Managing Air Quality - Control Strategies to Achieve Air Pollution Reduction

EPA Pesticide Factsheets

Considerations in designing an effective control strategy related to air quality, controlling pollution sources, need for regional or national controls, steps to developing a control strategy, and additional EPA resources.

Comparison of indoor air quality management strategies between the school and district levels in New York State.

PubMed

Lin, Shao; Kielb, Christine L; Reddy, Amanda L; Chapman, Bonnie R; Hwang, Syni-An

2012-03-01

Good school indoor air quality (IAQ) can affect the health and functioning of school occupants. Thus, it is important to assess the degree to which schools and districts employ strategies to ensure good IAQ management. We examined and compared the patterns of IAQ management strategies between public elementary schools and their school districts in New York State. District-level information obtained from surveys of district facilities managers in 326 districts was described and stratified by district size and socioeconomic status. School-level information obtained from surveys of head custodians in 770 elementary schools was then compared with the district-level information in 241 districts. About 47% of participating school districts reported having a district-wide IAQ program, with a large range in the prevalence of specific IAQ management strategies. Airing out newly painted areas was the most commonly reported (92%) and having a classroom animal policy was the least commonly reported (29%). Larger districts and districts with a district-wide IAQ program were more likely to report certain IAQ strategies than other districts. Elementary schools and their districts were most likely to report airing out newly painted areas (76%). The most common area of disagreement was construction after hours (50%). The top strategy not reported at either level was having an IAQ coordinator (53%). Many school districts lack key IAQ management strategies, and differences exist between district-level policy and school-level practice. Districts and schools should work together to formalize and expand existing IAQ policies and inform stakeholders about these strategies. © 2012, American School Health Association.

Making Quality Happen: How Training Can Turn Strategy into Real Improvement. The Jossey-Bass Management Series.

ERIC Educational Resources Information Center

Cocheu, Ted

This book, written by an organizational development director and consultant in the fields of quality improvement, management, and design of training systems to Fortune 500 clients, offers a six-step improvement strategy and a six-phase training curriculum that can be adapted to the needs of companies in various fields. Seven chapters present ideas…

Disease management as a performance improvement strategy.

PubMed

McClatchey, S

2001-11-01

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

Environmental management strategy: four forces analysis.

PubMed

Doyle, Martin W; Von Windheim, Jesko

2015-01-01

We develop an analytical approach for more systematically analyzing environmental management problems in order to develop strategic plans. This approach can be deployed by agencies, non-profit organizations, corporations, or other organizations and institutions tasked with improving environmental quality. The analysis relies on assessing the underlying natural processes followed by articulation of the relevant societal forces causing environmental change: (1) science and technology, (2) governance, (3) markets and the economy, and (4) public behavior. The four forces analysis is then used to strategize which types of actions might be most effective at influencing environmental quality. Such strategy has been under-used and under-valued in environmental management outside of the corporate sector, and we suggest that this four forces analysis is a useful analytic to begin developing such strategy.

Environmental Management Strategy: Four Forces Analysis

NASA Astrophysics Data System (ADS)

Doyle, Martin W.; Von Windheim, Jesko

2015-01-01

We develop an analytical approach for more systematically analyzing environmental management problems in order to develop strategic plans. This approach can be deployed by agencies, non-profit organizations, corporations, or other organizations and institutions tasked with improving environmental quality. The analysis relies on assessing the underlying natural processes followed by articulation of the relevant societal forces causing environmental change: (1) science and technology, (2) governance, (3) markets and the economy, and (4) public behavior. The four forces analysis is then used to strategize which types of actions might be most effective at influencing environmental quality. Such strategy has been under-used and under-valued in environmental management outside of the corporate sector, and we suggest that this four forces analysis is a useful analytic to begin developing such strategy.

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

PubMed

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

2015-01-01

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

Self-managing teams: a strategy for quality improvement.

PubMed

Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen

2003-01-01

Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.

Quality management, a directive approach to patient safety.

PubMed

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.

Total Quality Management Implementation Plan Defense Depot Memphis

DTIC Science & Technology

1989-07-01

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

Management strategies to effect change in intensive care units: lessons from the world of business. Part I. Targeting quality improvement initiatives.

PubMed

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

2014-02-01

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

Air quality management in Mexico.

PubMed

Fernández-Bremauntz, Adrián

2008-01-01

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

Relationship between total quality management, critical paths, and outcomes management.

PubMed

Lynn, P A

1996-09-01

Total quality management (TQM), clinical paths, and outcomes management are high-profile strategies in today's health care environment. Each strategy is distinct, yet there are interrelationships among them. TQM supports a customer-focused organizational culture, providing tools and techniques to identify and solve problems. Clinical paths are tools for enhancing patient care coordination and for identifying system-wide and patient population specific issues. Outcomes management is an integrated system for measuring the results in patient populations over time. There is a recent shift in outcomes measurement towards expanding both the nature of the outcomes examined and the timeframes in which they are studied.

[Access to prenatal care and quality of care in the Family Health Strategy: infrastructure, care, and management].

PubMed

Guimarães, Wilderi Sidney Gonçalves; Parente, Rosana Cristina Pereira; Guimarães, Thayanne Louzada Ferreira; Garnelo, Luiza

2018-05-10

This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care. In the distribution according to geopolitical regions, the findings pertaining to the units' infrastructure indicate a direct relationship between the infrastructure's adequacy and social contexts with higher municipal human development indices and income. For the clinical actions in patient care, the teams in all the regions scored low on adequacy, with slightly better results in the North and South regions of the country. There were important differences between the states of the North, and the states with higher mean income and human development scored higher on adequacy. The results indicate important organizational difficulties in both access and quality of care provided by the health teams, in addition to visible insufficiency in management activities aimed to improve access and quality of prenatal care.

Selecting habitat management strategies on refuges

USGS Publications Warehouse

Schroeder, Richard L.; King, Wayne J.; Cornely, John E.

1998-01-01

This report is a joint effort of the Biological Resources Division, U.S. Geological Survey and the U.S. Fish and Wildlife Service (FWS) to provide National Wildlife Refuge (NWR) managers guidance on the selection and evaluation of habitat management strategies to meet stated objectives. The FWS recently completed a handbook on writing refuge management goals and objectives (U.S. Fish and Wildlife Service 1996a). the National Wildlife Refuge System Improvement Act of 1997 requires that National Wildlife Refuge System (NWRS) lands be managed according to approved Comprehensive Conservation Plans to guide management decisions and devise strategies for achieving refuge unit purposes and meeting the NWRS mission. It is expected that over the next several years most refuges will develop new or revised refuge goals and objectives for directing their habitat management strategies. This paper outlines the steps we recommend in selecting and evaluating habitat management strategies to meet specific refuge habitat objectives. We selected two examples to illustrate the process. Although each refuge is unique and will require specific information and solutions, these two examples can be used as guidance when selecting and evaluating habitat management strategies for other refuge resources: Example 1. Management of floodplain woods habitat for forest interior birds. The biological recourse of concern is the quality and quantity of floodplain woods habitat for eastern forest interior birds in the Cypress Creek NWR (U.S. Fish and Wildlife Service 1996b). Example 2. Management of habitat for biodiversity: Historical landscape proportions. The biological resource of concern is the change in diversity associated with man-induced changes in the distribution and abundance of habitat types at the Minnesota Valley NWR (U.S. Fish and Wildlife Service 1996c).

Assessing Concentrations and Health Impacts of Air Quality Management Strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST)

PubMed Central

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

Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

PubMed

Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

2016-09-01

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 that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning

Improvements in medical quality and patient safety through implementation of a case bundle management strategy in a large outpatient blood collection center.

PubMed

Zhao, Shuzhen; He, Lujia; Feng, Chenchen; He, Xiaoli

2018-06-01

Laboratory errors in blood collection center (BCC) are most common in the preanalytical phase. It is, therefore, of vital importance for administrators to take measures to improve healthcare quality and patient safety.In 2015, a case bundle management strategy was applied in a large outpatient BCC to improve its medical quality and patient safety.Unqualified blood sampling, complications, patient waiting time, largest number of patients waiting during peak hours, patient complaints, and patient satisfaction were compared over the period from 2014 to 2016.The strategy reduced unqualified blood sampling, complications, patient waiting time, largest number of patients waiting during peak hours, and patient complaints, while improving patient satisfaction.This strategy was effective in improving BCC healthcare quality and patient safety.

Soil environmental quality in greenhouse vegetable production systems in eastern China: Current status and management strategies.

PubMed

Hu, Wenyou; Zhang, Yanxia; Huang, Biao; Teng, Ying

2017-03-01

Greenhouse vegetable production (GVP) has become an important source of public vegetable consumption and farmers' income in China. However, various pollutants can be accumulated in GVP soils due to the high cropping index, large agricultural input, and closed environment. Ecological toxicity caused by excessive pollutants' accumulation can then lead to serious health risks. This paper was aimed to systematically review the current status of soil environmental quality, analyze their impact factors, and consequently to propose integrated management strategies for GVP systems. Results indicated a decrease in soil pH, soil salinization, and nutrients imbalance in GVP soils. Fungicides, remaining nutrients, antibiotics, heavy metals, and phthalate esters were main pollutants accumulating in GVP soils comparing to surrounding open field soils. Degradation of soil ecological function, accumulation of major pollutants in vegetables, deterioration of neighboring water bodies, and potential human health risks has occurred due to the changes of soil properties and accumulation of pollutants such as heavy metals and fungicides in soils. Four dominant factors were identified leading to the above-mentioned issues including heavy application of agricultural inputs, outmoded planting styles with poor environmental protection awareness, old-fashion regulations, unreasonable standards, and ineffective supervisory management. To guarantee a sustainable GVP development, several strategies were suggested to protect and improve soil environmental quality. Implementation of various strategies not only requires the concerted efforts among different stakeholders, but also the whole lifecycle assessment throughout the GVP processes as well as effective enforcement of policies, laws, and regulations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Summary of strategies for planning Productivity Improvement and Quality Enhancement (PIQE)

NASA Technical Reports Server (NTRS)

1986-01-01

The Summary of NASA Strategies for Productivity Improvement and Quality Enhancement respond to NASA's eighth top goal: Establish NASA as a leader in the development and application of advanced technology and management practices which contribute to significant increases in both Agency and national productivity. The Strategies provide the framework for development of the agency-wide Productivity Improvement and Quality Enhancement (PIQE) Plans.

Linking quality and performance. Quality orientation can be a competitive strategy for health care providers.

PubMed

Rapert, M I; Babakus, E

1996-01-01

Many organizations are not convinced a quality orientation pays off and are looking for ways to link quality with performance. The authors' exploratory study found that a quality orientation is a differentiating factor between low-performing and high-performing general service hospitals. They also developed a quality scale to assess the performance implications of quality-based strategies in the health care industry. Successful health care organizations (1) develop a strategic quality orientation at the management level, (2) support the pursuit of quality at the contact level, and (3) monitor external customers' perceptions of quality.

The impact of the board's strategy-setting role on board-management relations and hospital performance.

PubMed

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

Effectiveness of Quality Improvement Strategies for the Management of CKD: A Meta-Analysis.

PubMed

Silver, Samuel A; Bell, Chaim M; Chertow, Glenn M; Shah, Prakesh S; Shojania, Kaveh; Wald, Ron; Harel, Ziv

2017-10-06

Quality improvement interventions have enhanced care for other chronic illnesses, but their effectiveness for patients with CKD is unknown. We sought to determine the effects of quality improvement strategies on clinical outcomes in adult patients with nondialysis-requiring CKD. We conducted a systematic review of randomized trials, searching Medline and the Cochrane Effective Practice and Organization of Care database from January of 2003 to April of 2015. Eligible studies evaluated one or more of 11 prespecified quality improvement strategies, and prespecified study outcomes included at least one process of care measure, surrogate outcome, or hard clinical outcome. We used a random effects model to estimate the pooled risk ratio (RR; dichotomous data) or the mean difference (continuous data). We reviewed 15 patient-level randomized trials ( n =3298 patients), and six cluster-randomized trials ( n =30,042 patients). Quality improvement strategies reduced dialysis incidence (seven trials; RR, 0.85; 95% confidence interval [95% CI], 0.74 to 0.97) and LDL cholesterol concentrations (four trials; mean difference, -17.6 mg/dl; 95% CI, -28.7 to -6.5), and increased the likelihood that patients received renin-angiotensin-aldosterone system inhibitors (nine trials; RR, 1.16; 95% CI, 1.06 to 1.27). We did not observe statistically significant effects on mortality, cardiovascular events, eGFR, glycated hemoglobin, and systolic or diastolic BP. Quality improvement interventions yielded significant beneficial effects on three elements of CKD care. Estimates of the effectiveness of quality improvement strategies were limited by study number and adherence to quality improvement principles. This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_09_06_CJASNPodcast_17_10.mp3. Copyright © 2017 by the American Society of Nephrology.

A New Frame for Managing Schools: Total Quality Management (TQM).

ERIC Educational Resources Information Center

Murgatroyd, Stephen

1992-01-01

Explores Total Quality Management (TQM) philosophy, its industrial achievements, and its promise for education. Key elements of TQM include establishing a strong sense of school vision, promoting personal mastery learning for all organization members, focusing strategy on customer-driven values, developing outrageous goals, working effectively…

Strategies in disability management. Corporate disability management programs implemented at the work site.

PubMed

Kalina, C M

1999-10-30

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

Manufacturing Credibility: The National Energy Management Institute and the Tobacco Institute's Strategy for Indoor Air Quality

PubMed Central

Balbach, Edith D.

2011-01-01

Objectives. We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. Methods. We analyzed tobacco industry documents, conducted literature searches in Lexis–Nexis for background and historical literature, and reviewed relevant public health and policy literature. Results. The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. Conclusions. NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either–or choice; in fact, both can improve worker health. PMID:21233427

Manufacturing credibility: the National Energy Management Institute and the Tobacco Institute's strategy for indoor air quality.

PubMed

Campbell, Richard B; Balbach, Edith D

2011-03-01

We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. We analyzed tobacco industry documents, conducted literature searches in Lexis-Nexis for background and historical literature, and reviewed relevant public health and policy literature. The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either-or choice; in fact, both can improve worker health.

Leadership and management in quality radiology

PubMed Central

2007-01-01

The practice of medical imaging and interventional radiology are undergoing rapid change in recent years due to technological advances, workload escalation, workforce shortage, globalisation, corporatisation, commercialisation and commoditisation of healthcare. These professional and economical changes are challenging the established norm but may bring new opportunities. There is an increasing awareness of and interest in the quality of care and patient safety in medical imaging and interventional radiology. Among the professional organisations, a range of quality systems are available to address individual, facility and system needs. To manage the limited resources successfully, radiologists and professional organisations must be leaders and champion for the cause of quality care and patient safety. Close collaboration with other stakeholders towards the development and management of proactive, long-term, system-based strategies and infrastructures will underpin a sustainable future in quality radiology. The International Radiology Quality Network can play a useful facilitating role in this worthwhile but challenging endeavour. PMID:21614284

Value-added strategy models to provide quality services in senior health business.

PubMed

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

[Global brain metastases management strategy: a multidisciplinary-based approach].

PubMed

Métellus, P; Tallet, A; Dhermain, F; Reyns, N; Carpentier, A; Spano, J-P; Azria, D; Noël, G; Barlési, F; Taillibert, S; Le Rhun, É

2015-02-01

Brain metastases management has evolved over the last fifteen years and may use varying strategies, including more or less aggressive treatments, sometimes combined, leading to an improvement in patient's survival and quality of life. The therapeutic decision is subject to a multidisciplinary analysis, taking into account established prognostic factors including patient's general condition, extracerebral disease status and clinical and radiological presentation of lesions. In this article, we propose a management strategy based on the state of current knowledge and available therapeutic resources. Copyright © 2015. Published by Elsevier SAS.

NASA total quality management 1990 accomplishments report

NASA Technical Reports Server (NTRS)

1991-01-01

NASA's efforts in Total Quality Management are based on continuous improvement and serve as a foundation for NASA's present and future endeavors. Given here are numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. These accomplishment benefit our Agency and help to achieve our primary goal, keeping American in the forefront of the aerospace industry.

Air quality management in Portugal: example of needs and available tools.

PubMed

Borrego, C; Miranda, A I; Coutinho, M; Ferreira, J; Carvalho, A C

2002-01-01

The Framework Directive (FWD) and the proposed Daughter Directives are the newest legislative instruments concerning a new political strategy and air quality management approach for Europe. Additionally, the member countries of the United Nations Economic Commission for Europe have included the concepts of critical load and level for planning air pollution abatement strategies and as a base of international agreements concerning limitation of the emissions of air pollutants. These concepts imply an accurate knowledge about pollutants deposition fluxes. The paper describes the main needs and the tools available to define a strategy of air quality management in Portugal. Two study cases are presented: (1) extensive monitoring plan to assess the impact of an urban incinerator plant; and (2) contribution to a methodology to estimate critical levels for a coastal region in Portugal. These different approaches allowed illustrating the complexity of the implementation of an air pollution management strategy.

[Comprehensive quality management in hospitals--experience and recommendations].

PubMed

Schubert, H J

1999-03-01

Total quality management concepts, increasingly being introduced into hospitals, offer opportunities for integrative leadership concepts because of their multidimensional character viewed from the aspects of results and from the standpoint of organisational design. Customized for leadership and organisation of hospitals in Germany, questions of introduction strategies as well as recommendations for the integration of total quality understanding into the daily practice of management and employees are discussed. The active support of top and middle management and a combination of radical change in selected problem areas and continual incremental improvements on a broad base have been proven as significant factors for the success in the introductory phase. For a lasting integration of the principles of a comprehensive quality management concept in a hospital, it will be necessary to carry out regularly relevant measurements of success. The results become an important part of agreements with management.

Performance Indicators and the Management of Quality in Education.

ERIC Educational Resources Information Center

Cuttance, Peter

Issues that affect the use of performance indicators in managing educational quality are discussed in this paper. Recent changes in public-sector organizational management include the development of strategies for the management of change itself and the changing role of the public sector. A trend within the public sector is an increase in the…

Quality of nurses' work life: strategies for enhancement.

PubMed

Davis, B; Thorburn, B

1999-01-01

The radical transformation resulting from health care reform, with its emphasis on restructuring, reorganizing and downsizing, has impacted on the nursing profession and has profoundly effected the quality of nurses' work life. The Health Care Corporation of St. John's experienced the stress associated with change when it simultaneously merged eight health care sites and introduced a programmed-based management structure. This article reviews the strategies developed in response to this transition by the Nurses' Quality of Worklife Team, to help reduce stress and enhance the quality of nurses' work life. In particular, it highlights the development and implementation of a professional support network called the Nursing Peer Support Program.

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

NASA Technical Reports Server (NTRS)

Schramm, Harry F.; Sullivan, Kenneth W.

1991-01-01

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

Drinking-water quality management: the Australian framework.

PubMed

Sinclair, Martha; Rizak, Samantha

The most effective means of assuring drinking-water quality and the protection of public health is through adoption of a preventive management approach that encompasses all steps in water production from catchment to consumer. However, the reliance of current regulatory structures on compliance monitoring of treated water tends to promote a reactive management style where corrective actions are initiated after monitoring reveals that prescribed levels have been exceeded, and generally after consumers have received the noncomplying water. Unfortunately, the important limitations of treated water monitoring are often not appreciated, and there is a widespread tendency to assume that intensification of compliance monitoring or lowering of compliance limits is an effective strategy to improving the protection of public health. To address these issues and emphasize the role of preventive system management, the Australian National Health and Medical Research Council in collaboration with the Co-operative Research Centre for Water Quality and Treatment has developed a comprehensive quality management approach for drinking water. This Framework for Management of Drinking Water Quality will assist water suppliers in providing a higher level of assurance for drinking water quality and safety. The framework integrates quality and risk management principles, and provides a comprehensive, flexible, and proactive means of optimizing, drinking-water quality and protecting public health. It does not eliminate the requirement for compliance monitoring but allows it to be viewed in the proper perspective as providing verification that preventive measures are effective, rather than as the primary means of protecting public health.

Strategies to address management challenges in larger intensive care units.

PubMed

Matlakala, M C; Bezuidenhout, M C; Botha, A D H

2015-10-01

To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

PubMed

Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

2017-09-07

While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

Physicians in training as quality managers: survival strategy for academic health centers.

PubMed

Wofford, J L; Moran, W P; Cohen, S J; Simon, R C

1997-12-01

Being responsible for medical education places academic health centers at a disadvantage in competing for managed care contracts. Although many suggestions have been made for changing medical education to produce physicians who are better prepared for the managed care environment, few studies have shown how physicians in training can actually contribute to the competitiveness of an academic health center. We present three examples of engaging trainees in projects with a population-based perspective that demonstrate how quality improvement for the academic health center can be operationalized and even led by physicians in training. In addition to gaining experience in a managed care skill that is increasingly important for future employment, physicians in training can simultaneously improve the quality of care delivered through the academic health center.

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

PubMed

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

2013-10-01

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

Building Perinatal Case Manager Capacity Using Quality Improvement.

PubMed

Fitzgerald, Elaine

2015-01-01

Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum.

Self-management in young adults with bipolar disorder: Strategies and challenges.

PubMed

Nicholas, Jennifer; Boydell, Katherine; Christensen, Helen

2017-02-01

Early adoption of effective self-management strategies for bipolar disorder (BD) results in better clinical outcomes and increased quality of life. Therefore, facilitation of these strategies in young adults who are early in their illness course is vital. However, an understanding of self-management practices and needs of young adults with BD is lacking. This study explores young adult's perspectives of disorder self-management practices and challenges. Young adults with BD completed an online survey about disorder management strategies and challenges. Self-management was investigated through self-report and ratings of literature-derived strategies. Results were analysed using descriptive statistics and qualitative thematic analysis. Eighty-nine participants aged 18-30 (M=24.4; SD=3.9) completed the survey. Adherence to treatment, disorder psychoeducation, and sleep-management were the strategies rated most helpful. Six participant-reported self-management strategies were identified (1) Maintaining a healthy lifestyle; (2) Treatment attendance and adherence; (3) Participation in meaningful activities; (4) Engagement with social support; (5) Meditation and relaxation practices; and (6) Symptom monitoring. The most common self-management challenges experienced by young adults concerned the nature of the disorder, interpersonal relationships, and stigma. Participants likely represent a sub-set of young adults engaged with healthcare and therefore may not be representative of the population. Strategies reported vital by those successfully managing their disorder are not adequately utilised by young adults with BD. Both differences in strategy use and perceived self-management challenges represent important areas of clinical support and intervention. This increased understanding will help facilitate self-management skill development in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Strategies for ensuring global consistency/comparability of water-quality data

USGS Publications Warehouse

Klein, J.M.

1999-01-01

In the past 20 years the water quality of the United States has improved remarkably-the waters are safer for drinking, swimming, and fishing. However, despite many accomplishments, it is still difficult to answer such basic questions as: 'How clean is the water?' and 'How is it changing over time?' These same questions exist on a global scale as well. In order to focus water-data issues in the United States, a national Intergovernmental Task Force on Monitoring Water Quality (ITFM) was initiated for public and private organizations, whereby key elements involved in data collection, analysis, storage, and management could be made consistent and comparable. The ITFM recommended and its members are implementing a nationwide strategy to improve water-quality monitoring, assessment, and reporting activities. The intent of this paper is to suggest that a voluntary effort be initiated to ensure the comparability and utility of hydrological data on a global basis. Consistent, long-term data sets that are comparable are necessary in order to formulate ideas regarding regional and global trends in water quantity and quality. The author recommends that a voluntary effort similar to the ITFM effort be utilized. The strategy proposed would involve voluntary representation from countries and international organizations (e.g. World Health Organization) involved in drinking-water assessments and/or ambient water-quality monitoring. Voluntary partnerships such as this will improve curability to reduce health risks and achieve a better return on public and private investments in monitoring, environmental protection, and natural resource management, and result in a collaborative process that will save millions of dollars.In this work it is suggested that a voluntary effort be initiated to ensure the comparability and utility of hydrological data on a global basis. The strategy proposed would involve voluntary representation from countries and international organizations involved in

DUQuE quality management measures: associations between quality management at hospital and pathway levels.

PubMed

Wagner, Cordula; Groene, Oliver; Thompson, Caroline A; Dersarkissian, Maral; Klazinga, Niek S; Arah, Onyebuchi A; Suñol, Rosa

2014-04-01

The assessment of integral quality management (QM) in a hospital requires measurement and monitoring from different perspectives and at various levels of care delivery. Within the DUQuE project (Deepening our Understanding of Quality improvement in Europe), seven measures for QM were developed. This study investigates the relationships between the various quality measures. It is a multi-level, cross-sectional, mixed-method study. As part of the DUQuE project, we invited a random sample of 74 hospitals in 7 countries. The quality managers of these hospitals were the main respondents. Furthermore, data of site visits of external surveyors assessing the participating hospitals were used. Three measures of QM at hospitals level focusing on integral systems (QMSI), compliance with the Plan-Do-Study-Act quality improvement cycle (QMCI) and implementation of clinical quality (CQII). Four measures of QM activities at care pathway level focusing on Specialized expertise and responsibility (SER), Evidence-based organization of pathways (EBOP), Patient safety strategies (PSS) and Clinical review (CR). Positive significant associations were found between the three hospitals level QM measures. Results of the relationships between levels were mixed and showed most associations between QMCI and department-level QM measures for all four types of departments. QMSI was associated with PSS in all types of departments. By using the seven measures of QM, it is possible to get a more comprehensive picture of the maturity of QM in hospitals, with regard to the different levels and across various types of hospital departments.

What is heartburn worth? A cost-utility analysis of management strategies.

PubMed

Heudebert, G R; Centor, R M; Klapow, J C; Marks, R; Johnson, L; Wilcox, C M

2000-03-01

To determine the best treatment strategy for the management of patients presenting with symptoms consistent with uncomplicated heartburn. We performed a cost-utility analysis of 4 alternatives: empirical proton pump inhibitor, empirical histamine2-receptor antagonist, and diagnostic strategies consisting of either esophagogastroduodenoscopy (EGD) or an upper gastrointestinal series before treatment. The time horizon of the model was 1 year. The base case analysis assumed a cohort of otherwise healthy 45-year-old individuals in a primary care practice. Empirical treatment with a proton pump inhibitor was projected to provide the greatest quality-adjusted survival for the cohort. Empirical treatment with a histamine2 receptor antagonist was projected to be the least costly of the alternatives. The marginal cost-effectiveness of using a proton pump inhibitor over a histamine2-receptor antagonist was approximately $10,400 per quality-adjusted life year (QALY) gained in the base case analysis and was less than $50,000 per QALY as long as the utility for heartburn was less than 0.95. Both diagnostic strategies were dominated by proton pump inhibitor alternative. Empirical treatment seems to be the optimal initial management strategy for patients with heartburn, but the choice between a proton pump inhibitor or histamine2-receptor antagonist depends on the impact of heartburn on quality of life.

