain to stakeholders, and sound in the sense that it reflects ecological complexity within catchments, the variability between catchments, and the conflicts demands for goods and services that human society places upon the ecological system. However ecological quality is defined, it will be driven by four interacting groups of factors. These represent the physical, chemical, ecological and socio-economic environments within and encompassing the catchment. Some of these groupings are better understood than others, for example hydrological processes and the transport of solutes are reasonably understood, even though they remain research areas in their own right. There are much larger gaps in our understanding at the interfaces, i.e. predicting how, for example, hydrological processes such as flow and river morphology influence ecological quality. Overall, it is clear we are not yet in a position to build deterministic models of the overall ecological behaviour of catchment. But we need predictive tools to support catchment management agencies in preparing robust plans. This poster describes our current exploration of soft modelling options to build a comprehensive macro-ecological model of UK catchments. This is taking place within the Catchment Science Centre, a joint venture between the University of Sheffield and the Environment Agency.
Using management information systems to enhance health care quality assurance.
Rosser, L H; Kleiner, B H
1995-01-01
Examines how computers and quality assurance are being used to improve the quality of health care delivery. Traditional quality assurance methods have been limited in their ability to effectively manage the high volume of data generated by the health care process. Computers on the other hand are able to handle large volumes of data as well as monitor patient care activities in both the acute care and ambulatory care settings. Discusses the use of computers to collect and analyse patient data so that changes and problems can be identified. In addition, computer models for reminding physicians to order appropriate preventive health measures for their patients are presented. Concludes that the use of computers to augment quality improvement is essential if the quality of patient care and health promotion are to be improved.
[Recommendations for the control of documents and the establishment of a documentary system].
Vinner, E
2013-06-01
The quality management system that must be implemented in a MBL to meet the requirements of the standard NF EN ISO 15189 is based, among other things, on the creation and use by staff of a documentary system approved and updated. This documentary system is constituted by external documents (standards, suppliers' documents...) and internal documents (quality manual, procedures, instructions, technical and quality recordings...). A procedure of the documentary system control must be formalized. The documentary system should be modeled in order to identify the various procedures to be drafted and the incurred risks in the case a document would be missing in this system. Each document must be indexed in a unique way and document management must be carried out rigorously. The use of document management software is a great help to manage the life cycle of documents.
The 3D Elevation Program: summary for Wisconsin
Carswell, William J.
2013-01-01
Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Wisconsin, elevation data are critical for agriculture and precision farming, natural resources conservation, flood risk management, infrastructure and construction management, water supply and quality, and other business uses. Today, high-quality light detection and ranging (lidar) data are the sources for creating elevation models and other elevation datasets. Federal, State, and local agencies work in partnership to (1) replace data, on a national basis, that are (on average) 30 years old and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data. The new 3D Elevation Program (3DEP) initiative, managed by the U.S. Geological Survey (USGS), responds to the growing need for high-quality topographic data and a wide range of other three-dimensional representations of the Nation’s natural and constructed features.
Collaborating for care: initial experience of embedded case managers across five medical homes.
Treadwell, Janet; Giardino, Angelo
2014-01-01
The purpose of this intervention was to answer the following question: Does an embedded nurse case manager from a health plan performing embedded care coordination and supporting a quality improvement project impact medical home service use, role satisfaction, and per member per month expense? The setting for this study was primary care medical home practices with a minimum of 1,000 lives, contracted with a health plan delivering Medicaid and Children's Health Insurance coverage. Five medical home practice sites were selected for the intervention. The study began with case manager training and project permission in 5 medical homes, followed by implementation of care coordination with health plan clients. The nurse case manager performed care coordination functions for clients and initiated a Lean Six Sigma quality improvement project at the medical home site. The analysis strategy was to compare each medical home with itself before and after the intervention, as well as to obtain satisfaction information from medical home staff and care coordinators. Reductions in expense, as demonstrated by decreased per member per month claim cost, admissions per thousand, and reduced variation in days per thousand, were documented. Quality projects attained significant improvements in 4 out of 5 sites, and practice staff as well as case managers described satisfaction with the embedded nurse case manager role. These findings support medical homes as being an effective delivery model of the Affordable Care Act. Case managers who practice in primary care sites can make a significant difference in patient outcomes and practice efficiencies. Embedded case managers have the ability to impact the population being served through modeling and supporting interprofessional relationships and case management expertise. Use of motivational interviewing, assessment skills, advocacy, and joint care planning engage patients in their own care, whereas quality initiatives bring efficiencies and effectiveness to overall operations. There is need for research to be conducted across a larger number of practice sites and diverse populations to substantiate the effect of embedded case management in medical home.
Next level of board accountability in health care quality.
Pronovost, Peter J; Armstrong, C Michael; Demski, Renee; Peterson, Ronald R; Rothman, Paul B
2018-03-19
Purpose The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety. Design/methodology/approach Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes. Findings The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model. Originality/value This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors' knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.
National strategic plan: modeling and data systems for wildland fire and air quality.
David V. Sandberg; Colin C. Hardy; Roger D. Ottmar; J.A. Kendall Snell; Ann Acheson; Janice L. Peterson; Paula Seamon; Peter Lahm; Dale Wade
1999-01-01
This strategic plan is a technical discussion of the implementation and development of models and data systems used to manage the air quality impacts of wildland and prescribed fires. Strategies and priorities in the plan were generated by the Express Team (chartered by the National Wildfire Coordinating Group) and a diverse group of 86 subject matter experts who...