Human capital strategy: talent management.

PubMed

Nagra, Michael

2011-01-01

Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

Project officer's perspective: quality assurance as a management tool.

PubMed

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.

Marketing quality and value to the managed care market.

PubMed

Kazmirski, G

1998-11-01

Quantifying quality and marketing care delivery have been long-term challenges in the health care market. Insurers, employers, other purchasers of care, and providers face a constant challenge in positioning their organizations in a proactive, competitive niche. Tools that measure patient's self-reported perception of health care needs and expectations have increased the ability to quantify quality of care delivery. When integrated with case management and disease management strategies, outcomes reporting and variance analysis tracking can be packaged to position a provider in a competitive niche.

The role of hospital managers in quality and patient safety: a systematic review

PubMed Central

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

Building Perinatal Case Manager Capacity Using Quality Improvement

PubMed Central

Fitzgerald, Elaine

2015-01-01

ABSTRACT Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

Values and strategies: management of radical organizational change in a university hospital.

PubMed

Orvik, Arne

2017-04-01

Managers' experiences of radical change were studied in a Norwegian university hospital, which was relocated from a traditional building to a new, high-tech building. The university hospital was also accredited as a health promoting hospital. Thirteen managers at different levels in the organization and a personnel safety representative were interviewed as part of a trailing research project. The aim of the study was to elucidate the managers' value orientation and strategies for dealing with value tensions. A combination of a hermeneutical, reflective method and a template for quality, efficiency and integrity guided the analysis. The template was based not only on the main findings but also on the core values of a model of organizational health. The results show that clinical managers focus on quality and top managers, not unexpectedly, focus on efficiency. Managers at both levels were concerned about their own integrity, and also about the integrity of their clinician colleagues, as well as showing concern for the hospital's mission, in terms of organizational effectiveness. The discussion was conducted in terms of dominance, cycling and balancing strategies, of which the last was the most prevalent. However, sustainable strategies for dealing with value tensions also call for value-based management and value-conscious leadership. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Perceptional and socio-demographic factors associated with household drinking water management strategies in rural Puerto Rico.

PubMed

Jain, Meha; Lim, Yili; Arce-Nazario, Javier A; Uriarte, María

2014-01-01

Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption.

Perceptional and Socio-Demographic Factors Associated with Household Drinking Water Management Strategies in Rural Puerto Rico

PubMed Central

Jain, Meha; Lim, Yili; Arce-Nazario, Javier A.; Uriarte, María

2014-01-01

Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption. PMID:24586302

Determinants of quality management systems implementation in hospitals.

PubMed

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

2009-03-01

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

Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: a systematic review.

PubMed

Peek, Kerry; Sanson-Fisher, Robert; Mackenzie, Lisa; Carey, Mariko

2016-06-01

Physiotherapist prescribed self-management strategies are an important adjunct to 'hands on' treatment. However, treatment outcomes are likely to be related to whether patients adhere to the prescribed strategy. Therefore, physiotherapists should be aware of adherence aiding interventions designed to maximise patient outcomes underpinned by quality research studies. To conduct a systematic review of the interventions used to aid patient adherence to all physiotherapist prescribed self-management strategies. The search included the databases CINAHL, EMBASE, MEDLINE, PUBMED, PSYCINFO, SPORTSDiscus, the Cochrane Central Register of Controlled Trials, PEDro and Mednar for randomised controlled trials (RCTs) published in a peer reviewed journal from inception to November 2014. Data were extracted using a standardised form from twelve included RCTs for patient adherence rates to self-management strategies for interventions used to aid patient adherence and usual care. Two independent reviewers conducted methodological quality assessment. Twelve different interventions to aid patient adherence to exercise were recorded from twelve fair to high quality RCTs. Potential adherence aiding interventions include an activity monitor and feedback system, written exercise instructions, behavioural exercise programme with booster sessions and goal setting. Despite a number of studies demonstrating interventions to positively influence patient adherence to exercise, there is insufficient data to endorse their use in clinical practice. No RCTs examining adherence aiding interventions to self-management strategies other than exercise were identified, indicating a significant gap in the literature. PROSPERO CRD42015014516. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

A comparison of alternative strategies for cost-effective water quality management in lakes.

PubMed

Kramer, Daniel Boyd; Polasky, Stephen; Starfield, Anthony; Palik, Brian; Westphal, Lynne; Snyder, Stephanie; Jakes, Pamela; Hudson, Rachel; Gustafson, Eric

2006-09-01

Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to determine whether septic upgrades or riparian buffers are a more cost-effective strategy to meet a phosphorus reduction target. We find that riparian buffers are the more cost-effective strategy in every case but one. Large transaction costs associated with the negotiation and monitoring of riparian buffers, however, may be prohibiting lake residents from implementing the most cost-effective strategy.

A Comparison of Alternative Strategies for Cost-Effective Water Quality Management in Lakes

NASA Astrophysics Data System (ADS)

Kramer, Daniel Boyd; Polasky, Stephen; Starfield, Anthony; Palik, Brian; Westphal, Lynne; Snyder, Stephanie; Jakes, Pamela; Hudson, Rachel; Gustafson, Eric

2006-09-01

Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to determine whether septic upgrades or riparian buffers are a more cost-effective strategy to meet a phosphorus reduction target. We find that riparian buffers are the more cost-effective strategy in every case but one. Large transaction costs associated with the negotiation and monitoring of riparian buffers, however, may be prohibiting lake residents from implementing the most cost-effective strategy.

Strategies for Talent Management: Greater Philadelphia Companies in Action

ERIC Educational Resources Information Center

Council for Adult and Experiential Learning (NJ1), 2008

2008-01-01

Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

[Management, quality of health and occupational safety and hospital organization: is integration possible?].

PubMed

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.

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

PubMed Central

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

2014-01-01

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

The Balanced Scorecard versus Total Quality Management: which is better for your organization?

PubMed

Schwartz, Jay

2005-10-01

Today's health care organizations must deal with managed care, government oversight, aging baby boomers, new technologies, and increasing pharmaceutical prices. It is imperative that health care organizations adopt some form of business strategy to manage the vast amount of information available. Two of the more popular strategies among health care organizations are the Balanced Scorecard and Total Quality Management. Which one of the strategies is best for an organization? The answer to this question is that it depends on the organization. This article provides the fundamentals of each strategy and contrasts their strengths and weaknesses, so that interested organizations can make informed decisions regarding the best strategy for each organization.

Ergonomics and quality management--humans in interaction with technology, work environment, and organization.

PubMed

Eklund, J A

1999-01-01

In many studies, ergonomics has been shown to influence human performance. The aim of this paper was to demonstrate important ergonomics influences on quality in industrial production, from the perspective of interactions between humans, technology, organization, and work environment. A second aim was to elaborate on the implications of these findings for the development of quality management strategies. This paper shows that ergonomics problems in terms of adverse work environmental conditions, inappropriate design of technology, and an unsuitable organization are important causes of quality deficiencies. Problem solving aimed at improving ergonomics, quality, and productivity simultaneously is likely to obtain support from most of the interest parties of the company, and may also enhance participation. Ergonomics has the potential of becoming a driving force for the development of new quality management strategies.

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

ERIC Educational Resources Information Center

Schauerman, Sam; Peachy, Burt

1994-01-01

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

Management strategies for fibromyalgia

PubMed Central

Le Marshall, Kim Francis; Littlejohn, Geoffrey Owen

2011-01-01

Clinical question What are the effective, evidence-based strategies available for the management of fibromyalgia? Conclusion There are a number of management strategies available with robust evidence to support their use in clinical practice. Definition Fibromyalgia is a complex pain syndrome characterized by widespread, chronic muscular pain and tenderness, disordered sleep, emotional distress, cognitive disturbance, and fatigue. Its prevalence is estimated to be 3%–5% in the population and higher yet in patients with comorbid rheumatic diseases. Level of evidence Systematic reviews, meta-analyses, randomized controlled trials (RCTs). Search sources PubMed, Cochrane Library, manual search Consumer summary Key messages for patients and clinicians are: There are many effective pharmacological management strategies available for fibromyalgia.A nonpharmacological, multicomponent approach utilizing education, aerobic exercise, psychological therapy, and other strategies is also effective for fibromyalgia.Despite the significant and, at times, disabling physical and psychological symptoms, fibromyalgia can be a manageable condition with a potentially good outcome. PMID:27790003

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

PubMed

Hellmann, Wolfgang

2017-12-01

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

Extreme weather events: Should drinking water quality management systems adapt to changing risk profiles?

PubMed

Khan, Stuart J; Deere, Daniel; Leusch, Frederic D L; Humpage, Andrew; Jenkins, Madeleine; Cunliffe, David

2015-11-15

Among the most widely predicted and accepted consequences of global climate change are increases in both the frequency and severity of a variety of extreme weather events. Such weather events include heavy rainfall and floods, cyclones, droughts, heatwaves, extreme cold, and wildfires, each of which can potentially impact drinking water quality by affecting water catchments, storage reservoirs, the performance of water treatment processes or the integrity of distribution systems. Drinking water guidelines, such as the Australian Drinking Water Guidelines and the World Health Organization Guidelines for Drinking-water Quality, provide guidance for the safe management of drinking water. These documents present principles and strategies for managing risks that may be posed to drinking water quality. While these principles and strategies are applicable to all types of water quality risks, very little specific attention has been paid to the management of extreme weather events. We present a review of recent literature on water quality impacts of extreme weather events and consider practical opportunities for improved guidance for water managers. We conclude that there is a case for an enhanced focus on the management of water quality impacts from extreme weather events in future revisions of water quality guidance documents. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Longitudinal Study of Total Quality Management Processes in Business Colleges.

ERIC Educational Resources Information Center

Vazzana, Gary; Elfrink, John; Bachmann, Duane P.

2000-01-01

Surveys of business school deans in 1995 (n=243) and 1998 (n=151) regarding total quality management (TQM) practices revealed increases in mission and strategy development, goal setting, and use of advisory boards and cross-functional teams. Few are using TQM to manage core learning processes. (SK)

Quality Management in Education.

ERIC Educational Resources Information Center

Tribus, Myron

When transferring the methods of quality management from industry to academia, there are important differences that must be considered. This paper describes the differences between traditional management and quality management, and shows how Deming's principles of Total Quality Management (TQM) can be applied to education. Some of these principles…

A data-driven approach to quality risk management

PubMed Central

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-01-01

Aim: An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Materials and Methods: Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. Results: Only a subset of the risk factors had a significant association with quality issues, and included: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Conclusion: Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety. PMID:24312890

A data-driven approach to quality risk management.

PubMed

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-10-01

An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. ONLY A SUBSET OF THE RISK FACTORS HAD A SIGNIFICANT ASSOCIATION WITH QUALITY ISSUES, AND INCLUDED: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety.

Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ).

PubMed

Thomas, S; Kersten, P; Thomas, P W; Slingsby, V; Nock, A; Jones, R; Davies Smith, A; Galvin, K T; Baker, R; Hillier, C

2015-10-20

To explore cross-sectional patterns of use of fatigue management strategies in people with multiple sclerosis (MS) who had attended a group-based fatigue management programme, Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ('FACETS'). In a multicentre randomised controlled trial (RCT) the FACETS programme was shown to reduce fatigue severity and improve self-efficacy and quality of life. A questionnaire substudy within a RCT involving the self-completed Fatigue Management Strategies Questionnaire (FMSQ). The FMSQ includes: (1) closed questions about the use and helpfulness of fatigue management strategies taught in FACETS and (2) open items about changes to lifestyle, attitudes or expectations, barriers or difficulties encountered and helpful strategies not covered in FACETS. All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. 82% (59/72) of participants returned the FMSQ. The fatigue management strategies most frequently used since attending FACETS were prioritisation (80%), pacing (78%), saying no to others (78%), grading tasks (75%) and challenging unhelpful thoughts (71%). Adding in those participants who were already using the respective strategies prior to FACETS, the three most used strategies at 4 months were prioritisation (55/59), grading (54/59) and pacing (53/58). Free-text comments illustrated the complex interplay between attitudes/expectations, behaviours, emotions and the environment. Issues related to expectations featured strongly in participants' comments. Expectations (from self and others) were both facilitators and barriers to effective fatigue management. Individuals' comments highlighted the complex, multifaceted nature of fatigue management. Revising expectations and a greater acceptance of fatigue

Data quality and processing for decision making: divergence between corporate strategy and manufacturing processes

NASA Astrophysics Data System (ADS)

McNeil, Ronald D.; Miele, Renato; Shaul, Dennis

2000-10-01

Information technology is driving improvements in manufacturing systems. Results are higher productivity and quality. However, corporate strategy is driven by a number of factors and includes data and pressure from multiple stakeholders, which includes employees, managers, executives, stockholders, boards, suppliers and customers. It is also driven by information about competitors and emerging technology. Much information is based on processing of data and the resulting biases of the processors. Thus, stakeholders can base inputs on faulty perceptions, which are not reality based. Prior to processing, data used may be inaccurate. Sources of data and information may include demographic reports, statistical analyses, intelligence reports (e.g., marketing data), technology and primary data collection. The reliability and validity of data as well as the management of sources and information is critical element to strategy formulation. The paper explores data collection, processing and analyses from secondary and primary sources, information generation and report presentation for strategy formulation and contrast this with data and information utilized to drive internal process such as manufacturing. The hypothesis is that internal process, such as manufacturing, are subordinate to corporate strategies. The impact of possible divergence in quality of decisions at the corporate level on IT driven, quality-manufacturing processes based on measurable outcomes is significant. Recommendations for IT improvements at the corporate strategy level are given.

[Data supporting quality circle management of inpatient depression treatment].

PubMed

Brand, S; Härter, M; Sitta, P; van Calker, D; Menke, R; Heindl, A; Herold, K; Kudling, R; Luckhaus, C; Rupprecht, U; Sanner, Dirk; Schmitz, D; Schramm, E; Berger, M; Gaebel, W; Schneider, F

2005-07-01

Several quality assurance initiatives in health care have been undertaken during the past years. The next step consists of systematically combining single initiatives in order to built up a strategic quality management. In a German multicenter study, the quality of inpatient depression treatment was measured in ten psychiatric hospitals. Half of the hospitals received comparative feedback on their individual results in comparison to the other hospitals (bench marking). Those bench markings were used by each hospital as a statistic basis for in-house quality work, to improve the quality of depression treatment. According to hospital differences concerning procedure and outcome, different goals were chosen. There were also differences with respect to structural characteristics, strategies, and outcome. The feedback from participants about data-based quality circles in general and the availability of bench-marking data was positive. The necessity of carefully choosing quality circle members and professional moderation became obvious. Data-based quality circles including bench-marking have proven to be useful for quality management in inpatient depression care.

The eighth NASA total quality management accomplishments report, 1990

NASA Technical Reports Server (NTRS)

1990-01-01

The eighth annual accomplishments report provides numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. NASA's continuous improvement efforts can provide insight for others to succeed in their own endeavors. The report covers: top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

Stand quality management in a late-rotation, red oak-sweetgum stand in east Mississippi: preliminary results following thinning

Treesearch

James S. Meadows; Daniel A. Skojac

2012-01-01

Stand quality management is a new management strategy in which thinning prescriptions are based solely on tree quality rather than a quantitative level of residual stand density. As long as residual density falls within fairly broad limits, prescriptions are based on tree quality alone. We applied four thinning prescriptions based on stand quality management, along...

Fault Management Design Strategies

NASA Technical Reports Server (NTRS)

Day, John C.; Johnson, Stephen B.

2014-01-01

Development of dependable systems relies on the ability of the system to determine and respond to off-nominal system behavior. Specification and development of these fault management capabilities must be done in a structured and principled manner to improve our understanding of these systems, and to make significant gains in dependability (safety, reliability and availability). Prior work has described a fundamental taxonomy and theory of System Health Management (SHM), and of its operational subset, Fault Management (FM). This conceptual foundation provides a basis to develop framework to design and implement FM design strategies that protect mission objectives and account for system design limitations. Selection of an SHM strategy has implications for the functions required to perform the strategy, and it places constraints on the set of possible design solutions. The framework developed in this paper provides a rigorous and principled approach to classifying SHM strategies, as well as methods for determination and implementation of SHM strategies. An illustrative example is used to describe the application of the framework and the resulting benefits to system and FM design and dependability.

Blood management issues using blood management strategies.

PubMed

Stulberg, Bernard N; Zadzilka, Jayson D

2007-06-01

Blood management strategies is a term used to address a coordinated approach to the management of blood loss in the perioperative period for total joint arthroplasty. The premise of any blood management strategy is that each patient, surgeon, and operative intervention experiences different risks of requiring transfusion, that those risks can be identified, and that a plan can be implemented to address them. A surgeon's decision to transfuse should be based on physiologic assessment of the patient's response to anemia and not on an arbitrary number ("transfusion trigger"). Intervention strategies can be applied preoperatively, intraoperatively, and postoperatively. Patient-specific planning allows for the appropriate use of patient, hospital, and system resources, ensuring that the consequences of anemia are minimized and that the patient's recovery process is optimized.

Leadership versus management: translating pharmacists' abilities into quality performance.

PubMed

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."

Top management leadership style and quality of care in nursing homes.

PubMed

Castle, Nicholas G; Decker, Frederic H

2011-10-01

The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style assessment came from primary data collected from approximately 4,000 NHAs and DONs that was linked to quality information (i.e., Nursing Home Compare Quality Measures and 5-Star rating scores) and nursing home information (i.e., Online Survey, Certification, And Reporting data). A consensus manager leadership style has a strong association with better quality. Top managers using this style solicit and act upon input from their employees. For NHAs exhibiting this leadership style, the coefficients on 5 of the 7 quality indicators are statistically significant, and all 7 are significant when the DON exhibits this style. When the NHA and DON both have a consensus manager leadership style, 6 of the 7 quality indicator coefficients are significantly associated with better quality. The findings indicate that NHA and DON leadership style is associated with quality of care. Leadership strategies are amenable to change; thus, the findings of this study may be used to develop policies for promoting more effective leadership in nursing homes.

Management Strategies for CLN2 Disease.

PubMed

Williams, Ruth E; Adams, Heather R; Blohm, Martin; Cohen-Pfeffer, Jessica L; de Los Reyes, Emily; Denecke, Jonas; Drago, Kristen; Fairhurst, Charlie; Frazier, Margie; Guelbert, Norberto; Kiss, Szilárd; Kofler, Annamaria; Lawson, John A; Lehwald, Lenora; Leung, Mary-Anne; Mikhaylova, Svetlana; Mink, Jonathan W; Nickel, Miriam; Shediac, Renée; Sims, Katherine; Specchio, Nicola; Topcu, Meral; von Löbbecke, Ina; West, Andrea; Zernikow, Boris; Schulz, Angela

2017-04-01

CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 (TPP1) enzyme deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness, and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability. Twenty-four disease experts were surveyed on CLN2 disease management and a subset met to discuss current practice. Management goals and strategies are consistent among experts globally and are guided by the principles of pediatric palliative care. Goals and interventions evolve as the disease progresses, with a shift in focus from maintenance of function early in the disease to maintenance of quality of life. A multidisciplinary approach is critical for optimal patient care. This work represents an initial step toward the development of consensus-based management guidelines for CLN2 disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2014-04-01

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

A survey of managed care strategies for pregnant smokers.

PubMed

Barker, D C; Robinson, L A; Rosenthal, A C

2000-01-01

The purpose of this study was to measure the content and comprehensiveness of pregnancy specific smoking cessation strategies within managed care organisations (MCOs) responding affirmatively to the national 1997-98 Addressing Tobacco in Managed Care (ATMC) survey. This cross sectional follow up study consisted of a fax survey sent to medical directors and a 37 question telephone survey of program overseers about the smoking cessation strategy. 147 MCOs identifying a pregnancy specific smoking cessation strategy on the 1997-98 ATMC survey served as the initial sample; 88 MCOs of 128 eligible plans completed both components, with a response rate of 69%. Pregnancy specific smoking cessation strategies varied. 40% of respondents used the Agency for Health Care Policy and Research guidelines for clinical smoking cessation to design their strategy. Strategies included self help materials, quit classes, telephone support and brief counselling by providers, linkages to quality improvement efforts, and use of patient databases for outreach. Only 42% offered a postpartum relapse prevention element. Lack of patient interest, competing clinic priorities, and the lack of a smoker identification system were the most problematic barriers to implementing strategies, common to at least a quarter of respondents. A majority ranked best practice manuals and web site linkages as the most useful form of technical assistance, followed by peer-to-peer counselling, regional workshops, newsletters, on-site assistance, and national conferences. The survey provides the first profile of prenatal tobacco treatment strategies in managed care. While design limitations prevent generalisation of these results to all MCOs, such information can help guide technical assistance to plans interested in reducing smoking among pregnant women.

Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study.

PubMed

Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M

2015-05-11

To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators. A cross-sectional study. All Dutch care groups (n=97). 23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers. The association between quality management, overall and in 6 domains ('organisation of care', 'multidisciplinary teamwork', 'patient centredness', 'performance management', 'quality improvement policy' and 'management strategies') on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53 mmol/mol (7%); low-density lipoprotein cholesterol below 2.5 mmol/L; and systolic blood pressure below 140 mm Hg) by weighted univariable linear regression. The domain 'management strategies' was significantly associated with the percentage of patients with a glycated haemoglobin <53 mmol/mol (β 0.28 (0.09; 0.46) p=0.01) after correction for multiple testing. The other domains as well as overall quality management were not associated with aggregate process or outcome indicators. This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains

Managing Quality by Action Research--Improving Quality Service Delivery in Higher Education as a Marketing Strategy.

ERIC Educational Resources Information Center

Corbitt, Brian

1998-01-01

Describes two action research projects undertaken at an Australian university to improve quality of services to foreign students and improve the institution's image through word of mouth, or informal marketing. Each project, although small, facilitated changes or improvements to a targeted service. The role of management in empowering employees…

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

PubMed

Sanders, Julie; Fitzpatrick, Joanne M

2017-01-01

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

Coping strategies used by poorly adherent patients for self-managing bipolar disorder.

PubMed

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual's coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness.

Implementing practice management strategies to improve patient care: the EPIC project.

PubMed

Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

2012-01-01

Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

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

2010-01-01

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

Strategy, Structure and Quality Service: Developing School Wide Quality Improvement.

ERIC Educational Resources Information Center

Murgatroyd, Stephen

1991-01-01

Builds on earlier contributions to the literature on educational leadership and total quality management in education. Introduces two new tools--the service guarantee and the House of Quality, placing them in the context of strategic marketing, structural change, and other total quality management methods. (19 references) (MLH)

Portuguese food composition database quality management system.

PubMed

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

2010-11-01

The harmonisation of food composition databases (FCDB) has been a recognised need among users, producers and stakeholders of food composition data (FCD). To reach harmonisation of FCDBs among the national compiler partners, the European Food Information Resource (EuroFIR) Network of Excellence set up a series of guidelines and quality requirements, together with recommendations to implement quality management systems (QMS) in FCDBs. The Portuguese National Institute of Health (INSA) is the national FCDB compiler in Portugal and is also a EuroFIR partner. INSA's QMS complies with ISO/IEC (International Organization for Standardisation/International Electrotechnical Commission) 17025 requirements. The purpose of this work is to report on the strategy used and progress made for extending INSA's QMS to the Portuguese FCDB in alignment with EuroFIR guidelines. A stepwise approach was used to extend INSA's QMS to the Portuguese FCDB. The approach included selection of reference standards and guides and the collection of relevant quality documents directly or indirectly related to the compilation process; selection of the adequate quality requirements; assessment of adequacy and level of requirement implementation in the current INSA's QMS; implementation of the selected requirements; and EuroFIR's preassessment 'pilot' auditing. The strategy used to design and implement the extension of INSA's QMS to the Portuguese FCDB is reported in this paper. The QMS elements have been established by consensus. ISO/IEC 17025 management requirements (except 4.5) and 5.2 technical requirements, as well as all EuroFIR requirements (including technical guidelines, FCD compilation flowchart and standard operating procedures), have been selected for implementation. The results indicate that the quality management requirements of ISO/IEC 17025 in place in INSA fit the needs for document control, audits, contract review, non-conformity work and corrective actions, and users' (customers

Water quality monitoring strategies - A review and future perspectives.

PubMed

Behmel, S; Damour, M; Ludwig, R; Rodriguez, M J

2016-11-15

The reliable assessment of water quality through water quality monitoring programs (WQMPs) is crucial in order for decision-makers to understand, interpret and use this information in support of their management activities aiming at protecting the resource. The challenge of water quality monitoring has been widely addressed in the literature since the 1940s. However, there is still no generally accepted, holistic and practical strategy to support all phases of WQMPs. The purpose of this paper is to report on the use cases a watershed manager has to address to plan or optimize a WQMP from the challenge of identifying monitoring objectives; selecting sampling sites and water quality parameters; identifying sampling frequencies; considering logistics and resources to the implementation of actions based on information acquired through the WQMP. An inventory and critique of the information, approaches and tools placed at the disposal of watershed managers was proposed to evaluate how the existing information could be integrated in a holistic, user-friendly and evolvable solution. Given the differences in regulatory requirements, water quality standards, geographical and geological differences, land-use variations, and other site specificities, a one-in-all solution is not possible. However, we advance that an intelligent decision support system (IDSS) based on expert knowledge that integrates existing approaches and past research can guide a watershed manager through the process according to his/her site-specific requirements. It is also necessary to tap into local knowledge and to identify the knowledge needs of all the stakeholders through participative approaches based on geographical information systems and adaptive survey-based questionnaires. We believe that future research should focus on developing such participative approaches and further investigate the benefits of IDSS's that can be updated quickly and make it possible for a watershed manager to obtain a

[Quality Manager 2.0 in hospitals: A practical guidance for executive managers, medical directors, senior consultants, nurse managers and practicing quality managers].

PubMed

Pilz, Stefan; Hülsmann, Sylvia; Michallik, Stefan; Rimbach-Schurig, Monika; Schollmeier, Margarita; Sommerhoff, Benedikt; Weßling, Adelheid

2013-01-01

Aiming at the development of perspectives and recommendations for modern quality management in health services the GQMG conducted a study on the role and self-conception of quality managers in hospitals. It seems obvious that the effectiveness of quality management clearly depends on the executive board's skilful installation of quality management, their support of quality managers and, particularly in larger-sized institutions on the coordination of staff units and cross-sectional functions.(As supplied by author). Copyright © 2013. Published by Elsevier GmbH.

Medical equipment management strategies.

PubMed

Wang, Binseng; Furst, Emanuel; Cohen, Ted; Keil, Ode R; Ridgway, Malcolm; Stiefel, Robert

2006-01-01

Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as well as with increasing expectations of health care organizations. In the last 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of joint Commission standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients. It is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article.

The reliability-quality relationship for quality systems and quality risk management.

PubMed

Claycamp, H Gregg; Rahaman, Faiad; Urban, Jason M

2012-01-01

Engineering reliability typically refers to the probability that a system, or any of its components, will perform a required function for a stated period of time and under specified operating conditions. As such, reliability is inextricably linked with time-dependent quality concepts, such as maintaining a state of control and predicting the chances of losses from failures for quality risk management. Two popular current good manufacturing practice (cGMP) and quality risk management tools, failure mode and effects analysis (FMEA) and root cause analysis (RCA) are examples of engineering reliability evaluations that link reliability with quality and risk. Current concepts in pharmaceutical quality and quality management systems call for more predictive systems for maintaining quality; yet, the current pharmaceutical manufacturing literature and guidelines are curiously silent on engineering quality. This commentary discusses the meaning of engineering reliability while linking the concept to quality systems and quality risk management. The essay also discusses the difference between engineering reliability and statistical (assay) reliability. The assurance of quality in a pharmaceutical product is no longer measured only "after the fact" of manufacturing. Rather, concepts of quality systems and quality risk management call for designing quality assurance into all stages of the pharmaceutical product life cycle. Interestingly, most assays for quality are essentially static and inform product quality over the life cycle only by being repeated over time. Engineering process reliability is the fundamental concept that is meant to anticipate quality failures over the life cycle of the product. Reliability is a well-developed theory and practice for other types of manufactured products and manufacturing processes. Thus, it is well known to be an appropriate index of manufactured product quality. This essay discusses the meaning of reliability and its linkages with quality

Advanced strategies for quality control of Chinese medicines.

PubMed

Zhao, Jing; Ma, Shuang-Cheng; Li, Shao-Ping

2018-01-05

Quality control is always the critical issue for Chinese medicines (CMs) with their worldwide increasing use. Different from western medicine, CMs are usually considered that multiple constituents are responsible for the therapeutic effects. Therefore, quality control of CMs is a challenge. In 2011, the strategies for quantification, related to the markers, reference compounds and approaches, in quality control of CMs were reviewed (Li, et al., J. Pharm. Biomed. Anal., 2011, 55, 802-809). Since then, some new strategies have been proposed in these fields. Therefore, the review on the strategies for quality control of CMs should be updated to improve the safety and efficacy of CMs. Herein, novel strategies related to quality marker discovery, reference compound development and advanced approaches (focused on glyco-analysis) for quality control, during 2011-2016, were summarized and discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

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)

Quality-Focused Management.

ERIC Educational Resources Information Center

Needham, Robbie Lee

1993-01-01

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

Strategies for positioning in the managed health care marketplace.

PubMed

Cohn, R

1994-01-01

Managed health care is becoming increasingly common as the demands of cost containment are placed on providers of care. This article defines managed health care, illustrates its continued growth, demonstrates its effect on clinical decision making and reimbursement issues, and suggests strategies for optimal positioning in the managed care marketplace. The hand therapy specialist, whether based in a hospital, an institution-based ambulatory care setting, or a private practice, must be aware of a managed plan's contractual limitations. Parameters discussed are patient length of stay, documentation, reimbursement, patient responsibility, alternatives to conventional treatment protocols, and the potential effects of utilization review on patient treatment. A heightened awareness of managed health care is critical for the manager and practitioner, especially because national health care reform is on the horizon. A provider must be well prepared to ensure delivery of quality care within the myriad restrictions imposed by managed care regulations.

A qualitative investigation of the impact of asthma and self-management strategies among older adults.

PubMed

O'Conor, Rachel; Martynenko, Melissa; Gagnon, Monica; Hauser, Diane; Young, Edwin; Lurio, Joseph; Wisnivesky, Juan P; Wolf, Michael S; Federman, Alex D

2017-01-02

 We sought feedback from elderly patients living with asthma to understand their experience with assuming self-management roles for their asthma in order to inform the design and implementation of a primary care-based strategy that could best support their asthma control. We held six focus groups with a total of 31 English- and Spanish-speaking older adults with a current diagnosis of asthma. Focus groups addressed the effect of asthma on patients' lives and self-management strategies. Transcripts were analyzed using constant comparative techniques. Asthma exerted a consistent effect on patients' physical and psychological well-being. Common barriers to self-care included misuse of controller medications and uncertainty whether shortness of breath, fatigue, and cough were due to their asthma or some other chronic illness. Patients developed coping strategies to continue with daily activities even when experiencing symptoms, but did not recognize attainable asthma quality of life. Asthma had a distinct impact on elderly adults' quality of life; due to their longstanding history with this condition, many patients had accepted these symptoms as a "new normal." Developing strategies to reorient patients' perceptions of the possibilities for managing their illness will be critical to the success of asthma self-management support programs specific to older adults.

Quality management in in vivo proton MRS.

PubMed

Pedrosa de Barros, Nuno; Slotboom, Johannes

2017-07-15

The quality of MR-Spectroscopy data can easily be affected in in vivo applications. Several factors may produce signal artefacts, and often these are not easily detected, not even by experienced spectroscopists. Reliable and reproducible in vivo MRS-data requires the definition of quality requirements and goals, implementation of measures to guarantee quality standards, regular control of data quality, and a continuous search for quality improvement. The first part of this review includes a general introduction to different aspects of quality management in MRS. It is followed by the description of a series of tests and phantoms that can be used to assure the quality of the MR system. In the third part, several methods and strategies used for quality control of the spectroscopy data are presented. This review concludes with a reference to a few interesting techniques and aspects that may help to further improve the quality of in vivo MR-spectra. Copyright © 2017 Elsevier Inc. All rights reserved.

Coping strategies used by poorly adherent patients for self-managing bipolar disorder

PubMed Central

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Background Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. Objective The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. Methods In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Results Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. Conclusion This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual’s coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness. PMID:27524888

A Comparison of Alternative Strategies for Cost-Effective Water Quality Management in Lakes

Treesearch

Daniel Boyd Kramer; Stephen Polasky; Anthony Starfield; Brian Palik; Lynn Westphal; Stephanie Snyder; Pamela Jakes; Rachel Hudson; Eric Gustafson

2006-01-01

Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to...

Managing human resources for successful strategy execution.

PubMed

Arnold, Edwin

2010-01-01

Managers face difficult challenges when they implement organizational strategies to achieve important goals. Execution of strategy has become more dependent upon the effective management of human resources. This article suggests how people can be managed more effectively to facilitate the execution of strategies and improve organizational performance.

What's your strategy for managing knowledge?

PubMed

Hansen, M T; Nohria, N; Tierney, T

1999-01-01

The rise of the computer and the increasing importance of intellectual assets have compelled executives to examine the knowledge underlying their businesses and how it is used. Because knowledge management as a conscious practice is so young, however, executives have lacked models to use as guides. To help fill that gap, the authors recently studied knowledge management practices at management consulting firms, health care providers, and computer manufacturers. They found two very different knowledge management strategies in place. In companies that sell relatively standardized products that fill common needs, knowledge is carefully codified and stored in databases, where it can be accessed and used--over and over again--by anyone in the organization. The authors call this the codification strategy. In companies that provide highly customized solutions to unique problems, knowledge is shared mainly through person-to-person contacts; the chief purpose of computers is to help people communicate. They call this the personalization strategy. A company's choice of knowledge management strategy is not arbitrary--it must be driven by the company's competitive strategy. Emphasizing the wrong approach or trying to pursue both can quickly undermine a business. The authors warn that knowledge management should not be isolated in a functional department like HR or IT. They emphasize that the benefits are greatest--to both the company and its customers--when a CEO and other general managers actively choose one of the approaches as a primary strategy.

Essentials of total quality management: a meta-analysis.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

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

Tracking and forecasting the Nation’s water quality - Priorities and strategies for 2013-2023

USGS Publications Warehouse

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.

Time management strategies for research productivity.

PubMed

Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

2013-02-01

Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

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

PubMed

Smith, Alan D; Offodile, O Felix

2008-01-01

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

The office of strategy management.

PubMed

Kaplan, Robert S; Norton, David P

2005-10-01

There is a disconnect in most companies between strategy formulation and strategy execution. On average, 95% of a company's employees are unaware of, or do not understand, its strategy. If employees are unaware of the strategy, they surely cannot help the organization implement it effectively. It doesn't have to be like this. For the past 15 years, the authors have studied companies that achieved performance breakthroughs by adopting the Balanced Scorecard and its associated tools to help them better communicate strategy to their employees and to guide and monitor the execution of that strategy. Some companies, of course, have achieved better, longer-lasting improvements than others. The organizations that have managed to sustain their strategic focus have typically established a new corporate-level unit to oversee all activities related to strategy: an office of strategy management (OS M). The OSM, in effect, acts as the CEO's chief of staff. It coordinates an array of tasks: communicating corporate strategy; ensuring that enterprise-level plans are translated into the plans of the various units and departments; executing strategic initiatives to deliver on the grand design; aligning employees' plans for competency development with strategic objectives; and testing and adapting the strategy to stay abreast of the competition. The OSM does not do all the work, but it facilitates the processes so that strategy is executed in an integrated fashion across the enterprise. Although the companies that Kaplan and Norton studied use the Balanced Scorecard as the framework for their strategy management systems, the authors say the lessons of the OSM are applicable even to companies that do not use it.

Soil and solid poultry waste nutrient management and water quality.

PubMed

Chapman, S L

1996-07-01

Concerns about the impacts of nitrogen, phosphorus, and pathogens on surface and ground water quality has forced the poultry industry to implement voluntary waste management guidelines for use by growers. In some states, animal waste guidelines are being enforced by regulatory agencies. Strategies that growers may use to properly dispose of poultry waste include: 1) local land application as a fertilizer; 2) offsite marketing for use as a fertilizer or soil amendment, feed additive, or energy source; and 3) chemical additives that will immobilize nitrogen and phosphorus in the manure or litter. If properly followed, these and other innovative strategies should be adequate to protect surface and ground water quality without adversely affecting the economics of poultry production.

Evaluation of mobile source greenhouse gas emissions for assessment of traffic management strategies.

DOT National Transportation Integrated Search

2011-08-01

In recent years, there has been an increasing interest in investigating the air quality benefits of traffic : management strategies in light of challenges associated with the global warming and climate change. : However, there has been a lack of syst...

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

PubMed Central

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

2017-01-01

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

Enhancing Leadership Quality. TQ Source Tips & Tools: Emerging Strategies to Enhance Educator Quality

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2008

2008-01-01

Teaching Quality (TQ) Source Tips & Tools: Emerging Strategies to Enhance Educator Quality is an online resource developed by the TQ Center. It is designed to help education practitioners tap into strategies and resources they can use to enhance educator quality. This publication is based on the TQ Source Tips & Tools topic area "Enhancing…

Canopy management in rainfed vineyards (cv. Tempranillo) for optimising water use and enhancing wine quality.

PubMed

Pascual, Miquel; Romero, María-Paz; Rufat, Josep; Villar, Josep M

2015-12-01

Rainfed viticulture, mainly in semi-arid environments, is limited by environmental variability, particularly precipitation and its seasonal distribution, and soil water availability, thus ultimately determining the final quality of grape and wine. Studies on the feasibility of practices such as canopy management to adapt plant growth and yield to soil water availability open up possibilities to preserve wine quality and reinforce the characteristics of the terroir. Principal components analysis was used to identify the relationships between a large set of variables, including soil, plant, canopy management, and wine characteristics. Canopy management was found to have a predominant influence on plant response to soil water by modifying plant water status, changing the amino acid profile in berries and, concomitantly, altering the sensorial attributes of the wine obtained. Grapevine canopy management strategies, such as reiterate shoot trimming to restrict growth during early phases, are effective in adapting plant response to soil water availability. Such strategies affect berry and wine quality, mainly the amino acid profile and sensorial attributes of the wine, without changing yield or grape harvest quality control parameters. Also, in such conditions, nitrogen does not make a significant contribution to grapevine growth or yield or to grape quality. © 2015 Society of Chemical Industry.

Total Quality Management: Getting Started

DTIC Science & Technology

1990-08-01

Quality Management (TQM) program using Organizational Development (OD) intervention techniques to gain acceptance of the program. It emphasizes human behavior and the need for collaborative management and consensus in organizational change. Lessons learned stress the importance of choosing a skilled TQM facilitator, training process action teams, and fostering open communication and teamwork to minimize resistance to change. Keywords: Management planning and control, Quality control, Quality , Management , Organization change, Organization development,

Cellular Strategies of Protein Quality Control

PubMed Central

Chen, Bryan; Retzlaff, Marco; Roos, Thomas; Frydman, Judith

2011-01-01

Eukaryotic cells must contend with a continuous stream of misfolded proteins that compromise the cellular protein homeostasis balance and jeopardize cell viability. An elaborate network of molecular chaperones and protein degradation factors continually monitor and maintain the integrity of the proteome. Cellular protein quality control relies on three distinct yet interconnected strategies whereby misfolded proteins can either be refolded, degraded, or delivered to distinct quality control compartments that sequester potentially harmful misfolded species. Molecular chaperones play a critical role in determining the fate of misfolded proteins in the cell. Here, we discuss the spatial and temporal organization of cellular quality control strategies and their implications for human diseases linked to protein misfolding and aggregation. PMID:21746797

National quality improvement policies and strategies in European healthcare systems.

PubMed

Spencer, E; Walshe, K

2009-02-01

This survey provides an overview of the development of policies and strategies for quality improvement in European healthcare systems, by mapping quality improvement policies and strategies, progress in their implementation, and early indications of their impact. A survey of quality improvement policies and strategies in healthcare systems of the European Union was conducted in 2005 for the first phase of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The survey, completed by 68 key experts in quality improvement from 24 European Union member states, represents their views and accounts of quality improvement policies and strategies in their healthcare systems. There are substantial international and intra-national variations in the development of healthcare quality improvement. Legal requirements for quality improvement strategies are an important driver of progress, along with the activities of national governments and professional associations and societies. Patient and service user organisations appear to have less influence on quality improvement. Wide variation in voluntary and mandatory coverage of quality improvement policies and strategies across sectors can potentially lead to varying levels of progress in implementation. Many healthcare organisations lack basic infrastructure for quality improvement. Some convergence can be observed in policies on quality improvement in healthcare. Nevertheless, the growth of patient mobility across borders, along with the implications of free market provisions for the organisation and funding of healthcare systems in European Union member states, require policies for cooperation and learning transfer.

Total quality management in American industry.

PubMed

Widtfeldt, A K; Widtfeldt, J R

1992-07-01

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

Total Quality and Organization Development. Total Quality Series.

ERIC Educational Resources Information Center

Lindsay, William M.; Petrick, Joseph A.

As the global business environment becomes more turbulent, quality management seems more indispensable. This book offers strategies for integrating the theory and practice of Total Quality Management (TQM) with organizational-development (OD) theory at all organizational levels. Chapter 1 answers the question "Why Total Quality Management and…

Homosexuality in Turkey: strategies for managing heterosexism.

PubMed

Bakacak, Ayça Gelgeç; Oktem, Pinar

2014-01-01

The goal of this study was to identify the strategies used by young homosexuals to manage their sexual minority status in Turkey. In-depth interviews were conducted with 15 self-identified homosexual university students. The data on the strategies employed by homosexuals suggested a categorization of these strategies into four interrelated areas: strategies employed in the process of self-acceptance; strategies to manage sexual stigma and prejudice; strategies specific to the coming-out process; and the strategies used while openly expressing their sexual identities.

Is there an optimal preoperative management strategy for phaeochromocytoma/paraganglioma?

PubMed

Challis, B G; Casey, R T; Simpson, H L; Gurnell, M

2017-02-01

Phaeochromocytomas and paragangliomas (PPGLs) are catecholamine secreting neuroendocrine tumours that predispose to haemodynamic instability. Currently, surgery is the only available curative treatment, but carries potential risks including hypertensive and hypotensive crises, cardiac arrhythmias, myocardial infarction and stroke, due to tumoral release of catecholamines during anaesthetic induction and tumour manipulation. The mortality associated with surgical resection of PPGL has significantly improved from 20-45% in the early 20th century (Apgar & Papper, AMA Archives of Surgery, 1951, 62, 634) to 0-2·9% in the early 21st century (Kinney et al. Journal of Cardiothoracic and Vascular Anesthesia, 2002, 16, 359), largely due to availability of effective pharmacological agents and advances in surgical and anaesthetic practice. However, surgical resection of PPGL still poses significant clinical management challenges. Preoperatively, alpha-adrenoceptor blockade is the mainstay of management, although various pharmacological strategies have been proposed, based largely on reports derived from retrospective data sets. To date, no consensus has been reached regarding the 'ideal' preoperative strategy due, in part, to a paucity of data from high-quality evidence-based studies comparing different treatment regimens. Here, based on the available literature, we address the Clinical Question: Is there an optimal preoperative management strategy for PPGL? © 2016 John Wiley & Sons Ltd.

Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators.

PubMed

Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard

2016-04-01

The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.

Managing Conflict: 50 Strategies for School Leaders

ERIC Educational Resources Information Center

Edmonson, Stacey; Combs, Julie; Harris, Sandra

2008-01-01

This book offers 50 easy-to-read strategies for managing conflicts in your school involving students, parents, and teachers. Individually, these strategies provide specific insights into conflict resolution, reduction, and management. As a whole, the 50 strategies provide a comprehensive method to lead constructive change in your school. With…

Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States

PubMed Central

Manangan, Lilia Ponce; Tryon, Cheryl; Magee, Elvin; Miramontes, Roque

2012-01-01

Introduction. The Centers for Disease Control and Prevention (CDC)'s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009. Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit. Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions' QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012. Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality. PMID:22685648

Quality risk management in pharmaceutical development.

PubMed

Charoo, Naseem Ahmad; Ali, Areeg Anwer

2013-07-01

The objective of ICH Q8, Q9 and Q10 documents is application of systemic and science based approach to formulation development for building quality into product. There is always some uncertainty in new product development. Good risk management practice is essential for success of new product development in decreasing this uncertainty. In quality by design paradigm, the product performance properties relevant to the patient are predefined in target product profile (TPP). Together with prior knowledge and experience, TPP helps in identification of critical quality attributes (CQA's). Initial risk assessment which identifies risks to these CQA's provides impetus for product development. Product and process are designed to gain knowledge about these risks, devise strategies to eliminate or mitigate these risks and meet objectives set in TPP. By laying more emphasis on high risk events the protection level of patient is increased. The process being scientifically driven improves the transparency and reliability of the manufacturer. The focus on risk to the patient together with flexible development approach saves invaluable resources, increases confidence on quality and reduces compliance risk. The knowledge acquired in analysing risks to CQA's permits construction of meaningful design space. Within the boundaries of the design space, variation in critical material characteristics and process parameters must be managed in order to yield a product having the desired characteristics. Specifications based on product and process understanding are established such that product will meet the specifications if tested. In this way, the product is amenable to real time release, since specifications only confirm quality but they do not serve as a means of effective process control.

Quality Management and Information Brokerage.

ERIC Educational Resources Information Center

van Halm, Johan

1995-01-01

To compete effectively, information brokers need to adopt management and marketing tools; Total Quality Management can upgrade an organization's performance by using customer feedback of its services. SERVQUAL identifies gaps in service by assessing quality expectations versus quality experiences. (AEF)

Total Quality Management Implementation Plan for Military Personnel Management

DTIC Science & Technology

1989-09-01

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

Environmental management practices in the Lebanese pharmaceutical industries: implementation strategies and challenges.

PubMed

Massoud, May A; Makarem, N; Ramadan, W; Nakkash, R

2015-03-01

This research attempts to provide an understanding of the Lebanese pharmaceutical industries' environmental management strategies, priorities, and perceptions as well as drivers, barriers, and incentives regarding the implementation of the voluntary ISO 14001 Environmental Management System. Accordingly, a semistructured in-depth interview was conducted with the pharmaceutical industries. The findings revealed a significant lack of knowledge about the standard among the industries. The main perceived drivers for adopting the ISO 14001 are improving the companies' image and overcoming international trade. The main perceived barriers for acquiring the standard are the lack of government support and the fact that ISO 14001 is not being legally required or enforced by the government. Moreover, results revealed that adopting the ISO 14001 standard is not perceived as a priority for the Lebanese pharmaceutical industries. Although the cost of certification was not considered as a barrier for the implementation of ISO 14001, the majority of the pharmaceutical industries are neither interested nor willing to adopt the Standard if they are not exposed to any regulatory pressure or external demand. They are more concerned with quality and safety issues with the most adopted international standard among the industries being the ISO 9001 quality management system. This study highlights the aspect that financial barriers are not always the hurdles for implementing environmental management strategies in developing countries and underscores the need for regulatory frameworks and enforcement.

Systematic review of strategies to manage and allocate scarce resources during mass casualty events.

PubMed

Timbie, Justin W; Ringel, Jeanne S; Fox, D Steven; Pillemer, Francesca; Waxman, Daniel A; Moore, Melinda; Hansen, Cynthia K; Knebel, Ann R; Ricciardi, Richard; Kellermann, Arthur L

2013-06-01

Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs. Our literature search included MEDLINE, Scopus, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Database of Systematic Reviews, from 1990 through late 2011. We also searched the gray literature, using the New York Academy of Medicine's Grey Literature Report and key Web sites. We included both English- and foreign-language articles. We included studies that evaluated strategies used in actual mass casualty events or tested through drills, exercises, or computer simulations. We excluded studies that lacked a comparison group or did not report quantitative outcomes. Data extraction, quality assessment, and strength of evidence ratings were conducted by a single researcher and reviewed by a second; discrepancies were reconciled by the 2 reviewers. Because of heterogeneity in outcome measures, we qualitatively synthesized findings within categories of strategies. From 5,716 potentially relevant citations, 74 studies met inclusion criteria. Strategies included reducing demand for health care services (18 studies), optimizing use of existing resources (50), augmenting existing resources (5), implementing crisis standards of care (5), and multiple categories (4). The evidence was sufficient to form conclusions on 2 strategies, although the strength of evidence was rated as low. First, as a strategy to reduce demand for health care services, points of dispensing can be used to efficiently distribute biological countermeasures after a bioterrorism attack or influenza pandemic, and their organization influences speed of

42 CFR 438.204 - Elements of State quality strategies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Elements of State quality strategies. 438.204 Section 438.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Improvement § 438.204 Elements of State quality strategies. At a minimum, State strategies must include the...

42 CFR 438.204 - Elements of State quality strategies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Elements of State quality strategies. 438.204 Section 438.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Improvement § 438.204 Elements of State quality strategies. At a minimum, State strategies must include the...

42 CFR 438.204 - Elements of State quality strategies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Elements of State quality strategies. 438.204 Section 438.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Improvement § 438.204 Elements of State quality strategies. At a minimum, State strategies must include the...

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

PubMed

Eisner, Reinhold; Patel, Rakeshkumar

2017-04-20

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

Total Quality Management (TQM) Bibliography

DTIC Science & Technology

1990-04-01

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

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2014-02-01

Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to external quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2013-09-01

Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

Growth, Yield and Fruit Quality of Grapevines under Organic and Biodynamic Management

PubMed Central

Döring, Johanna; Frisch, Matthias; Tittmann, Susanne; Stoll, Manfred; Kauer, Randolf

2015-01-01

The main objective of this study was to determine growth, yield and fruit quality of grapevines under organic and biodynamic management in relation to integrated viticultural practices. Furthermore, the mechanisms for the observed changes in growth, yield and fruit quality were investigated by determining nutrient status, physiological performance of the plants and disease incidence on bunches in three consecutive growing seasons. A field trial (Vitis vinifera L. cv. Riesling) was set up at Hochschule Geisenheim University, Germany. The integrated treatment was managed according to the code of good practice. Organic and biodynamic plots were managed according to Regulation (EC) No 834/2007 and Regulation (EC) No 889/2008 and according to ECOVIN- and Demeter-Standards, respectively. The growth and yield of the grapevines differed strongly among the different management systems, whereas fruit quality was not affected by the management system. The organic and the biodynamic treatments showed significantly lower growth and yield in comparison to the integrated treatment. The physiological performance was significantly lower in the organic and the biodynamic systems, which may account for differences in growth and cluster weight and might therefore induce lower yields of the respective treatments. Soil management and fertilization strategy could be responsible factors for these changes. Yields of the organic and the biodynamic treatments partially decreased due to higher disease incidence of downy mildew. The organic and the biodynamic plant protection strategies that exclude the use of synthetic fungicides are likely to induce higher disease incidence and might partially account for differences in the nutrient status of vines under organic and biodynamic management. Use of the biodynamic preparations had little influence on vine growth and yield. Due to the investigation of important parameters that induce changes especially in growth and yield of grapevines under

Environmental factors and health information technology management strategy.

PubMed

Menachemi, Nir; Shin, Dong Yeong; Ford, Eric W; Yu, Feliciano

2011-01-01

: Previous studies have provided theoretical and empirical evidence that environmental forces influence hospital strategy. : Rooted in resource dependence theory and the information uncertainty perspective, this study examined the relationship between environmental market characteristics and hospitals' selection of a health information technology (HIT) management strategy. : A cross-sectional design is used to analyze secondary data from the American Hospital Association Annual Survey, the Healthcare Information and Management Systems Society Analytics Database, and the Area Resource File. Univariate and multinomial logistic regression analyses are used. : Overall, 3,221 hospitals were studied, of which 60.9% pursed a single-vendor HIT management strategy, 28.9% pursued a best-of-suite strategy, and 10.2% used a best-of-breed strategy. Multivariate analyses controlling for hospital characteristics found that measures of environmental factors representing munificence, dynamism, and/or complexity were systematically associated with various hospital HIT management strategy use. Specifically, the number of generalist physicians per capita was positively associated with the single-vendor strategy (B = -5.64, p = .10). Hospitals in urban markets were more likely to pursue the best-of-suite strategy (B = 0.622, p < .001). Dynamism, measured as the number of managed care contracts for a given hospital, was negatively associated with the single-vendor strategy (B = 0.004, p = .049). Lastly, complexity, measured as market competition, was positively associated with the best-of-breed strategy (B = 0.623, p = .042). : By and large, environmental factors are associated with hospital HIT management strategies in mostly theoretically supported ways. Hospital leaders and policy makers interested in influencing the adoption of hospital HIT should consider how market conditions influence HIT management decisions as part of programs to promote meaningful use.