USDA-ARS?s Scientific Manuscript database
Sunflower and soybean are summer annuals that can be grown as an alternative to corn and may be particularly useful in organic production systems. Rapid and low cost methods of analyzing plant quality would be helpful for crop management. We developed and validated calibration models for Near-infrar...
Grayson, Richard; Kay, Paul; Foulger, Miles
2008-01-01
Diffuse pollution poses a threat to water quality and results in the need for treatment for potable water supplies which can prove costly. Within the Yorkshire region, UK, nitrates, pesticides and water colour present particular treatment problems. Catchment management techniques offer an alternative to 'end of pipe' solutions and allow resources to be targeted to the most polluting areas. This project has attempted to identify such areas using GIS based modelling approaches in catchments where water quality data were available. As no model exists to predict water colour a model was created using an MCE method which is capable of predicting colour concentrations at the catchment scale. CatchIS was used to predict pesticide and nitrate N concentrations and was found to be generally capable of reliably predicting nitrate N loads at the catchment scale. The pesticides results did not match the historic data possibly due to problems with the historic pesticide data and temporal and spatially variability in pesticide usage. The use of these models can be extended to predict water quality problems in catchments where water quality data are unavailable and highlight areas of concern. IWA Publishing 2008.
A framework for modeling contaminant impacts on reservoir water quality
NASA Astrophysics Data System (ADS)
Jeznach, Lillian C.; Jones, Christina; Matthews, Thomas; Tobiason, John E.; Ahlfeld, David P.
2016-06-01
This study presents a framework for using hydrodynamic and water quality models to understand the fate and transport of potential contaminants in a reservoir and to develop appropriate emergency response and remedial actions. In the event of an emergency situation, prior detailed modeling efforts and scenario evaluations allow for an understanding of contaminant plume behavior, including maximum concentrations that could occur at the drinking water intake and contaminant travel time to the intake. A case study assessment of the Wachusett Reservoir, a major drinking water supply for metropolitan Boston, MA, provides an example of an application of the framework and how hydrodynamic and water quality models can be used to quantitatively and scientifically guide management in response to varieties of contaminant scenarios. The model CE-QUAL-W2 was used to investigate the water quality impacts of several hypothetical contaminant scenarios, including hypothetical fecal coliform input from a sewage overflow as well as an accidental railway spill of ammonium nitrate. Scenarios investigated the impacts of decay rates, season, and inter-reservoir transfers on contaminant arrival times and concentrations at the drinking water intake. The modeling study highlights the importance of a rapid operational response by managers to contain a contaminant spill in order to minimize the mass of contaminant that enters the water column, based on modeled reservoir hydrodynamics. The development and use of hydrodynamic and water quality models for surface drinking water sources subject to the potential for contaminant entry can provide valuable guidance for making decisions about emergency response and remediation actions.
Using a Content Management System for Integrated Water Quantity, Quality and Instream Flows Modeling
NASA Astrophysics Data System (ADS)
Burgholzer, R.; Brogan, C. O.; Scott, D.; Keys, T.
2017-12-01
With increased population and water demand, in-stream flows can become depleted by consumptive uses and dilution of permitted discharges may be compromised. Reduced flows downstream of water withdrawals may increase the violation rate of bacterial concentrations from direct deposition by livestock and wildlife. Water storage reservoirs are constructed and operated to insure more stable supplies for consumptive demands and dilution flows, however their use comes at the cost of increased evaporative losses, potential for thermal pollution, interrupted fish migration, and reduced flooding events that are critical to maintain habitat and water quality. Due to this complex interrelationship between water quantity, quality and instream habitat comprehensive multi-disciplinary models must be developed to insure long-term sustainability of water resources and to avoid conflicts between drinking water, food and energy production, and aquatic biota. The Commonwealth of Virginia funded the expansion of the Chesapeake Bay Program Phase 5 model to cover the entire state, and has been using this model to evaluate water supply permit and planning since 2009. This integrated modeling system combines a content management system (Drupal and PHP) for model input data and leverages the modularity of HSPF with the custom segmentation and parameterization routines programmed by modelers working with the Chesapeake Bay Program. The model has been applied to over 30 Virginia Water Permits, instream flows and aquatic habitat models and a Virginias 30 year water supply demand projections. Future versions will leverage the Bay Model auto-calibration routines for adding small-scale water supply and TMDL models, utilize climate change scenarios, and integrate Virginia's reservoir management modules into the Chesapeake Bay watershed model, feeding projected demand and operational changes back up to EPA models to improve the realism of future Bay-wide simulations.
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.
NASA Astrophysics Data System (ADS)
Pinder, R. W.; Akhtar, F.; Loughlin, D. H.; Henze, D. K.; Bowman, K. W.
2012-12-01
Poor air quality, ecosystem damages, and climate change all are caused by the combustion of fossil fuels, yet environmental management often addresses each of these challenges separately. This can lead to sub-optimal strategies and unintended consequences. Here we present GLIMPSE -- a decision support tool for simultaneously achieving our air quality and climate change mitigation goals. GLIMPSE comprises of two types of models, (i) the adjoint of the GEOS-Chem chemical transport model, to calculate the relationship between emissions and impacts at high spatial resolution, and (ii) the MARKAL energy system model, to calculate the relationship between energy technologies and emissions. This presentation will demonstrate how GLIMPSE can be used to explore energy scenarios to better achieve both improved air quality and mitigate climate change. Second, this presentation will discuss how space-based observations can be incorporated into GLIMPSE to improve decision-making. NASA satellite products, namely ozone radiative forcing from the Tropospheric Emission Spectrometer (TES), are used to extend GLIMPSE to include the impact of emissions on ozone radiative forcing. This provides a much needed observational constraint on ozone radiative forcing.