[Quality management is associated with high quality services in health care].

PubMed

Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

Water resources management strategies and its implications on hydrodynamic and hydrochemical changes of costal groundwater: Case of Grombalia shallow aquifer, NE Tunisia

NASA Astrophysics Data System (ADS)

Lachaal, Fethi; Chekirbane, Anis; Chargui, Sameh; Sellami, Haykel; Tsujimura, Maki; Hezzi, Hmida; Faycel, Jelassi; Mlayah, Ammar

2016-12-01

Information on groundwater quantity as well as quality is required by water managers and decision-makers for defining a sustainable management strategy. This requires a comprehensive assessment of the surface water and groundwater resources. This paper provides an assessment of water resources management strategy in the Grombalia region (Northeast Tunisia) and its impact on quantity and quality evolution of groundwater resources based on an approach that combines (i) hydro-climatic data, (ii) field monitoring, (iii) historic piezometric records, and (iv) geochemical and stable isotopes (δ18O and δ2H) analyses. We apply this approach to identify the origin of the various water resources and outline how the actual water management impact the quantity and quality of the groundwater in the region. As consequence of poor water resources management, the shallow groundwater levels have been disrupted: a groundwater rise is observed in the centre and a piezometric drawdown is observed in the upstream regions. Groundwater quality degradation was registered especially in the centre and downstream zones.

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

PubMed

Noordhuizen, J P; Welpelo, H J

1996-12-01

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

Coping strategies, vision-related quality of life, and emotional health in managing retinitis pigmentosa: a survey study.

PubMed

Anil, Krithika; Garip, Gulcan

2018-01-30

Retinitis pigmentosa is a group of genetic progressive retinal dystrophies that may adversely affect daily life. Those with RP should develop adaptive coping strategies to manage their condition. This study investigates the relationship between engaging (ECS) and disengaging coping strategies (DCS), vision-related quality of life (VRQoL), and emotional health, in adults living at home with retinitis pigmentosa. One hundred and five participants (70 female; mean age of 46.98, SD age  = 13.77) completed a cross-sectional survey. The questionnaire booklet consisted of the Coping Strategies Inventory - Short Form (32 items), the National Eye Institute Visual Functioning Questionnaire 25 (25 items), Marylands Trait Depression Scale (18 items), the Warwick-Edinburgh Mental Well-being Scale (14 items), and the Subjective Happiness Scale (4 items). Data was analysed with a two-block hierarchical multiple regression, with the first block controlling for the demographic data (age, sex, years since retinitis pigmentosa diagnosis, number of comorbidities, participant-perceived retinitis pigmentosa severity, and knowing RP type) and the second block consisting of primary measures (type of coping strategy, VRQoL, and Emotional Health). Type of coping strategy was found to impact psychosocial variables of VRQoL, not overall VRQoL. These psychosocial VRQoL variables had a positive association with ECS and a negative association with DCS. Emotional Health increased with ECS and decreased with DCS. There was a larger impact of DCS on VRQoL and Emotional Health compared to ECS, that is, VRQoL and Emotional Health decreased more with increasing DCS than VRQoL, and Emotional Health increased with increasing ECS. In concordance with previous research, ECS increased with increasing VRQoL and DCS decreased with increasing VRQoL. However, the findings also indicated that DCS had a greater impact than ECS on VRQoL and Emotional Health. This suggests that diminishing DCS should be

Internal quality control: planning and implementation strategies.

PubMed

Westgard, James O

2003-11-01

The first essential in setting up internal quality control (IQC) of a test procedure in the clinical laboratory is to select the proper IQC procedure to implement, i.e. choosing the statistical criteria or control rules, and the number of control measurements, according to the quality required for the test and the observed performance of the method. Then the right IQC procedure must be properly implemented. This review focuses on strategies for planning and implementing IQC procedures in order to improve the quality of the IQC. A quantitative planning process is described that can be implemented with graphical tools such as power function or critical-error graphs and charts of operating specifications. Finally, a total QC strategy is formulated to minimize cost and maximize quality. A general strategy for IQC implementation is recommended that employs a three-stage design in which the first stage provides high error detection, the second stage low false rejection and the third stage prescribes the length of the analytical run, making use of an algorithm involving the average of normal patients' data.

Nurse managers' conceptions of quality management as promoted by peer supervision.

PubMed

Hyrkäs, Kristiina; Koivula, Meeri; Lehti, Kristiina; Paunonen-Ilmonen, Marita

2003-01-01

The aim of the study was to describe nurse managers' conceptions of quality management in their work as promoted by peer supervision. Quality management is one of the topical issues in a nurse manager's demanding and changing work. As first-line managers, they have a key role in quality management which is seen to create the system and environment for high quality services and quality improvement. Despite the official recommendations and definitions of quality management, several published reports have shown that there is no single solution for quality management. Peer supervision or the support provided by it to nursing managers have rarely been a subject of study. This study was carried out at Tampere University Hospital between 1996 and 1998. The peer supervision intervention was organized once a month, 2 hours at a time and in closed supervisor-led groups of nine nurse managers. Data were collected by themed interviews. Fifteen nurse managers participated in the study. The data were analysed using the phenomenographic method. Two main categories were formed of nurse managers' conceptions. The first described supportive and reflective characteristics of peer supervision. This main category was described by horizontal, hierarchical categories of support from peer group and reflection. The second main category described nurse managers' conceptions of individual development of leadership during peer supervision. This main category was also described by three horizontal categories: personal growth, finding psychological resources and internalization of leadership. The finding of this study show that peer supervision benefited nurse managers in quality management through reflection and support. The reflective and supportive characteristics of peer supervision promoted the nurse managers' individual development, but also that of leadership. It can be concluded that peer supervision promotes quality management in nurse managers' work.

Chemical application strategies to protect water quality.

PubMed

Rice, Pamela J; Horgan, Brian P; Barber, Brian L; Koskinen, William C

2018-07-30

Management of turfgrass on golf courses and athletic fields often involves application of plant protection products to maintain or enhance turfgrass health and performance. However, the transport of fertilizer and pesticides with runoff to adjacent surface waters can enhance algal blooms, promote eutrophication and may have negative impacts on sensitive aquatic organisms and ecosystems. Thus, we evaluated the effectiveness of chemical application setbacks to reduce the off-site transport of chemicals with storm runoff. Experiments with water soluble tracer compounds confirmed an increase in application setback distance resulted in a significant increase in the volume of runoff measured before first off-site chemical detection, as well as a significant reduction in the total percentage of applied chemical transported with the storm runoff. For example, implementation of a 6.1 m application setback reduced the total percentage of an applied water soluble tracer by 43%, from 18.5% of applied to 10.5% of applied. Evaluation of chemographs revealed the efficacy of application setbacks could be observed with storms resulting in lesser (e.g. 100 L) and greater (e.g. > 300 L) quantities of runoff. Application setbacks offer turfgrass managers a mitigation approach that requires no additional resources or time inputs and may serve as an alternative practice when buffers are less appropriate for land management objectives or site conditions. Characterizing potential contamination of surface waters and developing strategies to safeguard water quality will help protect the environment and improve water resource security. This information is useful to grounds superintendents for designing chemical application strategies to maximize environmental stewardship. The data will also be useful to scientists and regulators working with chemical transport and risk models. Copyright © 2018. Published by Elsevier Inc.

Study protocol: patient reported outcomes for bladder management strategies in spinal cord injury.

PubMed

Patel, Darshan P; Lenherr, Sara M; Stoffel, John T; Elliott, Sean P; Welk, Blayne; Presson, Angela P; Jha, Amitabh; Rosenbluth, Jeffrey; Myers, Jeremy B

2017-10-10

The majority of spinal cord injury (SCI) patients have urinary issues, such as incontinence, retention, and frequency. These problems place a significant burden on patients' physical health and quality of life (QoL). There are a wide variety of bladder management strategies available to patients with no clear guidelines on appropriate selection. Inappropriate bladder management can cause hospitalizations and serious complications, such as urosepsis and renal failure. Patients believe that both independence and ability to carry out daily activities are just as important as physical health in selecting the right bladder-management strategy but little is known about patient's QoL with different bladder managements. Our study's aim is to assess patient reported QoL measures with various bladder managements after SCI. This manuscript describes the approach, study design and common data elements for our central study. This is a multi-institutional prospective cohort study comparing three different bladder-management strategies (clean intermittent catheterization, indwelling catheters, and surgery). Information collected from participants includes demographics, past medical and surgical history, injury characteristics, current and past bladder management, and SCI /bladder-related complications. Patient reported outcomes and QoL questionnaires were administered at enrollment and every 3 months for 1 year. Aims of this study protocol are: (1) to assess baseline QoL differences between the three different bladder-management strategies; (2) determine QoL impact when those using either form of catheter management undergo a surgery over the 1 year of follow-up among patients eligible for surgery; (3) assess the effects of changes in bladder management and complications on QoL over a 1-year longitudinal follow-up. By providing information about patient-reported outcomes associated with different bladder management strategies after SCI, and the impact of bladder management

Improving The Quality of Education Through School-Based Management: Learning From International Experiences

NASA Astrophysics Data System (ADS)

Grauwe, Anton De

2005-07-01

School-based management is being increasingly advocated as a shortcut to more efficient management and quality improvement in education. Research, however, has been unable to prove conclusively such a linkage. Especially in developing countries, concerns remain about the possible detrimental impact of school-based management on school quality; equity among different schools in the same system; the motivation of and relationships between principals and teachers; and financial as well as administrative transparency. The present study defines school-based management and, in view of its implementation in different world regions, examines some of its advantages and disadvantages. In particular, the author explores the strategies which must accompany school-based management in order to ensure a positive impact on quality. These are found to include (1) guaranteeing that all schools have certain basic resources; (2) developing an effective school-support system; (3) providing schools with regular information on their performance and advice on how they might improve; and (4) emphasizing the motivational element in the management work of the school principal.

Management of Hyposalivation and Xerostomia: Criteria for Treatment Strategies.

PubMed

Epstein, Joel B; Beier Jensen, Siri

2015-09-01

Saliva management in patients with hyposalivation is potentially complex. Future development of oral care products and treatment strategies requires attention to the biology of saliva and the best means of providing a continuum of relief for people with xerostomia--the sensation of dry mouth--and hyposalivation--documented reduction in saliva flow. Improvement in patient care requires that clinicians be aware of approaches to management, desirable qualities of methods and products, and that they seek the development of products that support the functions of saliva and promote comfort and health. In this brief review of the epidemiology of hyposalivation, the biology and functions of saliva are presented in order to guide clinical decision-making to address the needs of patients with dry mouth.

Region 7 Quality Management Plan

EPA Pesticide Factsheets

To document adherence to EPA Order 5360.1 A2, EPA requires each organizational unitto develop a quality management plan per the specifications in EPA Requirements for QualityManagement Plans, EPA QA R-2.

Strategies for Managing a Multigenerational Workforce

NASA Astrophysics Data System (ADS)

Iden, Ronald

The multigenerational workforce presents a critical challenge for business managers, and each generation has different expectations. A human resource management study of organizations with more than 500 employees reported 58% of the managers experiencing conflict between younger and older workers. The purpose of this single case study was to explore the multigenerational strategies used by 3 managers from a Franklin County, Ohio manufacturing facility with a population size of 6 participants. The conceptual framework for this study was built upon generational theory and cohort group theory. The data were collected through face-to-face semistructured interviews, company documents, and a reflexive journal. Member checking was completed to strengthen the credibility and trustworthiness of the interpretation of participants' responses. A modified van Kaam method enabled separation of themes following the coding of data. Four themes emerged from the data: (a) required multigenerational managerial skills, (b) generational cohort differences, (c) most effective multigenerational management strategies, and (d) least effective multigenerational management strategies. Findings from this study may contribute to social change through better understanding, acceptance, and appreciation of the primary generations in the workforce, and, in turn, improve community relationships.

Putting Residents First: Strategies Developed by CNAs to Prevent and Manage Resident-to-Resident Violence in Nursing Homes

PubMed Central

Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C.

2015-01-01

Purpose of the Study: Resident-to-resident violence (RRV) in nursing homes (NHs) is common and threatens the safety and quality of life of both residents and caregivers. The purpose of this portion of a larger qualitative study was to explore strategies developed by certified nurses’ assistants (CNAs) to prevent and manage RRV in NHs. Design and Methods: Semistructured interviews were used to collect data. Data were analyzed utilizing content analysis and constant comparison. Results: Analysis revealed one overriding theme, “Putting Residents First” which the CNAs described as a conscious effort to put themselves or a beloved family member in the place of the resident while administering care. Within this theme, there were three related subthemes: (a) Knowing the Residents, (b) Keeping Residents Safe, and (c) Spending Quality Time. Implications: Together, these themes suggest that the formulation of strategies for decreasing and managing RRV was influenced significantly by the ability of the CNAs to empathize with the residents for whom they were caring. The results indicate that in the absence of evidence-based interventions, CNAs have developed their own strategies for the management and prevention of RRV. These strategies may provide a foundation for the development and testing of interventions aimed at preventing and managing RRV in NHs. PMID:26055786

Defense Depot Tracy Total Quality Management Plan

DTIC Science & Technology

1989-07-01

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

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

DTIC Science & Technology

1989-09-01

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

Clinical roundtable monograph: effective management of quality of life in metastatic breast cancer.

PubMed

Christopher, Twelves; Gradishar, William J; O'Shaughnessy, Joyce A; Bramsen, Betsy; Lurie, Robert H

2014-02-01

Quality of life is accepted as an important consideration in the management of patients with metastatic breast cancer, which remains incurable. Recent clinical trials of newer agents, such as eribulin and trastuzumab emtansine, have incorporated quality of life analyses. Quality of life is impacted by multiple patient-related, disease-related, and treatment-related factors. Therapies most beneficial for maintaining or improving quality of life include those that can effectively reduce tumor burden and tumor-related symptoms, but have toxicity profiles that are well tolerated and easily managed. Overall outcomes of patients with metastatic breast cancer improve when therapy is focused not only on the disease itself, but also on the goals of minimizing diseaserelated and treatment-related symptoms. A paradigm shift now reflected in major guidelines is the incorporation of palliative care strategies earlier in the course of metastatic disease management. The selection and sequence of treatments should be made in cooperation with the patient and after consideration of her particular priorities.

Comparison of medicines management strategies in insurance schemes in middle-income countries: four case studies.

PubMed

Kaplan, Warren A; Ashigbie, Paul G; Brooks, Mohamad I; Wirtz, Veronika J

2017-01-01

Many middle-income countries are scaling up health insurance schemes to provide financial protection and access to affordable medicines to poor and uninsured populations. Although there is a wealth of evidence on how high income countries with mature insurance schemes manage cost-effective use of medicines, there is limited evidence on the strategies used in middle-income countries. This paper compares the medicines management strategies that four insurance schemes in middle-income countries use to improve access and cost-effective use of medicines among beneficiaries. We compare key strategies promoting cost-effective medicines use in the New Rural Cooperative Medical Scheme (NCMS) in China, National Health Insurance Scheme in Ghana, Jamkesmas in Indonesia and Seguro Popular in Mexico. Through the peer-reviewed and grey literature as of late 2013, we identified strategies that met our inclusion criteria as well as any evidence showing if, and/or how, these strategies affected medicines management. Stakeholders involved and affected by medicines coverage policies in these insurance schemes were asked to provide relevant documents describing the medicines related aspects of these insurance programs. We also asked them specifically to identify publications discussing the unintended consequences of the strategies implemented. Use of formularies, bulk procurement, standard treatment guidelines and separation of prescribing and dispensing were present in all four schemes. Also, increased transparency through publication of tender agreements and procurement prices was introduced in all four. Common strategies shared by three out of four schemes were medicine price negotiation or rebates, generic reference pricing, fixed salaries for prescribers, accredited preferred provider network, disease management programs, and monitoring of medicines purchases. Cost-sharing and payment for performance was rarely used. There was a lack of performance monitoring strategies in all

Quality of Life and Coping Strategies in Coronary Heart Disease Patients

NASA Astrophysics Data System (ADS)

Yazdi, Seyedeh-Monavar; Hosseinian, Simin; Eslami, Mansoure; Fathi-Ashtiani, Ali

This study aims to find the relationship between quality of life and coping strategies in coronary heart disease patients. Two hundred coronary heart disease patients at Tehran Heart Center, who had been diagnosed with the disease 3 months before, were selected and filled out The Coping Inventory for Stressful Situations (CISS) and Quality of Life-SF36. Results showed a discrepancy between quality of life indices and coping strategies. Task-oriented strategy had a positive and significant relationship with total quality of life and PF indices while it had a negative and significant relationship with MH, RE and RP indices. Emotional-oriented strategy had a positive and significant relationship with RP and RE indices while it had a negative and significant relationship with PF, GH, PH, total psychological health and total quality of life indices. Avoidance-oriented strategy had a negative and significant relationship only with MH index. Furthermore, quality of life aspects (physical and psychological) had a positive and significant relationship with emotional-oriented strategy, but it did not have a significant relationship with task-oriented and avoidance-oriented strategies. Also, the social aspect of quality of life did not have a significant relationship with any of the strategies. Considering the effect of stress on decreasing the quality of life, we recommend a psychologist train coping strategies to coronary heart disease patients along with medical treatments in order to improve recovery, maintain health and reduce recurrence.

A model to evaluate quality and effectiveness of disease management.

PubMed

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.

WITHDRAWN: Initial management strategies for dyspepsia.

PubMed

Delaney, Brendan; Ford, Alex C; Forman, David; Moayyedi, Paul; Qume, Michelle

2009-10-07

This review considers management strategies (combinations of initial investigation and empirical treatments) for dyspeptic patients. Dyspepsia was defined to include both epigastric pain and heartburn. To determine the effectiveness, acceptability, and cost effectiveness of the following initial management strategies for patients presenting with dyspepsia (a) Initial pharmacological therapy (including endoscopy for treatment failures). (b) Early endoscopy. (c) Testing for Helicobacter pylori (H. pylori )and endoscope only those positive. (d) H. pylori eradication therapy with or without prior testing. Trials were located through electronic searches and extensive contact with trialists. All randomised controlled trials of dyspeptic patients presenting in primary care. Data were collected on dyspeptic symptoms, quality of life and use of resources. An individual patient data meta-analysis of health economic data was conducted Twenty-five papers reporting 27 comparisons were found. Trials comparing proton pump inhibitors (PPI) with antacids (three trials) and histamine H2-receptor antagonists (H2RAs) (three trials), early endoscopy with initial acid suppression (five trials), H. pylori test and endoscope versus usual management (three trials), H. pylori test and treat versus endoscopy (six trials), and test and treat versus acid suppression alone in H. pylori positive patients (four trials), were pooled. PPIs were significantly more effective than both H2RAs and antacids. Relative risks (RR) and 95% confidence intervals (CI) were; for PPI compared with antacid 0.72 (95% CI 0.64 to 0.80), PPI compared with H2RA 0.63 (95% CI 0.47 to 0.85). Results for other drug comparisons were either absent or inconclusive. Initial endoscopy was associated with a small reduction in the risk of recurrent dyspeptic symptoms compared with H. pylori test and treat (OR 0.75, 95% CI 0.58 to 0.96), but was not cost effective (mean additional cost of endoscopy US$401 (95% CI $328 to 474

Embracing technology? Using change management strategies to improve the use of continuous lateral rotation therapy.

PubMed

Cybulski, Pamela; Zantinge, Johanna; Abbott-McNeil, Deanna

2006-01-01

The purpose of this quality improvement initiative was to improve the utilization of continuous lateral rotation therapy (CLRT) in a nine-bed community hospital ICU within the context of a nurse-driven protocol. Nursing focus groups, analyzed using a strength, weakness, opportunity, threat (SWOT) approach, resulted in the implementation of four interventions over seven weeks. Change management strategies guided all aspects of the project. Results showed a modest increase in the utilization of CLRT. This initiative demonstrates that change management strategies may assist with the incorporation of technology into nursing practice by increasing empowerment and creating an attachment to and responsibility for outcomes.

Investigation of priorities in water quality management based on correlations and variations.

PubMed

Boyacıoğlu, Hülya; Gündogdu, Vildan; Boyacıoğlu, Hayal

2013-04-15

The development of water quality assessment strategies investigating spatial and temporal changes caused by natural and anthropogenic phenomena is an important tool in management practices. This paper used cluster analysis, water quality index method, sensitivity analysis and canonical correlation analysis to investigate priorities in pollution control activities. Data sets representing 22 surface water quality parameters were subject to analysis. Results revealed that organic pollution was serious threat for overall water quality in the region. Besides, oil and grease, lead and mercury were the critical variables violating the standard. In contrast to inorganic variables, organic and physical-inorganic chemical parameters were influenced by variations in physical conditions (discharge, temperature). This study showed that information produced based on the variations and correlations in water quality data sets can be helpful to investigate priorities in water management activities. Moreover statistical techniques and index methods are useful tools in data - information transformation process. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Eighth Annual NASA/Contractors Conference and 1991 National Symposium on Quality and Productivity: Extending the boundaries of total quality management

NASA Technical Reports Server (NTRS)

Templeton, Geoffrey B. (Editor); Stewart, Lynne M. (Editor); Still, William T. (Editor)

1992-01-01

The Eighth Annual NASA/Contractors Conference and 1991 National Symposium on Quality and Productivity provided a forum to exchange knowledge and experiences in these areas of continuous improvement. The more than 1,100 attendees from government, industry, academia, community groups, and the international arena had a chance to learn about methods, tools, and strategies for excellence and to discuss continuous improvement strategies, successes, and failures. This event, linked via satellite to concurrent conferences hosted by the NASA Goddard Space Flight Center in Greenbelt, Maryland, and Martin Marietta Astronautics Group in Denver, Colorado, also explored extending the boundaries of Total Quality Management to include partnerships for quality within communities and encouraged examination, evaluation, and change to incorporate the principles of continuous improvement.

Total quality management in blood transfusion.

PubMed

Smit-Sibinga, C T

2000-01-01

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

Diabetes benefit management: evolving strategies for payers.

PubMed

Tzeel, Albert L

2011-11-01

Over the next quarter century, the burden of type 2 diabetes mellitus (T2DM) is expected to at least double. Currently, 1 in every 10 healthcare dollars is spent on diabetes management; by 2050, it has been projected that the annual costs of managing T2DM will rise to $336 billion. Without substantial, systemic changes, T2DM management costs will lead to a potentially untenable strain on the healthcare system. However, the appropriate management of diabetes can reduce associated mortality and delay comorbidities. In addition, adequate glycemic control can improve patient outcomes and significantly reduce diabetes-related complications. This article provides an overview of key concepts associated with a value-based insurance design (VBID) approach to T2DM coverage. By promoting the use of services or treatments that provide high benefits relative to cost, and by alternatively discouraging patients from utilizing services whose benefits do not justify their cost, VBID improves the quality of healthcare while simultaneously reining in spending. VBID initiatives tend to focus on chronic disease management and generally target prescription drug use. However, some programs have expanded their scope by incorporating services traditionally offered by wellness and disease management programs. The concept of VBID is growing, and it is increasingly being implemented by a diverse and growing number of public and private entities, including pharmacy benefit managers, health plans, and employers. This article provides key background on VBID strategies, with a focus on T2DM management. It also provides a road map for health plans seeking to implement VBID as part of their programs.

Assessing the quality of cost management

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

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

1995-12-31

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

Management of groundwater supply and water quality in the Los Angeles Basin, California

USGS Publications Warehouse

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

Air Quality Management Process Cycle

EPA Pesticide Factsheets

Air quality management are activities a regulatory authority undertakes to protect human health and the environment from the harmful effects of air pollution. The process of managing air quality can be illustrated as a cycle of inter-related elements.

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

PubMed

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

2004-02-01

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

Total Quality Management Implementation Plan.

DTIC Science & Technology

1989-06-01

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

Total quality management in orthodontic practice.

PubMed

Atta, A E

1999-12-01

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

Total Quality Management, DLA Finance Center

DTIC Science & Technology

1989-07-01

ton. DC 20503. DATE 3. REPORT TYPE AND DATES COVERED SJuly 1989 4. TITLE AND SUBTIT’LE 5. FUNDING NUMBERS Total Quality Management , DLA Finance Center 6...1989 ~ D 14. SUBJECT TERMS 15. NUMBER OF PAGES TQM (Total Quality Management ), Continuous Process Improvement. ., I Management 16. PRICE CODE 17...CONCEPTS TQM BASICS Total Quality Management (TQM) is a concept which is based on the work of a variety of people in a variety of fields. It includes

The quality assurance-risk management interface.

PubMed

Little, N

1992-08-01

Involvement with both risk management and quality assurance programs has led many authors to the conclusion that the fundamental differences between these activities are, in fact, very small. "At the point of overlap, it is almost impossible to distinguish the purposes and methods of both functions from one another." "Good risk management includes real improvement in patient care through organized quality assurance activities." The interface between a proactive risk management program and a quality assurance program is dynamic and can serve the legitimate interests of both. There is little to be gained by thinking of them as separate entities and much to be gained by sharing the lessons of both. If one thinks of risk management in terms of "risk" to quality patient care, and that "assuring quality" is the most productive type of risk management, then there is no practical reason to separate one from the other.

Long-term effect of the self-management comprehensive coping strategy program on quality of life in patients with breast cancer treated with high-dose chemotherapy.

PubMed

Gaston-Johansson, Fannie; Fall-Dickson, Jane M; Nanda, Joy P; Sarenmalm, Elisabeth Kenne; Browall, Maria; Goldstein, Nancy

2013-03-01

This study aims to examine the effectiveness of a self-management multimodal comprehensive coping strategy program (CCSP) on quality of life (QOL) among breast cancer patients 1 year after treatment. Patients (n = 110) with stage II, III, or IV breast cancer scheduled to receive high dose chemotherapy and autologous hematopoietic stem cell transplantation were randomized to either CCSP treatment or control group. The CCSP intervention was taught 2 week before hospital admission with reinforcement at specified times during treatment and 3 months after discharge. The CCSP components included educational information, cognitive restructuring, coping skills enhancement, and relaxation with guided imagery. Instruments administered at baseline included the following: Quality of Life Index-Cancer Version (QOLI-CV), State-Trait Anxiety Inventory, Beck Depression Inventory, and Coping Strategies Questionnaire. At 1-year follow-up, patients (n = 73) completed and returned the follow-up QOLI-CV. Patients were mainly ≥ 40 years of age, married, Caucasian, and diagnosed with advanced breast cancer. A model measuring effectiveness of CCSP on QOL (total and subscale) at 1-year follow-up showed that the CCSP group (n = 38) had significant improvement in overall QOL (p < 0.01), health and functioning (p < 0.05), and socioeconomic (p < 0.05) and psychological/spiritual well-being (p < 0.01) compared with the control group (n = 35). The CCSP patients frequently used the CCSP to manage psychological (51%) and sleep problems (60%). The CCSP improved QOL for patients at 1-year follow-up. Patients overwhelmingly reported that CCSP was beneficial. The CCSP as an effective coping intervention has potential as a self-management program for breast cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Water quality management plans. 130.6... QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM... and certified and approved updates to those plans. Continuing water quality planning shall be based...