Nursing leadership and management effects work environments.
Tomey, Ann Marriner
2009-01-01
The aim of this literature search was to identify recent research related to nursing leadership and management effects on work environment using the 14 forces of magnetism. This article gives some historical perspective from the original 1983 American Academy of Nursing study through to the 2002 McClure and Hinshaw update to 2009 publications. Research publications were given a priority for references. The 14 forces of magnetism as identified by Unden and Monarch were: '1. Quality of leadership..., 2. Organizational structure..., 3. Management style..., 4. Personnel policies and programs..., 5. Professional models of care..., 6. Quality of care..., 7 Quality improvement..., 8. Consultation and resources..., 9. Autonomy..., 10. Community and the hospital..., 11. Nurse as teacher..., 12. Image of nursing..., 13. Interdisciplinary relationships... and 14. Professional development....'. Correlations have been found among positive workplace management initiatives, style of transformational leadership and participative management; patient-to-nurse ratios; education levels of nurses; quality of patient care, patient satisfaction, employee health and well-being programmes; nurse satisfaction and retention of nurses; healthy workplace environments and healthy patients and personnel. This article identifies some of the research that provides evidence for evidence-based nursing management and leadership practice.
Food quality, effects on health and sustainability today: a model case report.
Borroni, Vittorio Natale; Fargion, Silvia; Mazzocchi, Alessandra; Giachetti, Marco; Lanzarini, Achille; Dall'Asta, Margherita; Scazzina, Francesca; Agostoni, Carlo
2017-02-01
The Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico is a five-century institution that, besides the unique clinical role in the center of Milan, may rely on benefactor donations such as fields and farming houses not far from the city, for a total of 8500 ha, all managed by the "Sviluppo Ca' Granda' Foundation". Presently, the main products of these fields are represented by rice and cow's milk. During the latest years, farmers and managers have developed a model of sustainable food production, with great attention to the product quality based on compositional analysis and functional nutritional characteristics. This experience represents a new holistic model of food production and consumption, taking great care of both sustainability and health.
U.S. EPA's Watershed Management Research Activities
Watershed and stormwater managers need modeling tools to evaluate alternative plans for environmental quality restoration and protection needs in urban and developing areas. A watershed-scale decision-support system, based on cost optimization, provides an essential tool to suppo...
EPA'S WATERSHED MANAGEMENT AND MODELING RESEARCH PROGRAM
Watershed management presumes that community groups can best solve many water quality and ecosystem problems at the watershed level rather than at the individual site, receiving waterbody, or discharger level. After assessing and ranking watershed problems, and setting environ...
Management of groundwater supply and water quality in the Los Angeles Basin, California
Reichard, E.G.; Crawford, S.M.; Land, M.T.; Paybins, K.S.
1999-01-01
Water use and water needs in the coastal Los Angeles Basin in California have been very closely tied to the development of the region during the last 150 years. The first water wells were drilled in the mid-1800s. Currently about 40% of the water supply (9.4 m3 s-1) in the region is provided by groundwater. Other sources of water supply include reclaimed water and surface water imported from Owens Valley, the Colorado River, and northern California. Increasing groundwater use in the basin led to over-abstraction and seawater instrusion. Because of this, an important component of water management in the area has been the artificial recharge of local, imported, and reclaimed water which is spread in ponds and injected in wells to recharge the aquifer system and control seawater intrusion. The US Geological Survey (USGS) is working co-operatively with the Water Replenishment District of Southern California to evaluate the hydraulic and water-quality effects of these recharge operations and to assess the potential impacts of alternative water-management strategies, including changes in pumping and increases in the use of reclaimed water. As part of this work, the USGS has developed a geographic information system (GIS), collected water-quality and geohydrological data from new and existing wells, and developed a multi-aquifer regional groundwater flow model. Chemical and isotopic data were used to identify the age and source of recharge to groundwater throughout the study area. This information is key to understanding the fate of artificially recharged water and helps define the three-dimensional groundwater flow system. The geohydrological data, especially the geophysical and geological data collected from 11 newly installed multi-completion monitoring wells, were used to redefine the regional hydrostratigraphy. The groundwater flow model is being used to enhance the understanding of the geohydrological system and to quantitatively evaluate new water-management strategies.As part of the work aimed at evaluating the hydraulic and water-quality effects of recharge operations and to assess the potential impacts of alternative water-management strategies, the US Geological Survey (USGS), has developed a geographic information system (GIS), collected water-quality and geohydrological data from new and existing wells, and developed a multi-aquifer regional groundwater flow model. At present, the developed model is being used to enhance the understanding of the geohydrological system and to quantitatively evaluate new water-management strategies.
NASA Astrophysics Data System (ADS)
Adams, R.; Quinn, P. F.; Bowes, M. J.
2014-09-01
A model for simulating runoff pathways and water quality fluxes has been developed using the Minimum Information (MIR) approach. The model, the Catchment Runoff Attenuation Tool (CRAFT) is applicable to meso-scale catchments which focusses primarily on hydrological pathways that mobilise nutrients. Hence CRAFT can be used investigate the impact of management intervention strategies designed to reduce the loads of nutrients into receiving watercourses. The model can help policy makers, for example in Europe, meet water quality targets and consider methods to obtain "good" ecological status. A case study of the 414 km2 Frome catchment, Dorset UK, has been described here as an application of the CRAFT model. The model was primarily calibrated on ten years of weekly data to reproduce the observed flows and nutrient (nitrate nitrogen - N - and phosphorus - P) concentrations. Also data from two years of sub-daily high resolution monitoring at the same site were also analysed. These data highlighted some additional signals in the nutrient flux, particularly of soluble reactive phosphorus, which were not observable in the weekly data. This analysis has prompted the choice of using a daily timestep for this meso-scale modelling study as the minimum information requirement. A management intervention scenario was also run to show how the model can support catchment managers to investigate how reducing the concentrations of N and P in the various flow pathways. This scale appropriate modelling tool can help policy makers consider a range of strategies to to meet the European Union (EU) water quality targets for this type of catchment.