The integrated rangeland fire management strategy actionable science plan

USGS Publications Warehouse

Aldridge, Cameron L.; Berg, Ken; Boyd, Chad S.; Boyte, Stephen P.; Bradford, John B.; Brunson, Ed; Cissel, John H.; Conway, Courtney J.; Chalfoun, Anna D.; Chambers, Jeanne C.; Clark, Patrick; Coates, Peter S.; Crist, Michele R.; Davis, Dawn M.; DeCrappeo, Nicole; Deibert, Patricia A.; Doherty, Kevin E.; Evers, Louisa B.; Finch, Deborah M.; Finn, Sean P.; Germino, Matthew J.; Glenn, Nancy F.; Gucker, Corey; Hall, John A.; Hanser, Steven E.; Havlina, Douglas W.; Heinrichs, Julie; Heller, Matt; Homer, Collin G.; Hunter, Molly E.; Jacobs, Ruth W.; Karl, Jason W.; Kearney, Richard; Kemp, Susan K; Kilkenny, Francis F.; Knick, Steven T.; Launchbaugh, Karen; Manier, Daniel J.; Mayer, Kenneth E.; Meyer, Susan E.; Monroe, Adrian; MontBlanc, Eugénie; Newingham, Beth A.; Pellant, Michael L.; Phillips, Susan L.; Pilliod, David S.; Ricca, Mark A.; Richardson, Bryce A.; Rose, Jeffrey A.; Shaw, Nancy; Sheley, Roger L.; Shinneman, Douglas J.; Wiechman , Lief A.; Wylie, Bruce K.

2016-01-01

The Integrated Rangeland Fire Management Strategy (hereafter Strategy, DOI 2015) outlined the need for coordinated, science-based adaptive management to achieve long-term protection, conservation, and restoration of the sagebrush (Artemisia spp.) ecosystem. A key component of this management approach is the identification of knowledge gaps that limit implementation of effective strategies to meet current management challenges. The tasks and actions identified in the Strategy address several broad topics related to management of the sagebrush ecosystem. This science plan is organized around these topics and specifically focuses on fire, invasive plant species and their effects on altering fire regimes, restoration, sagebrush and greater sage-grouse (Centrocercus urophasianus), and climate and weather.

Clinical Decision Support Knowledge Management: Strategies for Success.

PubMed

Khalifa, Mohamed; Alswailem, Osama

2015-01-01

Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

A Climate Change Adaptation Strategy for Management of ...

EPA Pesticide Factsheets

Sea level rise is causing shoreline erosion, increased coastal flooding, and marsh vulnerability to the impact of storms. Coastal marshes provide flood abatement, carbon and nutrient sequestration, water quality maintenance, and habitat for fish, shellfish, and wildlife, including species of concern, such as the saltmarsh sparrow (Ammodramus caudacutus). We present a climate change adaptation strategy (CCAS) adopted by scientific, management, and policy stakeholders for managing coastal marshes and enhancing system resiliency. A common adaptive management approach previously used for restoration projects was modified to identify climate-related vulnerabilities and plan climate change adaptive actions. As an example of implementation of the CCAS, we describe the stakeholder plans and management actions the US Fish and Wildlife Service and partners developed to build coastal resiliency in the Narrow River Estuary, RI, in the aftermath of Superstorm Sandy. When possible, an experimental BACI (before-after, control-impact) design, described as pre- and post-sampling at the impact site and one or more control sites, was incorporated into the climate change adaptation and implementation plans. Specific climate change adaptive actions and monitoring plans are described and include shoreline stabilization, restoring marsh drainage, increasing marsh elevation, and enabling upland marsh migration. The CCAS provides a framework and methodology for successfully managing coa

Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

PubMed

Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

2018-01-16

Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement.

PubMed

Savage, Carl; Parke, Louise; von Knorring, Mia; Mazzocato, Pamela

2016-10-19

Health care has experimented with many different quality improvement (QI) approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI. We used a qualitative study design with semi-structured interviews to explore twelve top managers' perceptions of the relationship between lean and quality improvement (QI) at a university-affiliated hospital. Managers described that QI and lean shared the same overall purpose: focus on patient needs and improve efficiency and effectiveness. Employee involvement was emphasized in both strategies, as well as the support offered by managers of staff initiatives. QI was perceived as a strategy that could support structural changes at the organizational level whereas lean was seen as applicable at the operational level. Moreover, lean carried a negative connotation, lacked the credibility of QI, and was perceived as a management fad. Aspects of QI and lean were misunderstood. In a context where lean remains an abstract term, and staff associate lean with automotive applications and cost reduction, it may be fruitful for managers to invest time and resources to develop a strategy for continual improvement and utilize vocabulary that resonates with health care staff. This could reduce the risk that improvement efforts are rejected out of hand.

Explore the impacts of river flow and quality on biodiversity for water resources management by AI techniques

NASA Astrophysics Data System (ADS)

Chang, Fi-John; Tsai Tsai, Wen-Ping; Chang, Li-Chiu

2016-04-01

Water resources development is very challenging in Taiwan due to her diverse geographic environment and climatic conditions. To pursue sustainable water resources development, rationality and integrity is essential for water resources planning. River water quality and flow regimes are closely related to each other and affect river ecosystems simultaneously. This study aims to explore the complex impacts of water quality and flow regimes on fish community in order to comprehend the situations of the eco-hydrological system in the Danshui River of northern Taiwan. To make an effective and comprehensive strategy for sustainable water resources management, this study first models fish diversity through implementing a hybrid artificial neural network (ANN) based on long-term observational heterogeneity data of water quality, stream flow and fish species in the river. Then we use stream flow to estimate the loss of dissolved oxygen based on back-propagation neural networks (BPNNs). Finally, the non-dominated sorting genetic algorithm II (NSGA-II) is established for river flow management over the Shihmen Reservoir which is the main reservoir in this study area. In addition to satisfying the water demands of human beings and ecosystems, we also consider water quality for river flow management. The ecosystem requirement takes the form of maximizing fish diversity, which can be estimated by the hybrid ANN. The human requirement is to provide a higher satisfaction degree of water supply while the water quality requirement is to reduce the loss of dissolved oxygen in the river among flow stations. The results demonstrate that the proposed methodology can offer diversified alternative strategies for reservoir operation and improve reservoir operation strategies for producing downstream flows that could better meet both human and ecosystem needs as well as maintain river water quality. Keywords: Artificial intelligence (AI), Artificial neural networks (ANNs), Non

Probability concepts in quality risk management.

PubMed

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

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Water quality management plans. 130.6... QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM... when they are needed to address water quality problems. (1) Total maximum daily loads. TMDLs in...

Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

PubMed

Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

2018-04-17

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest

Managing loss adjustment expenses: strategies for health care risk managers.

PubMed

Quinley, K M

1991-01-01

Like most businesses, adjusting companies are not charitable organizations. They are entitled to a reasonable profit, which the risk manager should not begrudge. As a buyer of adjusting services, a risk manager with an inordinate obsession with slashing adjusting bills can destroy the goal of high-quality service. It is best for risk managers to pick and choose the areas for cutting adjusting expenses. To an extent, health care risk managers should view payment of high-quality adjusting services as an investment, with the payback being money saved by fighting fraudulent, exaggerated, and questionable claims.

Emotion Regulation Strategies in Preschoolers with Autism: Associations with Parent Quality of Life and Family Functioning

ERIC Educational Resources Information Center

Nuske, Heather Joy; Hedley, Darren; Tseng, Chen Hsiang; Begeer, Sander; Dissanayake, Cheryl

2018-01-01

Children with autism experience challenges with emotion regulation. It is unclear how children's management of their emotions is associated with their family's quality of life. Forty-three preschoolers with autism and 28 typically developing preschoolers were coded on emotion regulation strategies used during low-level stress tasks. Parents…

Quality management in Irish health care.

PubMed

Ennis, K; Harrington, D

1999-01-01

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

Quality of Life after Surgery for Stanford Type A Aortic Dissection: Influences of Different Operative Strategies.

PubMed

Ghazy, Tamer; Eraqi, Mohamed; Mahlmann, Adrian; Hegelmann, Helena; Matschke, Klaus; Kappert, Utz; Weiss, Norbert

2017-06-22

Outcome of surgery for acute Stanford type A aortic dissection extends beyond mortality and morbidity. More than one operative strategy is available but little is known regarding their influence on quality of life. This study analyzes the influence of defensive and aggressive operative strategies on the patients' midterm quality of life (QoL). From July 2007 to July 2010, 95 patients underwent surgery for acute Stanford type A aortic dissection in our institution. Patients who survived the procedure, gave consent to inclusion in the institution prospective registry, completed at least 2-years of follow-up protocol, and answered two quality of life questionnaires (SF-36 and WHO-QOL-BREF) were included in the study. Patients were divided into two groups according to operative strategy: defensive (DS) with replacement of the ascending aorta only, and aggressive (AS) with replacement of the ascending aorta, aortic arch with/out a frozen elephant trunk procedure. The preoperative, operative, postoperative and the midterm QoL were analyzed and compared. 39 patients were included in the study. The DS group had a shorter operative time (184 ± 54 versus 276 ± 110 minutes respectively, P = .001). The AS group had higher incidence of dialysis (31% versus 4% respectively, P = .038). The midterm QoL analysis showed a collective lower value than the normal population. In the SF-36, DS performed better in all categories but with no statistical significance. In the WHO-QOL-BREF, DS performed significantly better in the global life quality and psychological health categories (P = .038 and .049 respectively). In Stanford type A aortic dissection, adopting an aggressive surgical strategy does not improve the quality of life in midterm follow-up compared to a defensive strategy. Unless the clinical setting dictates an aggressive management strategy, a defensive strategy can be safely adopted.

Land management strategies for improving water quality in biomass production under changing climate

DOE PAGES

Ha, Miae; Wu, May

2017-03-07

Here, the Corn Belt states are the largest corn-production areas in the United States because of their fertile land and ideal climate. This attribute is particularly important as the region also plays a key role in the production of bioenergy feedstock. In much of the nation, agricultural nutrients are a primary cause of water quality degradation. This study focuses on potential change in streamflow, sediment, nitrogen, and phosphorus due to climate change and land management practices in the South Fork Iowa River (SFIR) watershed, Iowa. Thirty-six projections from select Regional Climate Models (RCM) for Representative Concentration Pathways (RCP) 2.5, 4.5,more » and 8.5 were used to develop climate change scenarios for the SFIR watershed and incorporated into the Soil and Water Assessment Tool (SWAT). The watershed is covered primarily with annual crops (corn and soybeans). Three scenarios of land use change and conservation practices were further developed to examine their impacts on water quality under historical and modeled future climate. With cropland conversion to switchgrass, stover harvest, and best management practices (BMPs) (such as establishing riparian buffers and applying cover crops) significant reductions in nutrients were observed in the SFIR watershed under historical climate and future climate scenarios. Under historical climate, suspended sediment (SS), total nitrogen (N), and phosphorus (P) at the outlet point of the SFIR watershed could decrease by up to 56.7%, 32.0%, and 16.5%, respectively, compare with current land use when a portion of the cropland is converted to switchgrass and cover crop is in place. Climate change could cause an increase in 12.0% (SS), 4.7% (N), and 7.7% (P) from current land use. This increase could be mitigated through land management and practices by 53.6% (SS), 27.8 (N), and 7.0% (P). Climate change reduced crop yield. Nutrient and sediments loadings distributed heterogeneously across the watershed. Water

Land management strategies for improving water quality in biomass production under changing climate

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

Ha, Miae; Wu, May

Here, the Corn Belt states are the largest corn-production areas in the United States because of their fertile land and ideal climate. This attribute is particularly important as the region also plays a key role in the production of bioenergy feedstock. In much of the nation, agricultural nutrients are a primary cause of water quality degradation. This study focuses on potential change in streamflow, sediment, nitrogen, and phosphorus due to climate change and land management practices in the South Fork Iowa River (SFIR) watershed, Iowa. Thirty-six projections from select Regional Climate Models (RCM) for Representative Concentration Pathways (RCP) 2.5, 4.5,more » and 8.5 were used to develop climate change scenarios for the SFIR watershed and incorporated into the Soil and Water Assessment Tool (SWAT). The watershed is covered primarily with annual crops (corn and soybeans). Three scenarios of land use change and conservation practices were further developed to examine their impacts on water quality under historical and modeled future climate. With cropland conversion to switchgrass, stover harvest, and best management practices (BMPs) (such as establishing riparian buffers and applying cover crops) significant reductions in nutrients were observed in the SFIR watershed under historical climate and future climate scenarios. Under historical climate, suspended sediment (SS), total nitrogen (N), and phosphorus (P) at the outlet point of the SFIR watershed could decrease by up to 56.7%, 32.0%, and 16.5%, respectively, compare with current land use when a portion of the cropland is converted to switchgrass and cover crop is in place. Climate change could cause an increase in 12.0% (SS), 4.7% (N), and 7.7% (P) from current land use. This increase could be mitigated through land management and practices by 53.6% (SS), 27.8 (N), and 7.0% (P). Climate change reduced crop yield. Nutrient and sediments loadings distributed heterogeneously across the watershed. Water

Total Quality Management (TQM). Implementers Workshop

DTIC Science & Technology

1990-05-15

SHEE’T :s t’ii ,rrl DEPARTMENT OF DEFENSE May 15, 1990 Lfl CN I TOTAL QUALITY MANAGEMENT (TQM) Implementers Workshop © Copyright 1990 Booz.Allen...must be continually performed in order to achieve successful TQM implementation. 1-5 = TOTAL QUALITY MANAGEMENT Implementers Workshop Course Content...information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar, that was provided for the Awareness Course. You may

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES.

PubMed

Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

2014-09-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized.

[Quality management in cardiovascular echography].

PubMed

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

Managers and the new definition of quality.

PubMed

Chilgren, Allison A

2008-01-01

The manager, particularly the mid-level manager, has a vital role in the success of any healthcare organization, especially in the realm of patient perception of quality. To patients, "quality" means how well a service was delivered, not how technically superior the actual service or clinical component turned out. This definition of quality can also be referred to as patient satisfaction. Managers, with help of an integrative team, can develop quality processes geared toward patient expectations by doing a number of things, including the following: clearly identify outcomes, and empower employees to achieve those goals; form an integrated quality development team to establish quality metrics; build in cultural competence into quality processes; and align the organization's mission to the overall quality program. With a successful quality program, managers can expect a considerable return on investment, satisfied patients and staff, and improved clinical outcomes.

Strategies for Meeting High Standards: Quality Management and the Baldrige Criteria in Education. Lessons from the States.

ERIC Educational Resources Information Center

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

This document, one of a series of reports, focuses on the adoption of principles of quality management, originally developed by W. Edwards Deming, and the Baldrige Criteria for use in education. These processes and tools for systemic organizational management, when comprehensively applied, produce performance excellence and continuous improvement.…

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

Developing a Scale for Quality of Using Learning Strategies

ERIC Educational Resources Information Center

Tasci, Guntay; Yurdugul, Halil

2016-01-01

This study aims to develop a measurement tool to measure the quality of using learning strategies. First, the quality of using learning strategies was described based on the literature. The 32 items in the 5-point Likert scale were then administered to 320 prospective teachers, and they were analysed with exploratory factor analysis using…

Internal versus External Quality Management

ERIC Educational Resources Information Center

Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

2008-01-01

This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

Spatial strategies for managing visitor impacts in National Parks

USGS Publications Warehouse

Leung, Y.-F.; Marion, J.L.

1999-01-01

Resource and social impacts caused by recreationists and tourists have become a management concern in national parks and equivalent protected areas. The need to contain visitor impacts within acceptable limits has prompted park and protected area managers to implement a wide variety of strategies and actions, many of which are spatial in nature. This paper classifies and illustrates the basic spatial strategies for managing visitor impacts in parks and protected areas. A typology of four spatial strategies was proposed based on the recreation and park management literature. Spatial segregation is a common strategy for shielding sensitive resources from visitor impacts or for separating potentially conflicting types of use. Two forms of spatial segregation are zoning and closure. A spatial containment strategy is intended to minimize the aggregate extent of visitor impacts by confining use to limited designated or established Iocations. In contrast, a spatial dispersal strategy seeks to spread visitor use, reducing the frequency of use to levels that avoid or minimize permanent resource impacts or visitor crowding and conflict. Finally, a spatial configuration strategy minimizes impacting visitor behavior though the judicious spatial arrangement of facilities. These four spatial strategics can be implemented separately or in combination at varying spatial scales within a single park. A survey of national park managers provides an empirical example of the diversity of implemented spatial strategies in managing visitor impacts. Spatial segregation is frequently applied in the form of camping restrictions or closures to protect sensitive natural or cultural resources and to separate incompatible visitor activities. Spatial containment is the most widely applied strategy for minimizing the areal extent of resource impacts. Spatial dispersal is commonly applied to reduce visitor crowding or conflicts in popular destination areas but is less frequently applied or

Total Quality Management: A Recipe for Success

DTIC Science & Technology

1990-04-02

Total Quality Management (TQM) is a high level Department of Defense (DOD) initiative that is being touted as the primary management tool to force...to create a DOD wide organizational climate that will stimulate and perpetuate individual productivity enhancing contributions. Keywords: Quality control; Quality management ; TQM.

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES

PubMed Central

YSA, TAMYKO; SIERRA, VICENTA; ESTEVE, MARC

2014-01-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized. PMID:25520529

Total Quality Management: Institutional Research Applications.

ERIC Educational Resources Information Center

Heverly, Mary Ann

Total Quality Management (TQM), a technique traditionally reserved for the manufacturing sector, has recently spread to service companies, government agencies, and educational institutions. TQM places responsibility for quality problems with management rather than on the workers. A principal concept of TQM is the management of Process Variation,…

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

PubMed

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

2015-01-01

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

Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support.

PubMed

Campmans-Kuijpers, Marjo J; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E

2015-02-01

To assess the change in level of diabetes quality management in primary care groups and outpatient clinics after feedback and tailored support. This before-and-after study with a 1-year follow-up surveyed quality managers on six domains of quality management. Questionnaires measured organization of care, multidisciplinary teamwork, patient centeredness, performance results, quality improvement policy, and management strategies (score range 0-100%). Based on the scores, responders received feedback and a benchmark and were granted access to a toolbox of quality improvement instruments. If requested, additional support in improving quality management was available, consisting of an elucidating phone call or a visit from an experienced consultant. After 1 year, the level of quality management was measured again. Of the initially 60 participating care groups, 51 completed the study. The total quality management score improved from 59.8% (95% CI 57.0-62.6%) to 65.1% (62.8-67.5%; P < 0.0001). The same applied to all six domains. The feedback and benchmark improved the total quality management score (P = 0.001). Of the 44 participating outpatient clinics, 28 completed the study. Their total score changed from 65.7% (CI 60.3-71.1%) to 67.3% (CI 62.9-71.7%; P = 0.30). Only the results in the domain multidisciplinary teamwork improved (P = 0.001). Measuring quality management and providing feedback and a benchmark improves the level of quality management in care groups but not in outpatient clinics. The questionnaires might also be a useful asset for other diabetes care groups, such as Accountable Care Organizations. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

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

PubMed

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

2017-10-01

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

Symptom Management Strategies for Men with Early-Stage Prostate Cancer: Results from the Prostate Cancer Patient Education Program (PCPEP)

PubMed Central

Vij, Alok; Kowalkowski, Marc A.; Hart, Tae; Goltz, Heather Honoré; Hoffman, David J.; Knight, Sara J.; Caroll, Peter R.

2013-01-01

While the literature on prostate cancer health-related quality of life has grown extensively, little is known about symptom management strategies used by men to manage treatment-related side effects and the effectiveness of those strategies. We collected 628 symptom management reports from 98 men treated for localized prostate cancer. Participants were recruited from email lists and a prostate cancer clinic in Northern California. Data were collected using the Critical Incident Technique. Symptom management reports were assigned to categories of urinary, sexual, bowel, mental health, systemic, or “other.” We calculated descriptive statistics by symptom type and management strategy effectiveness. The most common symptoms were urinary (26 %) and sexual (23 %). Participants’ symptom management strategies varied widely, from medical and surgical interventions (20 %) to behavioral strategies (11 %) to diet and lifestyle interventions (12 %). The effectiveness of symptom management strategies varied, with sexual symptoms being managed effectively only 47 % of the time to mental health symptom management strategies considered effective 89 % of the time. Doing nothing was a commonly reported (15 %) response to symptoms and was effective only 14 % of the time. Men report the least effectiveness in symptom management for sexual dysfunction after prostate cancer treatment. Including men’s experience with managing treatment side effects may be an important way to improve survivorship programs and make them more acceptable to men. More work is needed to find out why men frequently do nothing in response to symptoms when effective solutions exist and how providers can successfully engage such men. PMID:23996206

The strategy for improving water-quality monitoring in the United States; final report of the Intergovernmental Task Force on Monitoring Water Quality; technical appendices

USGS Publications Warehouse

,

1995-01-01

The Intergovernmental Task Force on Monitoring Water Quality (ITFM) prepared this report in collaboration with representatives of all levels of government and the private sector. The report recommends a strategy for nationwide water-quality monitoring and technical monitoring improvements to support sound water-quality decisionmaking. The strategy is intended to achieve a better return on public and private investments in monitoring, environmental protection, and natural resources management. It is also designed to expand the base of information useful to a variety of users at multiple geographic scales. Institutional and technical changes are needed to improve water-quality monitoring and to meet the full range of monitoring requirements. Monitoring must be incorporated as a critical element of program planning, implementation, and evaluation. The strategy includes recommendations in many key elements, such as the development of goal-oriented monitoring and indicators, institutional collaboration, and methods comparability. Initial actions have been taken to implement the strategy. Several Federal agencies have jointly purchased and shared remotely sensed land-cover information needed for water assessment. Major agency data systems are using common data-element names and reference tables that will ensure easy sharing of data. A number of States have held meetings with collectors of water information to initiate statewide monitoring strategies. New monitoring guidance has been developed for Federal water-quality grants to States. Many State offices have changed monitoring programs to place emphasis on priority watersheds and to improve assessment of water quality. As the competition increases for adequate supplies of clean water, concerns about public health and the environment escalate, and more demands are placed on the water information infrastructure. To meet these demands, the collaborative approach has already produced benefits, which will continue to grow as

Drinking water quality management: a holistic approach.

PubMed

Rizak, S; Cunliffe, D; Sinclair, M; Vulcano, R; Howard, J; Hrudey, S; Callan, P

2003-01-01

A growing list of water contaminants has led to some water suppliers relying primarily on compliance monitoring as a mechanism for managing drinking water quality. While such monitoring is a necessary part of drinking water quality management, experiences with waterborne disease threats and outbreaks have shown that compliance monitoring for numerical limits is not, in itself, sufficient to guarantee the safety and quality of drinking water supplies. To address these issues, the Australian National Health and Medical Research Council (NHMRC) has developed a Framework for Management of Drinking Water Quality (the Framework) for incorporation in the Australian Drinking Water Guidelines, the primary reference on drinking water quality in Australia. The Framework was developed specifically for drinking water supplies and provides a comprehensive and preventive risk management approach from catchment to consumer. It includes holistic guidance on a range of issues considered good practice for system management. The Framework addresses four key areas: Commitment to Drinking Water Quality Management, System Analysis and System Management, Supporting Requirements, and Review. The Framework represents a significantly enhanced approach to the management and regulation of drinking water quality and offers a flexible and proactive means of optimising drinking water quality and protecting public health. Rather than the primary reliance on compliance monitoring, the Framework emphasises prevention, the importance of risk assessment, maintaining the integrity of water supply systems and application of multiple barriers to assure protection of public health. Development of the Framework was undertaken in collaboration with the water industry, regulators and other stakeholder, and will promote a common and unified approach to drinking water quality management throughout Australia. The Framework has attracted international interest.

What are the most effective strategies for improving quality and safety of health care?

PubMed

Scott, I

2009-06-01

There is now a plethora of different quality improvement strategies (QIS) for optimizing health care, some clinician/patient driven, others manager/policy-maker driven. Which of these are most effective remains unclear despite expressed concerns about potential for QIS-related patient harm and wasting of resources. The objective of this study was to review published literature assessing the relative effectiveness of different QIS. Data sources comprising PubMed Clinical Queries, Cochrane Library and its Effective Practice and Organization of Care database, and HealthStar were searched for studies of QIS between January 1985 and February 2008 using search terms based on an a priori QIS classification suggested by experts. Systematic reviews of controlled trials were selected in determining effect sizes for specific QIS, which were compared as a narrative meta-review. Clinician/patient driven QIS were associated with stronger evidence of efficacy and larger effect sizes than manager/policy-maker driven QIS. The most effective strategies (>10% absolute increase in appropriate care or equivalent measure) included clinician-directed audit and feedback cycles, clinical decision support systems, specialty outreach programmes, chronic disease management programmes, continuing professional education based on interactive small-group case discussions, and patient-mediated clinician reminders. Pay-for-performance schemes directed to clinician groups and organizational process redesign were modestly effective. Other manager/policy-maker driven QIS including continuous quality improvement programmes, risk and safety management systems, public scorecards and performance reports, external accreditation, and clinical governance arrangements have not been adequately evaluated with regard to effectiveness. QIS are heterogeneous and methodological flaws in much of the evaluative literature limit validity and generalizability of results. Based on current best available evidence

Symptom management strategies for men with early-stage prostate cancer: results from the Prostate Cancer Patient Education Program (PC PEP).

PubMed

Vij, Alok; Kowalkowski, Marc A; Hart, Tae; Goltz, Heather Honoré; Hoffman, David J; Knight, Sara J; Caroll, Peter R; Latini, David M

2013-12-01

While the literature on prostate cancer health-related quality of life has grown extensively, little is known about symptom management strategies used by men to manage treatment-related side effects and the effectiveness of those strategies. We collected 628 symptom management reports from 98 men treated for localized prostate cancer. Participants were recruited from email lists and a prostate cancer clinic in Northern California. Data were collected using the Critical Incident Technique. Symptom management reports were assigned to categories of urinary, sexual, bowel, mental health, systemic, or "other." We calculated descriptive statistics by symptom type and management strategy effectiveness. The most common symptoms were urinary (26 %) and sexual (23 %). Participants' symptom management strategies varied widely, from medical and surgical interventions (20 %) to behavioral strategies (11 %) to diet and lifestyle interventions (12 %). The effectiveness of symptom management strategies varied, with sexual symptoms being managed effectively only 47 % of the time to mental health symptom management strategies considered effective 89 % of the time. Doing nothing was a commonly reported (15 %) response to symptoms and was effective only 14 % of the time. Men report the least effectiveness in symptom management for sexual dysfunction after prostate cancer treatment. Including men's experience with managing treatment side effects may be an important way to improve survivorship programs and make them more acceptable to men. More work is needed to find out why men frequently do nothing in response to symptoms when effective solutions exist and how providers can successfully engage such men.

Strategies for sustainable management of renewable resources during environmental change.

PubMed

Lindkvist, Emilie; Ekeberg, Örjan; Norberg, Jon

2017-03-15

As a consequence of global environmental change, management strategies that can deal with unexpected change in resource dynamics are becoming increasingly important. In this paper we undertake a novel approach to studying resource growth problems using a computational form of adaptive management to find optimal strategies for prevalent natural resource management dilemmas. We scrutinize adaptive management, or learning-by-doing, to better understand how to simultaneously manage and learn about a system when its dynamics are unknown. We study important trade-offs in decision-making with respect to choosing optimal actions (harvest efforts) for sustainable management during change. This is operationalized through an artificially intelligent model where we analyze how different trends and fluctuations in growth rates of a renewable resource affect the performance of different management strategies. Our results show that the optimal strategy for managing resources with declining growth is capable of managing resources with fluctuating or increasing growth at a negligible cost, creating in a management strategy that is both efficient and robust towards future unknown changes. To obtain this strategy, adaptive management should strive for: high learning rates to new knowledge, high valuation of future outcomes and modest exploration around what is perceived as the optimal action. © 2017 The Author(s).

Total Quality Management Simplified.

ERIC Educational Resources Information Center

Arias, Pam

1995-01-01

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

Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management

NASA Astrophysics Data System (ADS)

Dreiss, Lindsay M.; Hessenauer, Jan-Michael; Nathan, Lucas R.; O'Connor, Kelly M.; Liberati, Marjorie R.; Kloster, Danielle P.; Barclay, Janet R.; Vokoun, Jason C.; Morzillo, Anita T.

2017-02-01

Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management.

PubMed

Dreiss, Lindsay M; Hessenauer, Jan-Michael; Nathan, Lucas R; O'Connor, Kelly M; Liberati, Marjorie R; Kloster, Danielle P; Barclay, Janet R; Vokoun, Jason C; Morzillo, Anita T

2017-02-01

Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

Relationship-Driven Classroom Management: Strategies That Promote Student Motivation.

ERIC Educational Resources Information Center

Vitto, John M.

This book combines information about resiliency, classroom management, and discipline into a user-friendly discussion suitable for all teachers. The material covers both preventive strategies and reactive strategies. The chapters of part 1, "Reinventive Strategies," are: (1) "Relationship-Driven Classroom Management and Resilience"; (2)…

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

PubMed Central

2013-01-01

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

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

PubMed

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

2013-04-05

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

Is the air pollution health research community prepared to support a multipollutant air quality management framework?

PubMed

Mauderly, Joe L; Burnett, Richard T; Castillejos, Margarita; Ozkaynak, Halûk; Samet, Jonathan M; Stieb, David M; Vedal, Sverre; Wyzga, Ronald E

2010-06-01

Ambient air pollution is always encountered as a complex mixture, but past regulatory and research strategies largely focused on single pollutants, pollutant classes, and sources one-at-a-time. There is a trend toward managing air quality in a progressively "multipollutant" manner, with the idealized goal of controlling as many air contaminants as possible in an integrated manner to achieve the greatest total reduction of adverse health and environmental impacts. This commentary considers the current ability of the environmental air pollution exposure and health research communities to provide evidence to inform the development of multipollutant air quality management strategies and assess their effectiveness. The commentary is not a literature review, but a summary of key issues and information gaps, strategies for filling the gaps, and realistic expectations for progress that could be made during the next decade. The greatest need is for researchers and sponsors to address air quality health impacts from a truly multipollutant perspective, and the most limiting current information gap is knowledge of personal exposures of different subpopulations, considering activities and microenvironments. Emphasis is needed on clarifying the roles of a broader range of pollutants and their combinations in a more forward-looking manner; that is not driven by current regulatory structures. Although advances in research tools and outcome data will enhance progress, the greater need is to direct existing capabilities toward strategies aimed at placing into proper context the contributions of multiple pollutants and their combinations to the health burdens, and the relative contributions of pollutants and other factors influencing the same outcomes. The authors conclude that the research community has very limited ability to advise multipollutant air quality management and assess its effectiveness at this time, but that considerable progress can be made in a decade, even at

Information Technology Management Strategies to Implement Knowledge Management Systems

ERIC Educational Resources Information Center

McGee, Mary Jane Christy

2017-01-01

More than 38% of the U.S. public workforce will likely retire by 2030, which may result in a labor shortage. Business leaders may adopt strategies to mitigate knowledge loss within their organizations by capturing knowledge in a knowledge management system (KMS). The purpose of this single case study was to explore strategies that information…

Total Quality Management in Education. Second Edition.

ERIC Educational Resources Information Center

Sallis, Edward

Quality is at the top of most agendas, and improving quality is probably the most important task facing any institution. In addition, quality is difficult to define or measure. This book, the second edition of "Total Quality Management in Education," introduces the key concepts of Total Quality Management (TQM) and demonstrates how they…

Do fibromyalgia patients use active pain management strategies? A cohort study.

PubMed

Gauffin, Jarno; Hankama, Tiina; Hannonen, Pekka; Kautiainen, Hannu; Pohjolainen, Timo; Haanpää, Maija

2013-05-01

The aim of this study was to examine the types of pain management strategies used by patients with fibromyalgia. A total of 158 patients with primary fibromyalgia attended a clinical visit to confirm the diagnosis. They completed 3 questionnaires: (i) a self-made questionnaire, (ii) Beck Depression Inventory IA (BDI IA), and (iii) Finnish version of Fibromyalgia Impact Questionnaire. The self-made questionnaire included questions about: intensity of current pain; general well-being; pain management strategies, including pain medications; efficacy of the pain management methods; current health problems other than fibromyalgia. The pain management strategies were subcategorized (e.g., physical exercise, massage and heat treatment). The strategies were also divided into active and passive types. The most frequently reported pain management strategies were physical exercise (54%), physical therapy (32%) and cold treatment (27%). The use of active pain management strategies, BDI IA < 10 points and age were independent predictors of the reported pain management efficacy. Patients who used active pain management strategies reported better efficacy with the BDI IA score ≥ 10 points. Active pain management strategies are most efficacious for fibromyalgia patients, regardless of the severity of fibromyalgia or optional comorbid depression.

Informational system as an instrument for assessing the performance of the quality management system

NASA Astrophysics Data System (ADS)

Rohan, R.; Roşu, M. M.

2017-08-01

At present there is used a significant number of techniques and methods for diagnosis and management analysis which support the decision-making process. All these methods facilitate reaching the objectives for improving the results through efficiency, quality and customer satisfaction. By developing a methodology for analysing the problems identified in the macro-productive companies there can be brought outstanding benefits to the management and there are offered new perspectives on the critical influencing factors within a system. Through this paper we present an effective management strategy, applicable to an organization with productive profile in order to design an informational system aimed to manage one of its most important and complex systems, namely the coordination of the quality management system. The informational organisation of the quality management system on management principles, ensures an optimization of the informational energy consumption, allowing the management to deal with the following: to ascertain the current situation; to seize the opportunities, but also the potential risks afferent to the organisation policy; to observe the strengths and weaknesses; to take appropriate decisions and then to control the effects obtained. In this way, the decisional factors are able to better understand the available opportunities and to base more efficiently the process of choosing the alternatives.

Time management strategies in nursing practice.

PubMed

Waterworth, Susan

2003-09-01

With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.

Deployment strategies of managed lanes on arterials.

DOT National Transportation Integrated Search

2015-02-01

This report investigates issues related to planning, financing, deployment, and operation of managed : lanes on arterials. In this report, a strategy for managed lanes refers to a combination of the managed : lane type, the design and implementation,...

Strategic Issues in Quality Management: 1. Theoretical Considerations.

ERIC Educational Resources Information Center

Johannsen, Carl Gustav

1996-01-01

Examines the relationship between strategic management and quality management concepts in a library and information services setting. Conceptual frameworks are presented and a new strategic quality management framework, inspired by the Japanese policy deployment approach, is developed that also discusses total quality management. (Author/LRW)

Total Quality Management Implementation Plan: Defense Depot, Ogden

DTIC Science & Technology

1989-07-01

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

The Changing Career Strategies of Managers.

ERIC Educational Resources Information Center

Wilson, Tony; Davies, Goronwy

1999-01-01

Faced with reduced employment security, managers are redefining careers to include work/personal life balance. Changes in any area can cause revision of career strategies. Depending on how they define careers, managers recognize career development as an individual, not an organizational, responsibility. (SK)

Parkinson's disease management strategies.

PubMed

Rajput, Alex; Rajput, Ali H

2006-01-01

Parkinson's disease (PD) treatment strategies should consider each patient individually. Drug therapy is the mainstay of treatment. An average 62-year-old male first diagnosed with PD will likely live for 20 years and treatment should be geared for long-term control of symptoms and quality of life. Of the currently available drugs, none are neurotoxic to the human substantia nigra and none are neuroprotective. As PD is a progressive disorder, all drugs have adverse effects and reduced efficacy with time. PD patients need regular follow-ups to make necessary medication adjustments. There is no perfect treatment. The authors have discussed their treatment methods and the reasoning behind it. Depending on the patient's age, the predominant symptoms and quality of life, treatment is individualized. In an average patient the least potent drugs, such as anticholinergics or amantadine, are administered first adding a dopamine agonist later on. Levodopa (LD) remains the most useful drug for PD and is reserved for later stages of disease. The objective is to keep the patient at Hoehn and Yahr Stage 2.0 or lower level of disability (bilateral findings with preserved postural reflexes) during off-stage and to avoid adverse effects. There is no long-term difference between standard preparations and control release formulations of LD/carbidopa or LD/benserazide. In older subjects, the first choice is LD. In patients who cannot be managed medically, surgical treatment is an option in selected patients (nondemented, <70 years old, previous good LD response). The surgical treatment of choice is currently subthalamic nucleus deep-brain stimulation. Physiotherapy, occupational therapy and speech therapy are valuable in advanced PD cases.

Managed care and total quality management: a necessary integration.

PubMed

Phoon, J; Corder, K; Barter, M

1996-01-01

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

Effectiveness of alternative management strategies in meeting conservation objectives

Treesearch

Richards S. Holthausen; Carolyn Hull Sieg

2007-01-01

This chapter evaluates how well various management strategies meet a variety of conservation objectives, summarizes their effectiveness in meeting objectives for rare or little-known (RLK) species, and proposes ways to combine strategies to meet overall conservation objectives. We address two broad categories of management strategies. Species approaches result in...

[A strategy of constructing the technological system for quality control of Chinese medicine based on process control and management].

PubMed

Cheng, Yi-Yu; Qian, Zhong-Zhi; Zhang, Bo-Li

2017-01-01

The current situation, bottleneck problems and severe challenges in quality control technology of Chinese Medicine (CM) are briefly described. It is presented to change the phenomenon related to the post-test as the main means and contempt for process control in drug regulation, reverse the situation of neglecting the development of process control and management technology for pharmaceutical manufacture and reconstruct the technological system for quality control of CM products. The regulation and technology system based on process control and management for controlling CM quality should be established to solve weighty realistic problems of CM industry from the root causes, including backwardness of quality control technology, weakness of quality risk control measures, poor reputation of product quality and so on. By this way, the obstacles from poor controllability of CM product quality could be broken. Concentrating on those difficult problems and weak links in the technical field of CM quality control, it is proposed to build CMC (Chemistry, Manufacturing and Controls) regulation for CM products with Chinese characteristics and promote the regulation international recognition as soon as possible. The CMC technical framework, which is clinical efficacy-oriented, manufacturing manner-centered and process control-focused, was designed. To address the clinical characteristics of traditional Chinese medicine (TCM) and the production feature of CM manufacture, it is suggested to establish quality control engineering for CM manufacturing by integrating pharmaceutical analysis, TCM chemistry, TCM pharmacology, pharmaceutical engineering, control engineering, management engineering and other disciplines. Further, a theoretical model of quality control engineering for CM manufacturing and the methodology of digital pharmaceutical engineering are proposed. A technology pathway for promoting CM standard and realizing the strategic goal of CM internationalization is

Stormwater quality management in rail transportation--past, present and future.

PubMed

Vo, Phuong Tram; Ngo, Huu Hao; Guo, Wenshan; Zhou, John L; Listowski, Andrzej; Du, Bin; Wei, Qin; Bui, Xuan Thanh

2015-04-15

Railways currently play an important role in sustainable transportation systems, owing to their substantial carrying capacity, environmental friendliness and land-saving advantages. Although total pollutant emissions from railway systems are far less than that of automobile vehicles, the pollution from railway operations should not be underestimated. To date, both scientific and practical papers dealing with stormwater management for rail tracks have solely focused on its drainage function. Unlike roadway transport, the potential of stormwater pollution from railway operations is currently mishandled. There have been very few studies into the impact of its operations on water quality. Hence, upon the realisation on the significance of nonpoint source pollution, stormwater management priorities should have been re-evaluated. This paper provides an examination of past and current practices of stormwater management in the railway industry, potential sources of stormwater pollution, obstacles faced in stormwater management and concludes with strategies for future management directions. Copyright © 2015 Elsevier B.V. All rights reserved.

Soil quality evaluation using Soil Management Assessment Framework (SMAF) in Brazilian oxisols with contrasting texture

USDA-ARS?s Scientific Manuscript database

To ensure current land use strategies and management practices are economically, environmentally, and socially sustainable, tools and techniques for assessing and quantifying changes in soil quality/health (SQ) need to be developed through rigorous research and potential use by consultants, and othe...

Towards a rational strategy for monitoring of microbiological quality of ambient waters

PubMed Central

Poma, Hugo Ramiro; Cacciabue, Dolores Gutiérrez; Garcé, Beatriz; Gonzo, Elio Emilio; Rajal, Verónica Beatriz

2012-01-01

Water is one of the main sources of human exposure to microbiological hazards. Although legislation establishes regulatory standards in terms of fecal indicator bacteria to assess the microbiological quality of water, these do not necessarily predict the presence of pathogens such as parasites and viruses. Better surveillance and management strategies are needed to assess the risk of pathogens waterborne transmission. We established a baseline dataset to characterize river water quality, identify changes over time, and design a rational monitoring strategy. Data from a year-long monthly monitoring campaign of the polluted Arenales River (Argentina), were analyzed to statistically correlate physicochemical and microbiological variables, the seasonal and longitudinal variation of the water quality and determine the similarity between study sites. The measured variables (sixteen) reflected the deterioration in the river quality through the city. Different viruses and parasites found did not correlate with the concentration of total and thermotolerant coliforms. There was significant seasonal variation for temperature, turbidity, conductivity, dissolved oxygen, enterococci, and norovirus. Strong correlations between some variables were found; we selected eight variables (dissolved oxygen, conductivity, turbidity, total and thermotolerant coliforms, Enterococcus, and adenovirus and Microsporidium as viral and parasitological indicators, respectively) for future monitoring. There was similarity between the monitoring locations, which were grouped into four clusters validated by cophenetic correlation and supported by discriminant analysis. This allowed us to reduce the number of sites, from eleven down to five. Sixty seven percent of the total variance and the correlation structure between variables was explained using five principal components. All these analyses led to a new long-term systematic monitoring scheme A rational monitoring strategy based on the selection of

Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

PubMed

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

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

Total Quality Management (TQM) as the Procedure for Management of Integrated Academics.

ERIC Educational Resources Information Center

Anderson, Lowell D.

Total Quality Management (TQM) is a way of doing business that involves every employee, both labor and management, in an effort to improve quality and productivity. The quality management concept consists of common principles: (1) customer focus; (2) process focus; (3) failure prevention; (4) mobilization of work force; (5) decision making based…

Purchaser strategies to influence quality of care: from rhetoric to global applications.

PubMed

McNamara, P

2006-06-01

The potential of purchasers to influence the quality and safety of care has captured the attention of health sector leaders worldwide. Quality based purchasing explicitly seeks to hold providers accountable for the quality and safety of care. Three strategies are available to purchasers: (1) selective contracting based on quality; (2) payment differentials based on quality; and (3) sponsorship of comparative provider report cards. Examples are given to illustrate each of the three strategies. Governments, employers, social insurance funds, community based insurance organizations, health plans, donors, and other buyers of health services are encouraged to explore and debate these purchaser strategies within the context of an overarching national or local quality framework. Public and private funders of operations research are encouraged to support and disseminate evaluations of purchaser efforts to improve quality. This paper is designed to highlight and frame purchasers' strategies explicitly crafted to enhance the quality and safety of care. The ultimate aim is to encourage thoughtful discussion about whether or not one or more purchaser strategy might support a particular country's goals to improve care. Experiences from both developed and developing countries are included to facilitate the exchange of ideas and provide the broadest of perspectives.

Optimizing diabetes management: managed care strategies.

PubMed

Tzeel, E Albert

2013-06-01

Both the prevalence of type 2 diabetes mellitus (DM) and its associated costs have been rising over time and are projected to continue to escalate. Therefore, type 2 DM (T2DM) management costs represent a potentially untenable strain on the healthcare system unless substantial, systemic changes are made. Managed care organizations (MCOs) are uniquely positioned to attempt to make the changes necessary to reduce the burdens associated with T2DM by developing policies that align with evidence-based DM management guidelines and other resources. For example, MCOs can encourage members to implement healthy lifestyle choices, which have been shown to reduce DM-associated mortality and delay comorbidities. In addition, MCOs are exploring the strengths and weaknesses of several different benefit plan designs. Value-based insurance designs, sometimes referred to as value-based benefit designs, use both direct and indirect data to invest in incentives that change behaviors through health information technologies, communications, and services to improve health, productivity, quality, and financial trends. Provider incentive programs, sometimes referred to as "pay for performance," represent a payment/delivery paradigm that places emphasis on rewarding value instead of volume to align financial incentives and quality of care. Accountable care organizations emphasize an alignment between reimbursement and implementation of best practices through the use of disease management and/ or clinical pathways and health information technologies. Consumer-directed health plans, or high-deductible health plans, combine lower premiums with high annual deductibles to encourage members to seek better value for health expenditures. Studies conducted to date on these different designs have produced mixed results.

Transforming an EPA QA/R-2 quality management plan into an ISO 9002 quality management system.

PubMed

Kell, R A; Hedin, C M; Kassakhian, G H; Reynolds, E S

2001-01-01

The Environmental Protection Agency's (EPA) Office of Emergency and Remedial Response (OERR) requires environmental data of known quality to support Superfund hazardous waste site projects. The Quality Assurance Technical Support (QATS) Program is operated by Shaw Environmental and Infrastructure, Inc. to provide EPA's Analytical Operations Center (AOC) with performance evaluation samples, reference materials, on-site laboratory auditing capabilities, data audits (including electronic media data audits), methods development, and other support services. The new QATS contract awarded in November 2000 required that the QATS Program become ISO 9000 certified. In a first for an EPA contractor, the QATS staff and management successfully transformed EPA's QA/R-2 type Quality Management Plan into a Quality Management System (QMS) that complies with the requirements of the internationally recognized ISO 9002 standard and achieved certification in the United States, Canada, and throughout Europe. The presentation describes how quality system elements of ISO 9002 were implemented on an already existing quality system. The psychological and organizational challenges of the culture change in QATS' day-to-day operations will be discussed for the benefit of other ISO 9000 aspirants.

Modelling raw water quality: development of a drinking water management tool.

PubMed

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.

[QUIPS: quality improvement in postoperative pain management].

PubMed

Meissner, Winfried

2011-01-01

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

Total Quality Management. A Selected Bibliography

DTIC Science & Technology

1994-03-01

THE FEDERAL GOVERNMENT, by Frank L . Lewis and others. Washington: May 1991. 34pp. (TS156 157 1991) Periodical Articles Aggarwal, Sumer. "A Quick Guide...to Total Quality Management." BUSINESS HORIZONS, Vol. 36, May-June 1993, pp. 66-68. Axline, Larry L . "TQM: A Look in the Mirror." MANAGEMENT REVIEW...Schuler, Randall S., and Harris, Drew L . MANAGING QUALITY: THE PRIMER FOR MIDDLE MANAGERS. Reading, MA: Addison-Wesley, 1992. 202pp. (HD62.15 S38

Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

PubMed

Tao, Ziqi

2015-06-01

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

Total quality management and nursing: a shared vision.

PubMed

Morey, W

1996-09-01

The application of the Total Quality Management (TQM) philosophy within the health care sector would enhance the development of nursing power, leadership and knowledge. TQM challenges conventional management techniques as it requires a participative management style in order to be effective. There are many potential benefits for nurses, when quality assurance monitoring within a hierarchical management structure, is replaced with a focus on continuous quality improvement by every member of staff. These benefits are described within the context of both organisational and personal commitment to Total Quality Management.

Assessing Fishers' Support of Striped Bass Management Strategies.

PubMed

Murphy, Robert D; Scyphers, Steven B; Grabowski, Jonathan H

2015-01-01

Incorporating the perspectives and insights of stakeholders is an essential component of ecosystem-based fisheries management, such that policy strategies should account for the diverse interests of various groups of anglers to enhance their efficacy. Here we assessed fishing stakeholders' perceptions on the management of Atlantic striped bass (Morone saxatilis) and receptiveness to potential future regulations using an online survey of recreational and commercial fishers in Massachusetts and Connecticut (USA). Our results indicate that most fishers harbored adequate to positive perceptions of current striped bass management policies when asked to grade their state's management regime. Yet, subtle differences in perceptions existed between recreational and commercial fishers, as well as across individuals with differing levels of fishing experience, resource dependency, and tournament participation. Recreational fishers in both states were generally supportive or neutral towards potential management actions including slot limits (71%) and mandated circle hooks to reduce mortality of released fish (74%), but less supportive of reduced recreational bag limits (51%). Although commercial anglers were typically less supportive of management changes than their recreational counterparts, the majority were still supportive of slot limits (54%) and mandated use of circle hooks (56%). Our study suggests that both recreational and commercial fishers are generally supportive of additional management strategies aimed at sustaining healthy striped bass populations and agree on a variety of strategies. However, both stakeholder groups were less supportive of harvest reductions, which is the most direct measure of reducing mortality available to fisheries managers. By revealing factors that influence stakeholders' support or willingness to comply with management strategies, studies such as ours can help managers identify potential stakeholder support for or conflicts that may

DLA-X Total Quality Management (TQM) Implementation Plan

DTIC Science & Technology

1989-07-01

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

Total Quality Education: Profiles of Schools That Demonstrate the Power of Deming's Management Principles.

ERIC Educational Resources Information Center

Schmoker, Michael J.; Wilson, Richard B.

This book presents profiles of schools that have demonstrated the power of Deming's Total Quality Management (TQM) principles. It describes schools that have successfully applied those strategies for change. The book explores what public education needs most--a compelling but flexible action plan for improvement. Chapter 1 offers a rationale for…

Relationship management strategies for daughters in conflicted relationships with their ageing mothers.

PubMed

Pickering, Carolyn E Z; Moon, Ailee; Pieters, Huibrie C; Mentes, Janet C; Phillips, Linda R

2015-03-01

To study relationship management strategies of daughters in conflicted relationships with their mothers and how they promoted or prevented elder abuse. Daughters have enduring, unique relationships with their mothers that often carry over into caregiving. Pre-caregiving relationship quality is related to many caregiving outcomes, although it is unclear how. Qualitative study. Grounded theory design, informed by feminism, with telephone interviews conducted between January 2013-July 2013. The sample (N = 13) was recruited through an online recruitment strategy, with advertisements posted on relevant websites asking 'Are you in an abusive relationship with your ageing mother?' Daughters used coping strategies and self-protective strategies aimed at decreasing their exposure to aggression and emotional distress when interacting with their ageing mothers. Daughters also used spiteful aggression out of the desire for revenge. Although the daughters' strategies served their personal needs, they jeopardized the mothers' needs by creating an environment where neglect could occur. Daughters also readily and intentionally used aggression against their mothers. These were strategies daughters have found useful. These strategies may be potential areas for designing interventions to promote healthy family relationships and decrease the occurrence of elder abuse and neglect. © 2014 John Wiley & Sons Ltd.

Do competition and managed care improve quality?

PubMed

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.

Improving Operational Readiness through Total Quality Management

DTIC Science & Technology

1991-06-21

DTIC AD-A236 611 EL CT F NAVAL WAR COLL GE C Newport, R. I. IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT by Herb Westphal Defense...IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT (TQM) A Case Study: The Defense Mapping Agency Combat Support Center (DMACSC) initiated a...of the Defense Mapping Agency Combat Support Center’s (DMACSC) Total Quality Management (TQM) improvement methodology. This allows the reader to

Level of quality management in the Municipal Sports Services, contrast trough EFQM Excellence Model.

PubMed

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.

White-collar productivity and quality issues; Proceedings of the Symposium on Productivity and Quality: Strategies for Improving Operations in Government and Industry, Washington, DC, September 25, 26, 1984

NASA Technical Reports Server (NTRS)

Gerard, M. (Editor); Edwards, P. W. (Editor)

1985-01-01

Techniques for improving the productivity of white-collar workers while maintaining high product quality are examined in reviews and reports. The emphasis is on the application of strategies developed in the private sector to government-agency and aerospace-industry operations. Topics discussed include international competition, organizational attitudes and orientation, management practices, education and training, renewing large organizations, encouraging innovation, national initiatives, employee involvement, management involvement, and applications of new technology.

[Medium-term strategy for the specific management of pneumology hospitals and wards after the decentralization of the sanitary system].