Utility of distributed hydrologic and water quality models for watershed management and sustainability studies should be accompanied by rigorous model uncertainty analysis. However, the use of complex watershed models primarily follows the traditional {calibrate/validate/predict}...
SUSTAIN - A BMP PROCESS AND PLACEMENT TOOL FOR URBAN WATERSHEDS
Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads (...
Multiple Watershed Scales Approach for Placement of BMPs in SUSTAIN
Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads ...
SUSTAIN - A BMP PROCESS AND PLACEMENT TOOL FOR URBAN WATERSHEDS
Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads ...
SWMM 5 REDEVELOPMENT QUALITY ASSURANCE PROGRAM
EPA recently released a new version of the Storm Water Management Model (SWMM) that combines a new interface with a completely re-written computational engine. The SWMM redevelopment project proceeded under a Quality Assurance Project Plan (QAPP) that describes methods and proced...
Tangen, Brian A.; Gleason, Robert A.; Stamm, John F.
2013-01-01
Many wetland impoundments managed by the U.S. Fish and Wildlife Service (USFWS) National Wildlife Refuge System throughout the northern Great Plains rely on rivers as a primary water source. A large number of these impoundments currently are being stressed from changes in water supplies and quality, and these problems are forecast to worsen because of projected changes to climate and land use. For example, many managed wetlands in arid regions have become degraded owing to the long-term accumulation of salts and increased salinity associated with evapotranspiration. A primary goal of the USFWS is to provide aquatic habitats for a diversity of waterbirds; thus, wetland managers would benefit from a tool that facilitates evaluation of wetland habitat quality in response to current and anticipated impacts of altered hydrology and salt balances caused by factors such as climate change, water availability, and management actions. A spreadsheet model that simulates the overall water and salinity balance (WSB model) of managed wetland impoundments is presented. The WSB model depicts various habitat metrics, such as water depth, salinity, and surface areas (inundated, dry), which can be used to evaluate alternative management actions under various water-availability and climate scenarios. The WSB model uses widely available spreadsheet software, is relatively simple to use, relies on widely available inputs, and is readily adaptable to specific locations. The WSB model was validated using data from three National Wildlife Refuges with direct and indirect connections to water resources associated with rivers, and common data limitations are highlighted. The WSB model also was used to conduct simulations based on hypothetical climate and management scenarios to demonstrate the utility of the model for evaluating alternative management strategies and climate futures. The WSB model worked well across a range of National Wildlife Refuges and could be a valuable tool for USFWS staff when evaluating system state and management alternatives and establishing long-term goals and objectives.
Assessment of reservoir system variable forecasts
NASA Astrophysics Data System (ADS)
Kistenmacher, Martin; Georgakakos, Aris P.
2015-05-01
Forecast ensembles are a convenient means to model water resources uncertainties and to inform planning and management processes. For multipurpose reservoir systems, forecast types include (i) forecasts of upcoming inflows and (ii) forecasts of system variables and outputs such as reservoir levels, releases, flood damage risks, hydropower production, water supply withdrawals, water quality conditions, navigation opportunities, and environmental flows, among others. Forecasts of system variables and outputs are conditional on forecasted inflows as well as on specific management policies and can provide useful information for decision-making processes. Unlike inflow forecasts (in ensemble or other forms), which have been the subject of many previous studies, reservoir system variable and output forecasts are not formally assessed in water resources management theory or practice. This article addresses this gap and develops methods to rectify potential reservoir system forecast inconsistencies and improve the quality of management-relevant information provided to stakeholders and managers. The overarching conclusion is that system variable and output forecast consistency is critical for robust reservoir management and needs to be routinely assessed for any management model used to inform planning and management processes. The above are demonstrated through an application from the Sacramento-American-San Joaquin reservoir system in northern California.
NASA Astrophysics Data System (ADS)
Leibovici, D. G.; Pourabdollah, A.; Jackson, M.
2011-12-01
Experts and decision-makers use or develop models to monitor global and local changes of the environment. Their activities require the combination of data and processing services in a flow of operations and spatial data computations: a geospatial scientific workflow. The seamless ability to generate, re-use and modify a geospatial scientific workflow is an important requirement but the quality of outcomes is equally much important [1]. Metadata information attached to the data and processes, and particularly their quality, is essential to assess the reliability of the scientific model that represents a workflow [2]. Managing tools, dealing with qualitative and quantitative metadata measures of the quality associated with a workflow, are, therefore, required for the modellers. To ensure interoperability, ISO and OGC standards [3] are to be adopted, allowing for example one to define metadata profiles and to retrieve them via web service interfaces. However these standards need a few extensions when looking at workflows, particularly in the context of geoprocesses metadata. We propose to fill this gap (i) at first through the provision of a metadata profile for the quality of processes, and (ii) through providing a framework, based on XPDL [4], to manage the quality information. Web Processing Services are used to implement a range of metadata analyses on the workflow in order to evaluate and present quality information at different levels of the workflow. This generates the metadata quality, stored in the XPDL file. The focus is (a) on the visual representations of the quality, summarizing the retrieved quality information either from the standardized metadata profiles of the components or from non-standard quality information e.g., Web 2.0 information, and (b) on the estimated qualities of the outputs derived from meta-propagation of uncertainties (a principle that we have introduced [5]). An a priori validation of the future decision-making supported by the outputs of the workflow once run, is then provided using the meta-propagated qualities, obtained without running the workflow [6], together with the visualization pointing out the need to improve the workflow with better data or better processes on the workflow graph itself. [1] Leibovici, DG, Hobona, G Stock, K Jackson, M (2009) Qualifying geospatial workfow models for adaptive controlled validity and accuracy. In: IEEE 17th GeoInformatics, 1-5 [2] Leibovici, DG, Pourabdollah, A (2010a) Workflow Uncertainty using a Metamodel Framework and Metadata for Data and Processes. OGC TC/PC Meetings, September 2010, Toulouse, France [3] OGC (2011) www.opengeospatial.org [4] XPDL (2008) Workflow Process Definition Interface - XML Process Definition Language.Workflow Management Coalition, Document WfMC-TC-1025, 2008 [5] Leibovici, DG Pourabdollah, A Jackson, M (2011) Meta-propagation of Uncertainties for Scientific Workflow Management in Interoperable Spatial Data Infrastructures. In: Proceedings of the European Geosciences Union (EGU2011), April 2011, Austria [6] Pourabdollah, A Leibovici, DG Jackson, M (2011) MetaPunT: an Open Source tool for Meta-Propagation of uncerTainties in Geospatial Processing. In: Proceedings of OSGIS2011, June 2011, Nottingham, UK
Modeling water quality in an urban river using hydrological factors--data driven approaches.
Chang, Fi-John; Tsai, Yu-Hsuan; Chen, Pin-An; Coynel, Alexandra; Vachaud, Georges
2015-03-15
Contrasting seasonal variations occur in river flow and water quality as a result of short duration, severe intensity storms and typhoons in Taiwan. Sudden changes in river flow caused by impending extreme events may impose serious degradation on river water quality and fateful impacts on ecosystems. Water quality is measured in a monthly/quarterly scale, and therefore an estimation of water quality in a daily scale would be of good help for timely river pollution management. This study proposes a systematic analysis scheme (SAS) to assess the spatio-temporal interrelation of water quality in an urban river and construct water quality estimation models using two static and one dynamic artificial neural networks (ANNs) coupled with the Gamma test (GT) based on water quality, hydrological and economic data. The Dahan River basin in Taiwan is the study area. Ammonia nitrogen (NH3-N) is considered as the representative parameter, a correlative indicator in judging the contamination level over the study. Key factors the most closely related to the representative parameter (NH3-N) are extracted by the Gamma test for modeling NH3-N concentration, and as a result, four hydrological factors (discharge, days w/o discharge, water temperature and rainfall) are identified as model inputs. The modeling results demonstrate that the nonlinear autoregressive with exogenous input (NARX) network furnished with recurrent connections can accurately estimate NH3-N concentration with a very high coefficient of efficiency value (0.926) and a low RMSE value (0.386 mg/l). Besides, the NARX network can suitably catch peak values that mainly occur in dry periods (September-April in the study area), which is particularly important to water pollution treatment. The proposed SAS suggests a promising approach to reliably modeling the spatio-temporal NH3-N concentration based solely on hydrological data, without using water quality sampling data. It is worth noticing that such estimation can be made in a much shorter time interval of interest (span from a monthly scale to a daily scale) because hydrological data are long-term collected in a daily scale. The proposed SAS favorably makes NH3-N concentration estimation much easier (with only hydrological field sampling) and more efficient (in shorter time intervals), which can substantially help river managers interpret and estimate water quality responses to natural and/or manmade pollution in a more effective and timely way for river pollution management. Copyright © 2014 Elsevier Ltd. All rights reserved.
Highway Air Pollution Dispersion Modeling : Preliminary Evaluation of Thirteen Models
DOT National Transportation Integrated Search
1978-06-01
Thirteen highway air pollution dispersion models have been tested, using a portion of the Airedale air quality data base. The Transportation Air Pollution Studies (TAPS) System, a data base management system specifically designed for evaluating dispe...
Highway Air Pollution Dispersion Modeling : Preliminary Evaluation of Thirteen Models
DOT National Transportation Integrated Search
1977-01-01
Thirteen highway air pollution dispersion models have been tested, using a portion of the Airedale air quality data base. The Transportation Air Pollution Studies (TAPS) System, a data base management system specifically designed for evaluating dispe...
Modeling Best Management Practices (BMPs) with HSPF
The Hydrological Simulation Program-Fortran (HSPF) is a semi-distributed watershed model, which simulates hydrology and water quality processes at user-specified spatial and temporal scales. Although HSPF is a comprehensive and highly flexible model, a number of investigators not...
The $500 Million Question: Can Charter Management Organizations Deliver Quality Education at Scale?
ERIC Educational Resources Information Center
Hall, Kevin; Lake, Robin
2011-01-01
Charter school management organizations (CMOs) have emerged as a popular means for bringing charter schooling to scale. Advocates credit CMOs with delivering a coherent model of charter schooling to a growing number of children across numerous sites. Skeptics have wondered whether CMOs constitute an effective management approach, whether they…
Laboratory Management Institute: A Model for the Professional Development of Scientists
ERIC Educational Resources Information Center
Galland, John C.; McCutcheon, Jade R.; Chronister, Lynne U.