PubMed

Muşat, Simona Nicoleta; Ioniţa, Diana; Paceonea, Mirela; Chiriac, Nona Delia; Stoicescu, Ileana Paula; Mihălţan, F D

2011-01-01

Identifying and promoting new management techniques for the descentralized pneumology hospitals or wards was one of the most ambitious objectives of the project "Quality in the pneumology medical services through continuous medical education and organizational flexibility", financed by the Human Resourses Development Sectorial Operational Programme 2007-2013 (ID 58451). The "Medium term Strategy on the specific management of the pneumology hospitals or wards after the descentralization of the sanitary system" presented in the article was written by the project's experts and discussed with pneumology managers and local authorities representatives. This Strategy application depends on the colaboration of the pneumology hospitals with professional associations, and local and central authorities.

Quality of chronic kidney disease management in primary care: a retrospective study.

PubMed

Van Gelder, Vincent A; Scherpbier-De Haan, Nynke D; De Grauw, Wim J C; Vervoort, Gerald M M; Van Weel, Chris; Biermans, Marion C J; Braspenning, Jozé C C; Wetzels, Jack F M

2016-01-01

Early detection and appropriate management of chronic kidney disease (CKD) in primary care are essential to reduce morbidity and mortality. To assess the quality of care (QoC) of CKD in primary healthcare in relation to patient and practice characteristics in order to tailor improvement strategies. Retrospective study using data between 2008 and 2011 from 47 general practices (207 469 patients of whom 162 562 were adults). CKD management of patients under the care of their general practitioner (GP) was qualified using indicators derived from the Dutch interdisciplinary CKD guideline for primary care and nephrology and included (1) monitoring of renal function, albuminuria, blood pressure, and glucose, (2) monitoring of metabolic parameters, and alongside the guideline: (3) recognition of CKD. The outcome indicator was (4) achieving blood pressure targets. Multilevel logistic regression analysis was applied to identify associated patient and practice characteristics. Kidney function or albuminuria data were available for 59 728 adult patients; 9288 patients had CKD, of whom 8794 were under GP care. Monitoring of disease progression was complete in 42% of CKD patients, monitoring of metabolic parameters in 2%, and blood pressure target was reached in 43.1%. GPs documented CKD in 31.4% of CKD patients. High QoC was strongly associated with diabetes, and to a lesser extent with hypertension and male sex. Room for improvement was found in all aspects of CKD management. As QoC was higher in patients who received structured diabetes care, future CKD care may profit from more structured primary care management, e.g. according to the chronic care model. Quality of care for chronic kidney disease patients in primary care can be improved. In comparison with guideline advice, adequate monitoring of disease progression was observed in 42%, of metabolic parameters in 2%, correct recognition of impaired renal function in 31%, and reaching blood pressure targets in 43% of chronic

Clinicians in management: a qualitative study of managers' use of influence strategies in hospitals.

PubMed

Spehar, Ivan; Frich, Jan C; Kjekshus, Lars Erik

2014-06-13

Combining a professional and managerial role can be challenging for doctors and nurses. We aimed to explore influence strategies used by doctors and nurses who are managers in hospitals with a model of unitary and profession neutral management at all levels. We did a study based on data from interviews and observations of 30 managers with a clinical background in Norwegian hospitals. Managers with a nursing background argued that medical doctors could more easily gain support for their views. Nurses reported deliberately not disclosing their professional background, and could use a doctor as their agent to achieve a strategic advantage. Doctors believed that they had to use their power as experts to influence peers. Doctors attempted to be medical role models, while nurses spoke of being a role model in more general terms. Managers who were not able to influence the system directly found informal workarounds. We did not identify horizontal strategies in the observations and accounts given by the managers in our study. Managers' professional background may be both a resource and constraint, and also determine the influence strategies they use. Professional roles and influence strategies should be a theme in leadership development programs for health professionals.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-04-02

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

Economic Evaluations in the Diagnosis and Management of Traumatic Brain Injury: A Systematic Review and Analysis of Quality.

PubMed

Alali, Aziz S; Burton, Kirsteen; Fowler, Robert A; Naimark, David M J; Scales, Damon C; Mainprize, Todd G; Nathens, Avery B

2015-07-01

Economic evaluations provide a unique opportunity to identify the optimal strategies for the diagnosis and management of traumatic brain injury (TBI), for which uncertainty is common and the economic burden is substantial. The objective of this study was to systematically review and examine the quality of contemporary economic evaluations in the diagnosis and management of TBI. Two reviewers independently searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, Health Technology Assessment Database, EconLit, and the Tufts CEA Registry for comparative economic evaluations published from 2000 onward (last updated on August 30, 2013). Data on methods, results, and quality were abstracted in duplicate. The results were summarized quantitatively and qualitatively. Of 3539 citations, 24 economic evaluations met our inclusion criteria. Nine were cost-utility, five were cost-effectiveness, three were cost-minimization, and seven were cost-consequences analyses. Only six studies were of high quality. Current evidence from high-quality studies suggests the economic attractiveness of the following strategies: a low medical threshold for computed tomography (CT) scanning of asymptomatic infants with possible inflicted TBI, selective CT scanning of adults with mild TBI as per the Canadian CT Head Rule, management of severe TBI according to the Brain Trauma Foundation guidelines, management of TBI in dedicated neurocritical care units, and early transfer of patients with TBI with nonsurgical lesions to neuroscience centers. Threshold-guided CT scanning, adherence to Brain Trauma Foundation guidelines, and care for patients with TBI, including those with nonsurgical lesions, in specialized settings appear to be economically attractive strategies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A systematic review on the composting of green waste: Feedstock quality and optimization strategies.

PubMed

Reyes-Torres, M; Oviedo-Ocaña, E R; Dominguez, I; Komilis, D; Sánchez, A

2018-04-27

Green waste (GW) is an important fraction of municipal solid waste (MSW). The composting of lignocellulosic GW is challenging due to its low decomposition rate. Recently, an increasing number of studies that include strategies to optimize GW composting appeared in the literature. This literature review focuses on the physicochemical quality of GW and on the effect of strategies used to improve the process and product quality. A systematic search was carried out, using keywords, and 447 papers published between 2002 and 2018 were identified. After a screening process, 41 papers addressing feedstock quality and 32 papers on optimization strategies were selected to be reviewed and analyzed in detail. The GW composition is highly variable due to the diversity of the source materials, the type of vegetation, and climatic conditions. This variability limits a strict categorization of the GW physicochemical characteristics. However, this research established that the predominant features of GW are a C/N ratio higher than 25, a deficit in important nutrients, namely nitrogen (0.5-1.5% db), phosphorous (0.1-0.2% db) and potassium (0.4-0.8% db) and a high content of recalcitrant organic compounds (e.g. lignin). The promising strategies to improve composting of GW were: i) GW particle size reduction (e.g. shredding and separation of GW fractions); ii) addition of energy amendments (e.g. non-refined sugar, phosphate rock, food waste, volatile ashes), bulking materials (e.g. biocarbon, wood chips), or microbial inoculum (e.g. fungal consortia); and iii) variations in operating parameters (aeration, temperature, and two-phase composting). These alternatives have successfully led to the reduction of process length and have managed to transform recalcitrant substances to a high-quality end-product. Copyright © 2018 Elsevier Ltd. All rights reserved.

An Introduction to Quality Management: Selected Readings.

DTIC Science & Technology

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

Quality Management for Schools.

ERIC Educational Resources Information Center

Mulligan, Dorothy

1992-01-01

W. Edwards Deming introduced management principles that helped Japan become a world economic power. Virginia is attempting to adapt these techniques to education with a grant that provides training and support for school personnel in several school districts. Describes a quality management program at Christa McAuliffe Elementary School that has…

High quality diabetes care: testing the effectiveness of strategies of regional implementation teams.

PubMed

Drach-Zahavy, Anat; Shadmi, Efrat; Freund, Anat; Goldfracht, Margalit

2009-01-01

The purpose of this article is to identify and test the effectiveness of work strategies employed by regional implementation teams to attain high quality care for diabetes patients. The study was conducted in a major health maintenance organization (HMO) that provides care for 70 per cent of Israel's diabetes patients. A sequential mixed model design, combining qualitative and quantitative methods was employed. In-depth interviews were conducted with members of six regional implementation teams, each responsible for the care of 25,000-34,000 diabetic patients. Content analysis of the interviews revealed that teams employed four key strategies: task-interdependence, goal-interdependence, reliance on top-down standardised processes and team-learning. These strategies were used to predict the mean percentage performance of eight evidence-based indicators of diabetes care: percentage of patients with HbA1c < 7 per cent, blood pressure < or = 130/80 and cholesterol < or = 100; and performance of: HbA1c tests, LDL cholesterol tests, blood pressure measurements, urine protein tests, and ophthalmic examinations. Teams were found to vary in their use of the four strategies. Mixed linear models analysis indicated that type of indicator (simple process, compound process, and outcome) and goal interdependence were significantly linked to team effectiveness. For simple-process indicators, reliance on top-down standardised processes led to team effectiveness, but for outcome measures this strategy was ineffective, and even counter-effective. For outcome measures, team-learning was more beneficial. The findings have implications for the management of chronic diseases. The advantage of allowing team members flexibility in the choice of the best work strategy to attain high quality diabetes care is attested.

Role of future scenarios in understanding deep uncertainty in long-term air quality management.

PubMed

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

Coping strategies and quality of life in caregivers of dependent elderly relatives.

PubMed

Rodríguez-Pérez, Margarita; Abreu-Sánchez, Ana; Rojas-Ocaña, María Jesús; Del-Pino-Casado, Rafael

2017-04-14

Despite the importance of coping in caregiving, there are few studies on the relationship between coping and quality of life in caregivers of the frail dependent elderly. Thus, this study aims to analyze the relationship between coping strategies and quality of life dimensions in primary caregivers of dependent elderly relatives. A cross-sectional study was conducted from 86 caregivers. Predictive variables were coping strategies (problem-focused, emotion-focused, socially-supported, and dysfunctional); dependent variables were quality of life dimensions (psychological, physical, relational, and environmental); and potential confounding variables were age, gender, perceived health and burden of caregiver, and functional capacity of care receiver. Correlation coefficients were calculated and multiple linear regression analysis was performed. After controlling for potential confounders, dysfunctional coping was related to worse quality of life in the psychological dimension, while emotion-focused and socially-supported coping were related to superior psychological and environmental dimensions of quality of life. The physical and relational dimensions of quality of life were not related to coping strategies. 1) it is important to consider coping strategies in the assessment of primary caregivers of dependent elderly relatives; 2) the quality of life of caregivers is related to their coping strategies, 3) their quality of life can be worsened by avoidance-type coping, and 4) their quality of life can be improved by active emotion-focused coping and socially-supported coping.

Quality Management Program

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

Not Available

1991-10-01

According to {section} 35.32, Quality Management Program,'' of 10 CFR Part 35, Medical Use of Byproduct Material,'' applicants or licensees, as applicable, are required to establish a quality management (QM) program. This regulatory guide provides guidance to licensees and applicants for developing policies and procedures for the QM program. This guide does not restrict or limit the licensee from using other guidance that may be equally useful in developing a QM program, e.g., information available from the Joint Commission on Accreditation of Healthcare Organizations or the American College of Radiology. Any information collection activities mentioned in this regulatory guide aremore » contained as requirements in 10 CFR Part 35, which provides the regulatory basis for this guide. This information collection requirements in 10 CFR Part 35 have been cleared under OMB Clearance No. 3150-0010.« less

Validation of a Quality Management Metric

DTIC Science & Technology

2000-09-01

quality management metric (QMM) was used to measure the performance of ten software managers on Department of Defense (DoD) software development programs. Informal verification and validation of the metric compared the QMM score to an overall program success score for the entire program and yielded positive correlation. The results of applying the QMM can be used to characterize the quality of software management and can serve as a template to improve software management performance. Future work includes further refining the QMM, applying the QMM scores to provide feedback

Effective managed care marketing strategies for evolving markets.

PubMed

Conlon, M K

1997-11-01

In a world of increased competition and changing consumer expectations, one of the keys to a fiscally sound health plan is having a dynamic marketing strategy that takes into account the shifting attitudes of consumers as managed care markets mature. The primary goal of any health plan marketing strategy should be the acquisition and retention of members. Providing cost-efficient and convenient service for enrollees, offering low or no deductibles, having convenient office locations, and minimizing paper-work are important elements of such a marketing strategy. Factors such as brand awareness and the perceived image of a health plan also are important considerations in acquiring and retaining market share. The relative importance of these consumer satisfaction criteria change as a managed care market evolves and matures. Financial and marketing managers, thus, should ascertain their market's stage of development and respond with appropriate marketing strategies.

Assessing Fishers' Support of Striped Bass Management Strategies

PubMed Central

Murphy, Robert D.; Scyphers, Steven B.; Grabowski, Jonathan H.

2015-01-01

Incorporating the perspectives and insights of stakeholders is an essential component of ecosystem-based fisheries management, such that policy strategies should account for the diverse interests of various groups of anglers to enhance their efficacy. Here we assessed fishing stakeholders’ perceptions on the management of Atlantic striped bass (Morone saxatilis) and receptiveness to potential future regulations using an online survey of recreational and commercial fishers in Massachusetts and Connecticut (USA). Our results indicate that most fishers harbored adequate to positive perceptions of current striped bass management policies when asked to grade their state’s management regime. Yet, subtle differences in perceptions existed between recreational and commercial fishers, as well as across individuals with differing levels of fishing experience, resource dependency, and tournament participation. Recreational fishers in both states were generally supportive or neutral towards potential management actions including slot limits (71%) and mandated circle hooks to reduce mortality of released fish (74%), but less supportive of reduced recreational bag limits (51%). Although commercial anglers were typically less supportive of management changes than their recreational counterparts, the majority were still supportive of slot limits (54%) and mandated use of circle hooks (56%). Our study suggests that both recreational and commercial fishers are generally supportive of additional management strategies aimed at sustaining healthy striped bass populations and agree on a variety of strategies. However, both stakeholder groups were less supportive of harvest reductions, which is the most direct measure of reducing mortality available to fisheries managers. By revealing factors that influence stakeholders’ support or willingness to comply with management strategies, studies such as ours can help managers identify potential stakeholder support for or conflicts that

Total Quality Management in Higher Education.

ERIC Educational Resources Information Center

Sherr, Lawrence A.; Lozier, G. Gredgory

1991-01-01

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

Managing Change from a Quality Perspective.

ERIC Educational Resources Information Center

Snyder, Karolyn J.

This paper presents findings of a study that examined the change process in 28 schools, with a focus on how principals went about transforming traditional school-work cultures into quality systems. The principals had participated in Managing Productive Schools (MPS), a comprehensive systems-approach program based on quality management concepts.…

2015/2016 Quality Risk Management Benchmarking Survey.

PubMed

Waldron, Kelly; Ramnarine, Emma; Hartman, Jeffrey

2017-01-01

This paper investigates the concept of quality risk management (QRM) maturity as it applies to the pharmaceutical and biopharmaceutical industries, using the results and analysis from a QRM benchmarking survey conducted in 2015 and 2016. QRM maturity can be defined as the effectiveness and efficiency of a quality risk management program, moving beyond "check-the-box" compliance with guidelines such as ICH Q9 Quality Risk Management , to explore the value QRM brings to business and quality operations. While significant progress has been made towards full adoption of QRM principles and practices across industry, the full benefits of QRM have not yet been fully realized. The results of the QRM Benchmarking Survey indicate that the pharmaceutical and biopharmaceutical industries are approximately halfway along the journey towards full QRM maturity. LAY ABSTRACT: The management of risks associated with medicinal product quality and patient safety are an important focus for the pharmaceutical and biopharmaceutical industries. These risks are identified, analyzed, and controlled through a defined process called quality risk management (QRM), which seeks to protect the patient from potential quality-related risks. This paper summarizes the outcomes of a comprehensive survey of industry practitioners performed in 2015 and 2016 that aimed to benchmark the level of maturity with regard to the application of QRM. The survey results and subsequent analysis revealed that the pharmaceutical and biopharmaceutical industries have made significant progress in the management of quality risks over the last ten years, and they are roughly halfway towards reaching full maturity of QRM. © PDA, Inc. 2017.

Modeling nutrient sources, transport and management strategies in a coastal watershed, Southeast China.

PubMed

Zhou, Pei; Huang, Jinliang; Hong, Huasheng

2018-01-01

Integrated watershed management requires an analytical model capable of revealing the full range of impacts that would be caused by the uses and developments in the watershed. The SPAtially Referenced Regressions On Watershed Attributes (SPARROW) model was developed in this study to provide empirical estimates of the sources, transport of total nitrogen (TN) and total phosphorus (TP) and to develop nutrient management strategies in the Jiulong River Watershed, southeast China that has enormous influence on the region's ecological safety. We calibrated the model using data related to daily streamflow, monthly TN and TP concentrations in 2014 at 30 locations. The model produced R 2 values for TN with 0.95 and TP with 0.94. It was found that for the entire watershed, TN came from fertilizer application (43%), livestock breeding (39%) and sewage discharge (18%), while TP came from livestock breeding (46%), fertilizer application (46%), and industrial discharge (8%). Fifty-eight percent of the TN and 80% of the TP in upstream reaches are delivered to the outlets of North and West rivers. A scenario analysis with SPARROW was coupled to develop suitable management strategies. Results revealed that controlling nutrient sources was effective in improving water quality. Normally sharp reduction in nutrient sources is not operational feasible. Hence, it is recommended that preventing nutrient on land from entering into the river as a suitable strategy in watershed management. Copyright © 2017 Elsevier B.V. All rights reserved.

Quality of health care in the US managed care system: comparing and highlighting successful states.

PubMed

Guo, Kristina L

2008-01-01

This paper aims to examine the issue of quality of care in the US managed care system and to compare state-level policies and programs. Specifically, it aims to describe five states which are making the most quality of care improvements. This study examines the literature to identify states' care quality rankings. Additionally, five state case studies are presented to illustrate various programs approach to quality. The paper finds that some states are better than others in their strategies to enhance quality of care. California, Florida, Maryland, Minnesota and Rhode Island are considered among the best. Thus, their programs are described. From a research perspective the study brings a renewed focus on various methods in which states invest to improve residents' quality of care. From a practical standpoint, since quality of care is an important topic and interesting to all stakeholders in health care--policymakers, consumers, providers, and payers--readers can use the study's results to compare states' strategies and develop new ways to increase quality. This study's value lies in the way it helps states to compare their performance over time and against other states as they make improvements to enhance quality.

Public health laboratory quality management in a developing country.

PubMed

Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut

2012-01-01

The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

Analysis of Human Resources Management Strategy in China Electronic Commerce Enterprises

NASA Astrophysics Data System (ADS)

Shao, Fang

The paper discussed electronic-commerce's influence on enterprise human resources management, proposed and proved the human resources management strategy which electronic commerce enterprise should adopt from recruitment strategy to training strategy, keeping talent strategy and other ways.

Current management strategies for patellofemoral pain: an online survey of 99 practising UK physiotherapists.

PubMed

Smith, Benjamin E; Hendrick, Paul; Bateman, Marcus; Moffatt, Fiona; Rathleff, Michael Skovdal; Selfe, James; Smith, Toby O; Logan, Pip

2017-05-08

Patellofemoral pain (PFP) is considered one of the commonest forms of knee pain. This study aimed to identify how physiotherapists in the United Kingdom (UK) currently manage patellofemoral pain (PFP), particularly in relation to exercise prescription, and response to pain. An anonymous survey was designed with reference to previous surveys and recent systematic reviews. Practising UK physiotherapists who treat patients with PFP were invited to take part via an invitation email sent through professional networks, the 'interactive Chartered Society of Physiotherapy (iCSP)' message board, and social media (Twitter). Descriptive statistics were used to analyse the data. A total of 99 surveys were completed. Responders reported a wide range of management strategies, including a broad selection of type and dose of exercise prescription. The five most common management strategies chosen were: closed chain strengthening exercises (98%); education and advice (96%); open chain strengthening exercises (76%); taping (70%) and stretches (65%). Physiotherapists with a special interest in treating PFP were statistically more likely to manage patients with orthotics (P = 0.02) and bracing (P = 0.01) compared to physiotherapists without a special interest. Approximately 55% would not prescribe an exercise if it was painful. Thirty-one percent of physiotherapists would advise patients not to continue with leisure and/or sporting activity if they experienced any pain. Current UK practice in the management strategies of PFP is variable. Further high quality research on which to inform physiotherapy practice is warranted for this troublesome musculoskeletal condition.

DESC (Defense Electronics Supply Center) Total Quality Management Plan

DTIC Science & Technology

1989-04-01

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

Total Quality Management Implementation Plan: DLA-N

DTIC Science & Technology

1989-07-01

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

Quality risk management of top spray fluidized bed process for antihypertensive drug formulation with control strategy engendered by Box-behnken experimental design space.

PubMed

Mukharya, Amit; Patel, Paresh U; Shenoy, Dinesh; Chaudhary, Shivang

2013-01-01

Lacidipine (LCDP) is a very low soluble and highly biovariable calcium channel blocker used in the treatment of hypertension. To increase its apparent solubility and to reduce its biovariability, solid dispersion fluid bed processing technology was explored, as it produces highly dispersible granules with a characteristic porous structure that enhances dispersibility, wettability, blend uniformity (by dissolving and spraying a solution of actives), flow ability and compressibility of granules for tableting and reducing variability by uniform drug-binder solution distribution on carrier molecules. Main object of this quality risk management (QRM) study is to provide a sophisticated "robust and rugged" Fluidized Bed Process (FBP) for the preparation of LCDP tablets with desired quality (stability) and performance (dissolution) by quality by design (QbD) concept. THIS STUDY IS PRINCIPALLY FOCUSING ON THOROUGH MECHANISTIC UNDERSTANDING OF THE FBP BY WHICH IT IS DEVELOPED AND SCALED UP WITH A KNOWLEDGE OF THE CRITICAL RISKS INVOLVED IN MANUFACTURING PROCESS ANALYZED BY RISK ASSESSMENT TOOLS LIKE: Qualitative Initial Risk-based Matrix Analysis (IRMA) and Quantitative Failure Mode Effective Analysis (FMEA) to identify and rank parameters with potential to have an impact on In Process/Finished Product Critical Quality Attributes (IP/FP CQAs). These Critical Process Parameters (CPPs) were further refined by DoE and MVDA to develop design space with Real Time Release Testing (RTRT) that leads to implementation of a control strategy to achieve consistent finished product quality at lab scale itself to prevent possible product failure at larger manufacturing scale.

Combating Obesity at Community Health Centers (COACH): A Quality Improvement Collaborative for Weight Management Programs

PubMed Central

Wilkes, Abigail E.; John, Priya M.; Vable, Anusha M.; Campbell, Amanda; Heuer, Loretta; Schaefer, Cynthia; Vinci, Lisa; Drum, Melinda L.; Chin, Marshall H.; Quinn, Michael T.; Burnet, Deborah L.

2013-01-01

Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians’ Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians’ Network members expressed interest in an obesity QI program. This pilot study aimed to determine whether the QI model can be feasibly implemented with limited resources at CHCs to improve weight management programs. Five health centers with weight management programs enrolled with CHC staff as primary study participants; this study did not attempt to measure patient outcomes. Participants attended learning sessions and monthly conference calls to build QI skills and share best practices. Tailored coaching addressed local needs. Topics rated most valuable were patient recruitment/retention strategies, QI techniques, evidence-based weight management, motivational interviewing. Challenges included garnering provider support, high staff turnover, and difficulty tracking patient-level data. This paper reports practical lessons about implementing a weight management QI collaborative in CHCs. PMID:23727964

Management strategy 3: fixed rate fertilizer applications

USDA-ARS?s Scientific Manuscript database

Previous chapters outlined management strategies for pond fertilization that take into account specific individual pond nutrient needs. Those methods would most likely be more ecologically efficient than a pre-determined fixed-rate nutrient addition strategy. However, the vast majority of available ...

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

NASA Astrophysics Data System (ADS)

Sikorsky, Charles S.

1997-05-01

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

Can integrative catchment management mitigate future water quality issues caused by climate change and socio-economic development?

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

EDUCATING MANAGERS ABOUT QUALITY THROUGH CUSTOMER-SUPPLIER UNDERSTANDING

EPA Science Inventory

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

77 FR 73320 - Approval of Air Quality Implementation Plans; California; South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... Implementation Plan (SIP) revision for the South Coast Air Quality Management District (SCAQMD or District... in a August 15, 2012 letter from the South Coast Air Quality Management District regarding specific...

Preservice Teachers' Knowledge and Perceptions of Effective Behavior Management Strategies

ERIC Educational Resources Information Center

Nields, Allison N.

2014-01-01

This study examined student teachers' perceptions and knowledge of behavior management strategies. A questionnaire that included questions about broad behavior management techniques, behavioral learning theory, and behavior management strategies related to behavioral learning theory was given to sixty-one student teacher candidates at a large…

Collection to Archival: A Data Management Strategy for the Ocean Acidification Community

NASA Astrophysics Data System (ADS)

Burger, E. F.; Smith, K. M.; Parsons, A. R.; Wanninkhof, R. H.; O'Brien, K.; Barbero, L.; Schweitzer, R.; Manke, A.

2014-12-01

Recently new data collection platforms, many of them autonomous mobile platforms, have added immensely to the data volume the Ocean Acidification community is dealing with. This is no exception with NOAA's Pacific Marine Environmental Laboratory (PMEL) Ocean Acidification (OA) effort. Collaboration between the PMEL Carbon group and the PMEL Science Data Integration group to manage local data has spawned the development of a data management strategy that covers the data lifecycle from collection to analysis to quality control to archival. The proposed software and workflow will leverage the successful data management framework pioneered by the Surface Ocean CO2 Atlas (SOCAT) project, but customized for Ocean Acidification requirements. This presentation will give a brief overview of the data management framework that will be implemented for Ocean Acidification data that are collected by PMEL scientists. We will also be discussing our plans to leverage this system to build an east coast ocean acidification management system at NOAA's Atlantic Oceanographic and Meteorological Laboratory (AOML), as well as a national OA management system at NOAA's National Oceanographic Data Center (NODC).

40 CFR 35.2102 - Water quality management planning.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Verification of a quality management theory: using a delphi study.

PubMed

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.

Evaluating the impact of field-scale management strategies on sediment transport to the watershed outlet.