2008-01-01
The Laboratory Management Institute (LMI) at the University of California, Davis (UC Davis) was an experiment designed to enhance the leadership and management skills of researchers and thereby enhance the overall quality of the academic research enterprise. The educational programs that resulted provide examples of how research administrators can…
The Healthy Learner Model for Student Chronic Condition Management--Part II: The Asthma Initiative
ERIC Educational Resources Information Center
Erickson, Cecelia DuPlessis; Splett, Patricia L.; Mullett, Sara Stoltzfus; Jensen, Charlotte; Belseth, Stephanie Bisson
2006-01-01
The Healthy Learner Asthma Initiative (HLAI) was designed as a comprehensive, school-community initiative to improve asthma management and produce healthy learners. National asthma guidelines were translated into components of asthma management in the school setting that defined performance expectations and lead to greater quality and consistency…
Assessing public concern for landscape quality: a potential model to identify visual thresholds
Arthur W. Magill
1990-01-01
Considerable public criticism and sometimes legal obstructions have been directed toward landscape management in relation to the extraction of natural resources. Many managers do not understand public concerns for visually attractive resources. Managers need to know when landscape alterations, like clearcuts, attract public attention and become visually objectionable....
Learning to Swim Using Video Modelling and Video Feedback within a Self-Management Program
ERIC Educational Resources Information Center
Lao, So-An; Furlonger, Brett E.; Moore, Dennis W.; Busacca, Margherita
2016-01-01
Although many adults who cannot swim are primarily interested in learning by direct coaching there are options that have a focus on self-directed learning. As an alternative a self-management program combined with video modelling, video feedback and high quality and affordable video technology was used to assess its effectiveness to assisting an…
patches to cycle from sink to source status and back.Objective: Through a combination of field studies and state-of-the-art quantitative models, we...landscapes with dynamic changes in habitat quality due to management. We also validated our general approach by comparing patterns in our focal species to general, cross-taxa, patterns.
Benjamin Wang; Robert E. Manning; Steven R. Lawson; William A. Valliere
2001-01-01
Recent research and management experience has led to several frameworks for defining and managing carrying capacity of national parks and related areas. These frameworks rely on monitoring indicator variables to ensure that standards of quality are maintained. The objective of this study was to develop a computer simulation model to estimate the relationships between...
NASA Astrophysics Data System (ADS)
Alizadeh, Mohammad Reza; Nikoo, Mohammad Reza; Rakhshandehroo, Gholam Reza
2017-08-01
Sustainable management of water resources necessitates close attention to social, economic and environmental aspects such as water quality and quantity concerns and potential conflicts. This study presents a new fuzzy-based multi-objective compromise methodology to determine the socio-optimal and sustainable policies for hydro-environmental management of groundwater resources, which simultaneously considers the conflicts and negotiation of involved stakeholders, uncertainties in decision makers' preferences, existing uncertainties in the groundwater parameters and groundwater quality and quantity issues. The fuzzy multi-objective simulation-optimization model is developed based on qualitative and quantitative groundwater simulation model (MODFLOW and MT3D), multi-objective optimization model (NSGA-II), Monte Carlo analysis and Fuzzy Transformation Method (FTM). Best compromise solutions (best management policies) on trade-off curves are determined using four different Fuzzy Social Choice (FSC) methods. Finally, a unanimity fallback bargaining method is utilized to suggest the most preferred FSC method. Kavar-Maharloo aquifer system in Fars, Iran, as a typical multi-stakeholder multi-objective real-world problem is considered to verify the proposed methodology. Results showed an effective performance of the framework for determining the most sustainable allocation policy in groundwater resource management.
2013-01-01
In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Specialized nurses with an autonomous role in patient care had comparable outcomes to physicians alone (Model 1) based on moderate quality evidence, with consistent results among a subgroup analysis of patients with diabetes based on low quality evidence. Model 2 showed an overall improvement in appropriate process measures, disease-specific measures, and patient satisfaction based on low to moderate quality evidence. There was low quality evidence that nurses working under Model 2 may reduce hospitalizations for patients with coronary artery disease. The specific role of the nurse in supplementing or substituting physician care was unclear, making it difficult to determine the impact on efficiency. Nurses with additional skills, training, or scope of practice may help improve the primary care of patients with chronic diseases. This review found that specialized nurses working on their own could achieve health outcomes that were similar to those of doctors. It also found that specialized nurses who worked with doctors could reduce hospital visits and improve certain patient outcomes related to diabetes, coronary artery disease, or heart failure. Patients who had nurse-led care were more satisfied and tended to receive more tests and medications. It is unclear whether specialized nurses improve quality of life or doctor workload.
NASA Astrophysics Data System (ADS)
Lee, Yu-Cheng; Yen, Tieh-Min; Tsai, Chih-Hung
This study provides an integrated model of Supplier Quality Performance Assesment (SQPA) activity for the semiconductor industry through introducing the ISO 9001 management framework, Importance-Performance Analysis (IPA) Supplier Quality Performance Assesment and Taguchi`s Signal-to-Noise Ratio (S/N) techniques. This integrated model provides a SQPA methodology to create value for all members under mutual cooperation and trust in the supply chain. This method helps organizations build a complete SQPA framework, linking organizational objectives and SQPA activities to optimize rating techniques to promote supplier quality improvement. The techniques used in SQPA activities are easily understood. A case involving a design house is illustrated to show our model.
Operator agency in process intervention: tampering versus application of tacit knowledge
NASA Astrophysics Data System (ADS)
Van Gestel, P.; Pons, D. J.; Pulakanam, V.
2015-09-01
Statistical process control (SPC) theory takes a negative view of adjustment of process settings, which is termed tampering. In contrast, quality and lean programmes actively encourage operators to acts of intervention and personal agency in the improvement of production outcomes. This creates a conflict that requires operator judgement: How does one differentiate between unnecessary tampering and needful intervention? Also, difficult is that operators apply tacit knowledge to such judgements. There is a need to determine where in a given production process the operators are applying tacit knowledge, and whether this is hindering or aiding quality outcomes. The work involved the conjoint application of systems engineering, statistics, and knowledge management principles, in the context of a case study. Systems engineering was used to create a functional model of a real plant. Actual plant data were analysed with the statistical methods of ANOVA, feature selection, and link analysis. This identified the variables to which the output quality was most sensitive. These key variables were mapped back to the functional model. Fieldwork was then directed to those areas to prospect for operator judgement activities. A natural conversational approach was used to determine where and how operators were applying judgement. This contrasts to the interrogative approach of conventional knowledge management. Data are presented for a case study of a meat rendering plant. The results identify specific areas where operators' tacit knowledge and mental model contribute to quality outcomes and untangles the motivations behind their agency. Also evident is how novice and expert operators apply their knowledge differently. Novices were focussed on meeting throughput objectives, and their incomplete understanding of the plant characteristics led them to inadvertently sacrifice quality in the pursuit of productivity in certain situations. Operators' responses to the plant are affected by their individual mental models of the plant, which differ between operators and have variable validity. Their behaviour is also affected by differing interpretations of how their personal agency should be applied to the achievement of production objectives. The methodology developed here is an integration of systems engineering, statistical analysis, and knowledge management. It shows how to determine where in a given production process the operator intervention is occurring, how it affects quality outcomes, and what tacit knowledge operators are using. It thereby assists the continuous quality improvement processes in a different way to SPC. A second contribution is the provision of a novel methodology for knowledge management, one that circumvents the usual codification barriers to knowledge management.
Graffigna, Guendalina; Bonanomi, Andrea
2017-01-01
Background Increasing bodies of scientific research today examines the factors and interventions affecting patients’ ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients’ ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. Objective To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. Material and methods This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 –short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients’ emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. Results According to the theoretical model we hypothesized, research results confirmed that patients’ activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients’ quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Conclusions Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence. PMID:28654686
Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea
2017-01-01
Increasing bodies of scientific research today examines the factors and interventions affecting patients' ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients' ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 -short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients' emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. According to the theoretical model we hypothesized, research results confirmed that patients' activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients' quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence.
A dynamic water-quality modeling framework for the Neuse River estuary, North Carolina
Bales, Jerad D.; Robbins, Jeanne C.
1999-01-01
As a result of fish kills in the Neuse River estuary in 1995, nutrient reduction strategies were developed for point and nonpoint sources in the basin. However, because of the interannual variability in the natural system and the resulting complex hydrologic-nutrient inter- actions, it is difficult to detect through a short-term observational program the effects of management activities on Neuse River estuary water quality and aquatic health. A properly constructed water-quality model can be used to evaluate some of the potential effects of manage- ment actions on estuarine water quality. Such a model can be used to predict estuarine response to present and proposed nutrient strategies under the same set of meteorological and hydrologic conditions, thus removing the vagaries of weather and streamflow from the analysis. A two-dimensional, laterally averaged hydrodynamic and water-quality modeling framework was developed for the Neuse River estuary by using previously collected data. Development of the modeling framework consisted of (1) computational grid development, (2) assembly of data for model boundary conditions and model testing, (3) selection of initial values of model parameters, and (4) limited model testing. The model domain extends from Streets Ferry to Oriental, N.C., includes seven lateral embayments that have continual exchange with the main- stem of the estuary, three point-source discharges, and three tributary streams. Thirty-five computational segments represent the mainstem of the estuary, and the entire framework contains a total of 60 computa- tional segments. Each computational cell is 0.5 meter thick; segment lengths range from 500 meters to 7,125 meters. Data that were used to develop the modeling framework were collected during March through October 1991 and represent the most comprehensive data set available prior to 1997. Most of the data were collected by the North Carolina Division of Water Quality, the University of North Carolina Institute of Marine Sciences, and the U.S. Geological Survey. Limitations in the modeling framework were clearly identified. These limitations formed the basis for a set of suggestions to refine the Neuse River estuary water-quality model.
Supporting Collaborative Model and Data Service Development and Deployment with DevOps
NASA Astrophysics Data System (ADS)
David, O.
2016-12-01
Adopting DevOps practices for model service development and deployment enables a community to engage in service-oriented modeling and data management. The Cloud Services Integration Platform (CSIP) developed the last 5 years at Colorado State University provides for collaborative integration of environmental models into scalable model and data services as a micro-services platform with API and deployment infrastructure. Originally developed to support USDA natural resource applications, it proved suitable for a wider range of applications in the environmental modeling domain. While extending its scope and visibility it became apparent community integration and adequate work flow support through the full model development and application cycle drove successful outcomes.DevOps provide best practices, tools, and organizational structures to optimize the transition from model service development to deployment by minimizing the (i) operational burden and (ii) turnaround time for modelers. We have developed and implemented a methodology to fully automate a suite of applications for application lifecycle management, version control, continuous integration, container management, and container scaling to enable model and data service developers in various institutions to collaboratively build, run, deploy, test, and scale services within minutes.To date more than 160 model and data services are available for applications in hydrology (PRMS, Hydrotools, CFA, ESP), water and wind erosion prediction (WEPP, WEPS, RUSLE2), soil quality trends (SCI, STIR), water quality analysis (SWAT-CP, WQM, CFA, AgES-W), stream degradation assessment (SWAT-DEG), hydraulics (cross-section), and grazing management (GRAS). In addition, supporting data services include soil (SSURGO), ecological site (ESIS), climate (CLIGEN, WINDGEN), land management and crop rotations (LMOD), and pesticides (WQM), developed using this workflow automation and decentralized governance.
[Applications of the hospital statistics management system].
Zhai, Hong; Ren, Yong; Liu, Jing; Li, You-Zhang; Ma, Xiao-Long; Jiao, Tao-Tao
2008-01-01
The Hospital Statistics Management System is built on an Office Automation Platform of Shandong provincial hospital system. Its workflow, role and popedom technologies are used to standardize and optimize the management program of statistics in the total quality control of hospital statistics. The system's applications have combined the office automation platform with the statistics management in a hospital and this provides a practical example of a modern hospital statistics management model.
Garman, Andrew N; McAlearney, Ann Scheck; Harrison, Michael I; Song, Paula H; McHugh, Megan
2011-01-01
: Although management practices are recognized as important factors in improving health care quality and efficiency, most research thus far has focused on individual practices, ignoring or underspecifying the contexts within which these practices are operating. Research from other industries, which has increasingly focused on systems rather than individual practices, has yielded results that may benefit health services management. : Our goal was to develop a conceptual model on the basis of prior research from health care as well as other industries that could be used to inform important contextual considerations within health care. : Using theoretical frameworks from A. Donabedian (1966), P. M. Wright, T. M. Gardner, and L. M. Moynihan (2003), and B. Schneider, D. B. Smith, and H. W. Goldstein (2000) and review methods adapted from R. Pawson (2006b), we reviewed relevant research from peer-reviewed and other industry-relevant sources to inform our model. The model we developed was then reviewed with a panel of practitioners, including experts in quality and human resource management, to assess the applicability of the model to health care settings. : The resulting conceptual model identified four practice bundles, comprising 14 management practices as well as nine factors influencing adoption and perceived sustainability of these practices. The mechanisms by which these practices influence care outcomes are illustrated using the example of hospital-acquired infections. In addition, limitations of the current evidence base are discussed, and an agenda for future research in health care settings is outlined. : Results may help practitioners better conceptualize management practices as part of a broader system of work practices. This may, in turn, help practitioners to prioritize management improvement efforts more systematically.
NASA Astrophysics Data System (ADS)
Vijayaraghavan, Krish; Cho, Sunny; Morris, Ralph; Spink, David; Jung, Jaegun; Pauls, Ron; Duffett, Katherine
2016-09-01
One of the potential environmental issues associated with oil sands development is increased ozone formation resulting from NOX and volatile organic compound emissions from bitumen extraction, processing and upgrading. To manage this issue in the Athabasca Oil Sands Region (AOSR) in northeast Alberta, a regional multi-stakeholder group, the Cumulative Environmental Management Association (CEMA), developed an Ozone Management Framework that includes a modelling based assessment component. In this paper, we describe how the Community Multi-scale Air Quality (CMAQ) model was applied to assess potential ground-level ozone formation and impacts on ambient air quality and vegetation health for three different ozone precursor cases in the AOSR. Statistical analysis methods were applied, and the CMAQ performance results met the U.S. EPA model performance goal at all sites. The modelled 4th highest daily maximum 8-h average ozone concentrations in the base and two future year scenarios did not exceed the Canada-wide standard of 65 ppb or the newer Canadian Ambient Air Quality Standards of 63 ppb in 2015 and 62 ppb in 2020. Modelled maximum 1-h ozone concentrations in the study were well below the Alberta Ambient Air Quality Objective of 82 ppb in all three cases. Several ozone vegetation exposure metrics were also evaluated to investigate the potential impact of ground-level ozone on vegetation. The chronic 3-months SUM60 exposure metric is within the CEMA baseline range (0-2000 ppb-hr) everywhere in the AOSR. The AOT40 ozone exposure metric predicted by CMAQ did not exceed the United Nations Economic Commission for Europe (UN/ECE) threshold of concern of 3000 ppb-hr in any of the cases but is just below the threshold in high-end future emissions scenario. In all three emission scenarios, the CMAQ predicted W126 ozone exposure metric is within the CEMA baseline threshold of 4000 ppb-hr. This study outlines the use of photochemical modelling of the impact of an industry (oil sands) on ground-level ozone levels as an air quality management tool in the AOSR. It allows an evaluation of the relationships between the pollutants emitted to the atmosphere and potential ground level ozone concentrations throughout the AOSR thereby extending the spatial coverage of the results beyond the monitoring network and also allowing an assessment of the potential impacts of possible future emission cases.
NASA Astrophysics Data System (ADS)
Llopis-Albert, Carlos; Palacios-Marqués, Daniel; Merigó, José M.
2014-04-01
In this paper a methodology for the stochastic management of groundwater quality problems is presented, which can be used to provide agricultural advisory services. A stochastic algorithm to solve the coupled flow and mass transport inverse problem is combined with a stochastic management approach to develop methods for integrating uncertainty; thus obtaining more reliable policies on groundwater nitrate pollution control from agriculture. The stochastic inverse model allows identifying non-Gaussian parameters and reducing uncertainty in heterogeneous aquifers by constraining stochastic simulations to data. The management model determines the spatial and temporal distribution of fertilizer application rates that maximizes net benefits in agriculture constrained by quality requirements in groundwater at various control sites. The quality constraints can be taken, for instance, by those given by water laws such as the EU Water Framework Directive (WFD). Furthermore, the methodology allows providing the trade-off between higher economic returns and reliability in meeting the environmental standards. Therefore, this new technology can help stakeholders in the decision-making process under an uncertainty environment. The methodology has been successfully applied to a 2D synthetic aquifer, where an uncertainty assessment has been carried out by means of Monte Carlo simulation techniques.