PubMed

Sommerlot, Andrew R; Pouyan Nejadhashemi, A; Woznicki, Sean A; Prohaska, Michael D

2013-10-15

Non-point source pollution from agricultural lands is a significant contributor of sediment pollution in United States lakes and streams. Therefore, quantifying the impact of individual field management strategies at the watershed-scale provides valuable information to watershed managers and conservation agencies to enhance decision-making. In this study, four methods employing some of the most cited models in field and watershed scale analysis were compared to find a practical yet accurate method for evaluating field management strategies at the watershed outlet. The models used in this study including field-scale model (the Revised Universal Soil Loss Equation 2 - RUSLE2), spatially explicit overland sediment delivery models (SEDMOD), and a watershed-scale model (Soil and Water Assessment Tool - SWAT). These models were used to develop four modeling strategies (methods) for the River Raisin watershed: Method 1) predefined field-scale subbasin and reach layers were used in SWAT model; Method 2) subbasin-scale sediment delivery ratio was employed; Method 3) results obtained from the field-scale RUSLE2 model were incorporated as point source inputs to the SWAT watershed model; and Method 4) a hybrid solution combining analyses from the RUSLE2, SEDMOD, and SWAT models. Method 4 was selected as the most accurate among the studied methods. In addition, the effectiveness of six best management practices (BMPs) in terms of the water quality improvement and associated cost were assessed. Economic analysis was performed using Method 4, and producer requested prices for BMPs were compared with prices defined by the Environmental Quality Incentives Program (EQIP). On a per unit area basis, producers requested higher prices than EQIP in four out of six BMP categories. Meanwhile, the true cost of sediment reduction at the field and watershed scales was greater than EQIP in five of six BMP categories according to producer requested prices. Copyright © 2013 Elsevier Ltd. All

Optimal pumping strategies for managing shallow, poorquality groundwater, western San Joaquin Valley, California

USGS Publications Warehouse

Barlow, P.; Wagner, B.; Belitz, K.

1995-01-01

Continued agricultural productivity in the western San Joaquin Valley, California, is threatened by the presence of shallow, poor-quality groundwater that can cause soil salinization. We evaluate the management alternative of using groundwater pumping to control the altitude of the water table and provide irrigation water requirements. A transient, three-dimensional, groundwater flow model was linked with nonlinear optimization to simulate management alternatives for the groundwater flow system. Optimal pumping strategies have been determined that substantially reduce the area subject to a shallow water table and bare-soil evaporation (that is, areas with a water table within 2.1 m of land surface) and the rate of drainflow to on-farm drainage systems. Optimal pumping strategies are constrained by the existing distribution of wells between the semiconfined and confined zones of the aquifer, by the distribution of sediment types (and associated hydraulic conductivities) in the western valley, and by the historical distribution of pumping throughout the western valley.

[Essential guidelines for Quality Management System].

PubMed

Daunizeau, A

2013-06-01

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

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

PubMed

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

2017-01-01

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

Asthma in pregnancy: management strategies.

PubMed

McCallister, Jennifer W

2013-01-01

Asthma is one of the most prevalent chronic medical conditions to complicate pregnancy. With approximately one-third of women experiencing a worsening of control during the course of their pregnancy, identifying those at greatest risk has the potential to improve maternal and fetal outcomes for a large number of pregnancies. Similarly, active management strategies that prioritize asthma control in this vulnerable population can have a far-reaching impact. Demographic characteristics and patient noncompliance place certain populations of pregnant women at increased risk of poor asthma control during pregnancy. In addition, undertreatment and disparities in care of acute exacerbations during pregnancy likely contribute. Targeted educational interventions and treatment algorithms using objective markers of disease activity have shown improved outcomes in asthma control. Active management strategies which focus on identifying patient-specific risk factors, patient and provider education, and targeted treatment interventions can improve asthma care for women during pregnancy.

Strategic collaborative quality management and employee job satisfaction

PubMed Central

Mosadeghrad, Ali Mohammad

2014-01-01

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

Strategic collaborative quality management and employee job satisfaction.

PubMed

Mosadeghrad, Ali Mohammad

2014-05-01

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

Verification of a Quality Management Theory: Using a Delphi Study

PubMed Central

Mosadeghrad, Ali Mohammad

2013-01-01

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

Total Quality Management for Schools.

ERIC Educational Resources Information Center

Greenwood, Malcolm S.; Gaunt, Helen J.

Education in the United Kingdom has been shaped by the advent of local school management and the rapid growth of grant-maintained schools. Total Quality Management (TQM) offers a new way of looking at management principles and structures by identifying the needs of both internal and external customers. This book applies principles of TQM…

Water quantity and quality model for the evaluation of water-management strategies in the Netherlands: application to the province of Friesland

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

Management Development Programs: The Effects of Management Level and Corporate Strategy. [and] Invited Reaction: Level and Strategy Should and Do Make a Difference!

ERIC Educational Resources Information Center

Blakely, Gerald L.; And Others

1994-01-01

Consensus of survey responses from 155 of 600 human resource managers was as follows: management development programs emphasized technical skills at lower levels, entrepreneurial skills at senior levels; organizations with corporate growth strategies focused on more areas than those with stability or retrenchment strategies. (Muschewske's reaction…

Strategies to control costs and quality: a focus on outcomes research for disease management.

PubMed

Villagra, Victor

2004-04-01

Rapid adoption of disease management has outpaced systematic evaluation of its net value in improving health outcomes and mitigating healthcare cost. This article identifies areas in which outcomes research in disease management is needed to demonstrate its value or to enhance its performance. Patient identification for disease management relies on administrative database queries but the trade-offs in sensitivity, specificity, and predictive value of alternative queries are not well known. Large-scale deployment, rapid patient engagement, and repeated interactions between patients and nurses could be important attributes for attaining measurable improvements in quality and cost reduction over short periods of time, but these hypothesis need to be tested. There is a trend toward integration of multiple chronic disease management programs onto a single platform. To support this trend, there is a need for a corresponding set of integrated clinical guidelines or "meta-guidelines" that combine the contents of individual practice guidelines. The relative contribution of various disease management interventions in improving clinical results, lowering costs, and their respective ease of implementation is not known. Research leading to a better understanding of tradeoffs could lead to more rational resource allocation and better overall outcomes. Coordination between disease management programs and physician practices is lacking. Research aimed at defining operational and technical interfaces and cultural and behavioral professional adjustments necessary to achieve integration and coordination is needed. The lack of a consistent analytical framework for evaluating clinical and financial outcomes has made comparisons of reported results impossible and has rendered many reports unreliable. Theoretical work on a standard methodology that integrates clinical and financial outcomes and empiric validation is needed.

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

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Study of microarthopod communities to assess soil quality in different managed vineyards

NASA Astrophysics Data System (ADS)

Gagnarli, E.; Goggioli, D.; Tarchi, F.; Guidi, S.; Nannelli, R.; Vignozzi, N.; Valboa, G.; Lottero, M. R.; Corino, L.; Simoni, S.

2015-01-01

Land use influences the abundance and diversity of soil arthropods. The evaluation of the impact of different management strategies on soil quality is increasingly requested. The determination of communities' structures of edaphic fauna can represent an efficient tool. In this study, in some vineyards in Piedmont (Italy), the effects of two different management systems, organic and integrated pest management (IPM), on soil biota were evaluated. As microarthropods living in soil surface are an important component of soil ecosystem interacting with all the other system components, a multi disciplinary approach was adopted by characterizing also some soil physical and chemical characteristics (soil texture, soil pH, total organic carbon, total nitrogen, calcium carbonate). Soil samplings were carried out on Winter 2011 and Spring 2012. All specimens were counted and determined up to the order level. The biological quality of the soil was defined through the determination of ecological indices, such as QBS-ar, species richness and indices of Shannon-Weaver, Pielou, Margalef and Simpson. The mesofauna abundance was affected by both the type of management and the soil texture. The analysis of microarthropod communities by QBS-ar showed higher values in organic than in IPM managed vineyards; in particular, the values registered in organic vineyards were similar to those characteristic of preserved soils.

Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review.

PubMed

Bhattarai, Priyanka; Newton-John, T R O; Phillips, Jane L

2018-03-01

To appraise the quality and usability of currently available pain applications that could be used by community-dwelling older adults to self-manage their arthritic pain. A systematic review. Searches were conducted in App Store and Google Play to identify pain self-management apps relevant to arthritic pain management. English language pain management apps providing pain assessment and documentation function and pain management education were considered for inclusion. A quality evaluation audit tool based on the Stanford Arthritis Self-Management Program was developed a priori to evaluate app content quality. The usability of included apps was assessed using an established usability evaluation tool. Out of the 373 apps that were identified, four met the inclusion criteria. The included apps all included a pain assessment and documentation function and instructions on medication use, communication with health professionals, cognitive behavioral therapy-based pain management, and physical exercise. Management of mood, depression, anxiety, and sleep were featured in most apps (N = 3). Three-quarters (N = 3) of the apps fell below the acceptable moderate usability score (≥3), while one app obtained a moderate score (3.2). Few of the currently available pain apps offer a comprehensive pain self-management approach incorporating evidence-based strategies in accordance with the Stanford Arthritis Self-Management Program. The moderate-level usability across the included apps indicates a need to consider the usability needs of the older population in future pain self-management app development endeavors.

Irritable bowel syndrome: contemporary nutrition management strategies.

PubMed

Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E

2014-09-01

Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome. © 2014 American Society for Parenteral and Enteral Nutrition.

Using scenario analysis to determine managed care strategy.

PubMed

Krentz, S E; Gish, R S

2000-09-01

In today's volatile healthcare environment, traditional planning tools are inadequate to guide financial managers of provider organizations in developing managed care strategies. These tools often disregard the uncertainty surrounding market forces such as employee benefit structure, the future of Medicare managed care, and the impact of consumer behavior. Scenario analysis overcomes this limitation by acknowledging the uncertain healthcare environment and articulating a set of plausible alternative futures, thus supplying financial executives with the perspective to craft strategies that can improve the market position of their organizations. By being alert for trigger points that might signal the rise of a specific scenario, financial managers can increase their preparedness for changes in market forces.

An Integrated Approach Is Needed for Ecosystem Based Fisheries Management: Insights from Ecosystem-Level Management Strategy Evaluation

PubMed Central

Fulton, Elizabeth A.; Smith, Anthony D. M.; Smith, David C.; Johnson, Penelope

2014-01-01

An ecosystem approach is widely seen as a desirable goal for fisheries management but there is little consensus on what strategies or measures are needed to achieve it. Management strategy evaluation (MSE) is a tool that has been widely used to develop and test single species fisheries management strategies and is now being extended to support ecosystem based fisheries management (EBFM). We describe the application of MSE to investigate alternative strategies for achieving EBFM goals for a complex multispecies fishery in southeastern Australia. The study was undertaken as part of a stakeholder driven process to review and improve the ecological, economic and social performance of the fishery. An integrated management strategy, involving combinations of measures including quotas, gear controls and spatial management, performed best against a wide range of objectives and this strategy was subsequently adopted in the fishery, leading to marked improvements in performance. Although particular to one fishery, the conclusion that an integrated package of measures outperforms single focus measures we argue is likely to apply widely in fisheries that aim to achieve EBFM goals. PMID:24454722

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

ERIC Educational Resources Information Center

Waks, Shlomo; Frank, Moti

1999-01-01

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

Perioperative managers: role stressors and strategies for coping.

PubMed

Schroeder, Marilyn; Worrall-Carter, Linda

2002-10-01

This qualitative study explored the role stressors experienced by perioperative nurse managers, and identified resources and strategies they used in order to cope with the multiple demands upon their role. Grounded Theory methodology was used to inform the inquiry through interviews with the participants and thematic analysis of the data. The perioperative nurse managers who participated in the study indicated that the major stressors they experienced were related to managing their staff Stress was reduced through the use of hospital resources and peer support, referring to post management education and information obtainedfrom attending conferences. In addition, they used team building strategies, balanced priorities and engaged in social activities. These findings will assist directors of nursing and other nursing leaders in formulating the direction of appropriate support and structure for the development of perioperative nurse managers.

[Quality indicators for National Disease Management Guidelines using the example of the National Disease Management Guideline for "Chronic Heart Failure"].

PubMed

Nothacker, Monika Judith; Langer, Thomas; Weinbrenner, Susanne

2011-01-01

Together with an expert committee a structured approach to determining quality indicators for National Disease Management Guidelines has been developed. The key steps of this approach include: introducing guideline authors to the methodology at an early stage of the process of guideline development, pre-selecting recommendations of the guideline which are potentially measurable by means of quality indicators, assessing the potentially measurable quality indicators in written form using five criteria (including their importance for the health care system and clarity of definitions) and approving them in a formal consensus process. For lack of a database these quality indicators must be regarded as preliminary. For the National Disease Management Guideline "Chronic Heart Failure" nine rate-based indicators have been chosen. The indicators correspond to important strong recommendations (grade of recommendation: A) from the fields of diagnosis (two), general therapeutic strategy (two), specific treatment (three), clinical monitoring (one) and co-ordination of care (one). In a second step, the quality indicators have to be validated within a pilot project. The determination and assessment of the potential quality indicators have revealed room for improvement of guideline development. In particular, there is a need for more health care data and for specification of recommendations.

Strategies for Hard Times in Higher Education.

ERIC Educational Resources Information Center

Desfosses, Louis R.

1996-01-01

Planning and management strategies used in the private sector have practical applications for higher education in a period of systemic and organizational stress. Promising strategies include organizational delayering; employee empowerment; boundless thinking, problem-solving teams; accelerated processes; quality management and improvement; and…

Ranking sources of hospital quality information for orthopedic surgery patients: consequences for the system of managed competition.

PubMed

Bes, Romy Evelien; van den Berg, Bernard

2013-01-01

Healthcare quality information is crucial for the system of managed competition. Within a system of managed competition, health insurers can selectively contract care providers and are allowed to channel patients towards contracted providers. The idea is that insurers have a stronger bargaining position compared to care providers when they are able to channel patients. In the Dutch system of managed competition that was implemented in 2006, channelling patients to preferred providers has not yet been very successful. Empirical knowledge of which sources of hospital quality information they find important may help us to understand how to channel patients to preferred providers. The objective of this survey was to measure how patients rank various sources of information when they compare hospital quality in a system of managed competition. A written survey was conducted among clients of a large Dutch health insurance company. These clients underwent orthopedic surgery on the hip or knee no longer than 12 months ago. Two major players within a system of managed competition-health insurers and the government-were not seen as important sources of hospital quality information. In contrast, own experience and general practitioners (GPs) were seen as the most important sources of hospital quality information within the Dutch system of managed competition. Health insurers should take the main finding-that GPs are the most important source of hospital quality information-into account when they contract care providers and develop strategies for channeling patients towards preferred providers. A well-functioning system of managed competition will benefit patients, as it involves incentives for care providers to increase healthcare quality and to produce at the lowest cost per unit of quality.

Engineering Quality Software: 10 Recommendations for Improved Software Quality Management

DTIC Science & Technology

2010-04-27

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

Quality risk management of top spray fluidized bed process for antihypertensive drug formulation with control strategy engendered by Box-behnken experimental design space

PubMed Central

Mukharya, Amit; Patel, Paresh U; Shenoy, Dinesh; Chaudhary, Shivang

2013-01-01

Introduction: Lacidipine (LCDP) is a very low soluble and highly biovariable calcium channel blocker used in the treatment of hypertension. To increase its apparent solubility and to reduce its biovariability, solid dispersion fluid bed processing technology was explored, as it produces highly dispersible granules with a characteristic porous structure that enhances dispersibility, wettability, blend uniformity (by dissolving and spraying a solution of actives), flow ability and compressibility of granules for tableting and reducing variability by uniform drug-binder solution distribution on carrier molecules. Materials and Methods: Main object of this quality risk management (QRM) study is to provide a sophisticated “robust and rugged” Fluidized Bed Process (FBP) for the preparation of LCDP tablets with desired quality (stability) and performance (dissolution) by quality by design (QbD) concept. Results and Conclusion: This study is principally focusing on thorough mechanistic understanding of the FBP by which it is developed and scaled up with a knowledge of the critical risks involved in manufacturing process analyzed by risk assessment tools like: Qualitative Initial Risk-based Matrix Analysis (IRMA) and Quantitative Failure Mode Effective Analysis (FMEA) to identify and rank parameters with potential to have an impact on In Process/Finished Product Critical Quality Attributes (IP/FP CQAs). These Critical Process Parameters (CPPs) were further refined by DoE and MVDA to develop design space with Real Time Release Testing (RTRT) that leads to implementation of a control strategy to achieve consistent finished product quality at lab scale itself to prevent possible product failure at larger manufacturing scale. PMID:23799202

A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure.

PubMed

Kwekkeboom, Kristine L; Bratzke, Lisa C

2016-01-01

Pain, dyspnea, fatigue, and sleep disturbance are prevalent and distressing symptoms in persons with advanced heart failure. Although many lifestyle and self-care interventions have been developed to control heart failure progression, very few studies have explored treatments exclusively for symptom palliation. Cognitive-behavioral strategies may be effective treatment for these symptoms in advanced heart failure. A systemic review was conducted to describe the effect of cognitive-behavioral strategies on pain, dyspnea, fatigue, and sleep disturbance in patients with heart failure. CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life. The 2 authors evaluated study quality, abstracted data elements from each study, and synthesized findings. Thirteen articles describing 9 unique studies met criteria and were included in the review. Five studies tested relaxation strategies, 3 tested meditation strategies, and 1 tested a guided imagery strategy. Of the 9 studies, 7 demonstrated some improvement in symptom outcomes. Relaxation, meditation, guided imagery, or combinations of these strategies resulted in less dyspnea and better sleep compared with attention control or usual care conditions and reduced pain, dyspnea, fatigue, and sleep disturbance within treatment groups (pretreatment to posttreatment). Symptom-related quality of life was improved with meditation compared with attention control and usual care conditions and improved pre- to post-guided imagery. Studies exploring cognitive-behavioral symptom management strategies in heart failure vary in quality and report mixed findings but indicate potential beneficial effects of relaxation, meditation, and guided imagery

Commentary: Is the Air Pollution Health Research Community Prepared to Support a Multipollutant Air Quality Management Framework?

EPA Science Inventory

Ambient air pollution is always encountered as a complex mixture, but past regulatory and research strategies largely focused on single pollutants, pollutant classes, and sources one-at-a-time. There is a trend toward managing air quality in a progressively “multipollutant” manne...

Managed care and the quality of substance abuse treatment.

PubMed

Shepard, Donald S; Daley, Marilyn; Ritter, Grant A; Hodgkin, Dominic; Beinecke, Richard H

2002-12-01

strengthening discharge planning may preserve the benefits of MBHC while avoiding its risks. Since reductions in Medicaid spending were impressive but finite, MBHC may not be the permanent solution to inflation in behavioral health care. MBHC firms should implement quality-monitoring programs to ensure that aggressive utilization management strategies do not compromise quality of care. The impact of managed behavioral health care should ideally be evaluated in randomized controlled studies. In addition, research is needed to establish that the quality measures employed in this evaluation - improved access, enhanced continuity and fewer rapid re-admissions actually correspond to reductions in drug or alcohol use and other favorable outcomes obtained through client self-report or urinalysis.

Development of perspective-based water management strategies for the Rhine and Meuse basins.

PubMed

van Deursen, W P A; Middelkoop, H

2005-01-01

Water management is surrounded by uncertainties. Water management thus has to answer the question: given the uncertainties, what is the best management strategy? This paper describes the application of the perspectives method on water management in the Rhine and Meuse basins. In the perspectives method, a structured framework to analyse water management strategies under uncertainty is provided. Various strategies are clustered in perspectives according to their underlying assumptions. This framework allows for an analysis of current water management strategies, but also allows for evaluation of the robustness of proposed future water strategies. It becomes clear that no water management strategy is superior to the others, but that inherent choices on risk acceptance and costs make a real political dilemma which will not be solved by further optimisation.

Beyond PARR - PMEL's Integrated Data Management Strategy

NASA Astrophysics Data System (ADS)

Burger, E. F.; O'Brien, K.; Manke, A. B.; Schweitzer, R.; Smith, K. M.

2016-12-01

NOAA's Pacific Marine Environmental Laboratory (PMEL) hosts a wide range of scientific projects that span a number of scientific and environmental research disciplines. Each of these 14 research projects have their own data streams that are as diverse as the research. With its requirements for public access to federally funded research results and data, the 2013 White House Office of Science and Technology memo on Public Access to Research Results (PARR) changed the data management landscape for Federal agencies. In 2015, with support from the PMEL Director, Dr. Christopher Sabine, PMEL's Science Data Integration Group (SDIG) initiated a multi-year effort to formulate and implement an integrated data-management strategy for PMEL research efforts. Instead of using external requirements, such as PARR, to define our approach, we focussed on strategies to provide PMEL science projects with a unified framework for data submission, interoperable data access, data storage, and easier data archival to National Data Centers. This improves data access to PMEL scientists, their collaborators, and the public, and also provides a unified lab framework that allows our projects to meet their data management objectives, as well as those required by the PARR. We are implementing this solution in stages that allows us to test technology and architecture choices before comitting to a large scale implementation. SDIG developers have completed the first year of development where our approach is to reuse and leverage existing frameworks and standards. This presentation will describe our data management strategy, explain our phased implementation approach, the software and framework choices, and how these elements help us meet the objectives of this strategy. We will share the lessons learned in dealing with diverse and complex datasets in this first year of implementation and how these outcomes will shape our decisions for this ongoing effort. The data management capabilities now

Comparison of approaches to Total Quality Management. Including an examination of the Department of Energy`s position on quality management

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

Bennett, C.T.

1994-03-01

This paper presents a comparison of several qualitatively different approaches to Total Quality Management (TQM). The continuum ranges from management approaches that are primarily standards -- with specific guidelines, but few theoretical concepts -- to approaches that are primarily philosophical, with few specific guidelines. The approaches to TQM discussed in this paper include the International Organization for Standardization (ISO) 9000 Standard, the Malcolm Baldrige National Quality Award, Senge`s the Learning Organization, Watkins and Marsick`s approach to organizational learning, Covey`s Seven Habits of Highly Successful People, and Deming`s Fourteen Points for Management. Some of these approaches (Deming and ISO 9000) aremore » then compared to the DOE`s official position on quality management and conduct of operations (DOE Orders 5700.6C and 5480.19). Using a tabular format, it is shown that while 5700.6C (Quality Assurance) maps well to many of the current approaches to TQM, DOE`s principle guide to management Order 5419.80 (Conduct of Operations) has many significant conflicts with some of the modern approaches to continuous quality improvement.« less

[ISO 9001:2015 Certification in Quality Management].

PubMed

Enders, Christian; Lang, Gabriele E; Lang, Gerhard K; Werner, Jens Ulrich

2017-07-01

Quality management improves the structures, processes and results of organizations of all kinds. Many practices and clinics have their existing quality management system certified according to ISO 9001, (e.g., to check their own quality management system or to obtain a testimonial against third parties). The latest version ISO 9001:2015 contains some changes, both structurally and in terms of content. These changes can be met with reasonable efforts. An ISO 9001:2015 certification represents a value for your organization, but these advantages are often not directly measurable. Georg Thieme Verlag KG Stuttgart · New York.

Strategy Maps in University Management: A Comparative Study

ERIC Educational Resources Information Center

Han, Shuangmiao; Zhong, Zhou

2015-01-01

In this study, the conceptual use of the strategy map approach and the strategy map which it produces have been adapted from the business sector and introduced as tools for achieving more effective strategic planning and management in higher education institutions (HEIs). This study discusses the development of strategy maps as transformational…

Management strategies in pancreatic cancer.

PubMed

Campen, Christopher J; Dragovich, Tomislav; Baker, Amanda F

2011-04-01

Current first-line and adjuvant chemotherapeutic strategies for management of patients with pancreatic cancer are reviewed. Pancreatic adenocarcinoma is the 10th most prevalent cancer and the fourth most common cause of cancer deaths in the United States. More than 80% of patients with pancreatic cancer are diagnosed with locally advanced or metastatic disease and are not candidates for surgery; these patients often require multimodal treatment. The most widely used chemotherapy for such patients, as well as patients requiring adjuvant therapy after surgery, is gemcitabine or gemcitabine-based chemotherapy. All current chemotherapies for pancreatic cancer are associated with dose-limiting hematologic toxicity and other adverse effects that require ongoing monitoring and dosage adjustment to balance the benefits and risks of treatment. Pharmacists can play an important role in monitoring and providing drug information and guidance to patients and oncologists. Current investigational strategies include efforts to improve chemotherapy response rates and outcomes through modulation of cell signaling pathways and use of nanotechnology to improve drug delivery. Current management of pancreatic cancer is multifaceted, involving anticancer therapy, supportive care, and toxicity management. Standard systemic therapy with gemcitabine as a single agent or in combination with other cytotoxic agents provides modest benefits in terms of response and symptom control.

EPA Region 3 Quality Management Plans

EPA Pesticide Factsheets

Has links to resources that describe the Region's Quality Assurance Program, which is a collection of the Region's ongoing quality assurance (QA) policies, procedures, responsibilities and management systems.

NASA total quality management 1989 accomplishments report

NASA Technical Reports Server (NTRS)

1990-01-01

Described here are the accomplishments of NASA as a result of the use of Total Quality Management (TQM). The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories of TQM discussed here are top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

[Quality assurance and quality management in intensive care].

PubMed

Notz, K; Dubb, R; Kaltwasser, A; Hermes, C; Pfeffer, S

2015-11-01

Treatment success in hospitals, particularly in intensive care units, is directly tied to quality of structure, process, and outcomes. Technological and medical advancements lead to ever more complex treatment situations with highly specialized tasks in intensive care nursing. Quality criteria that can be used to describe and correctly measure those highly complex multiprofessional situations have only been recently developed and put into practice.In this article, it will be shown how quality in multiprofessional teams can be definded and assessed in daily clinical practice. Core aspects are the choice of a nursing theory, quality assurance measures, and quality management. One possible option of quality assurance is the use of standard operating procedures (SOPs). Quality can ultimately only be achieved if professional groups think beyond their boundaries, minimize errors, and establish and live out instructions and SOPs.

Diabetes quality management in Dutch care groups and outpatient clinics: a cross-sectional study.

PubMed

Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E H M

2014-08-07

In recent years, most Dutch general practitioners started working under the umbrella of diabetes care groups, responsible for the organisation and coordination of diabetes care. The quality management of these new organisations receives growing interest, although its association with quality of diabetes care is yet unclear. The best way to measure quality management is unknown and it has not yet been studied at the level of outpatient clinics or care groups. We aimed to assess quality management of type 2 diabetes care in care groups and outpatient clinics. Quality management was measured with online questionnaires, containing six domains (see below). They were divided into 28 subdomains, with 59 (care groups) and 57 (outpatient clinics) questions respectively. The mean score of the domains reflects the overall score (0-100%) of an organisation. Two quality managers of all Dutch care groups and outpatient clinics were invited to fill out the questionnaire.Sixty care groups (response rate 61.9%) showed a mean score of 59.6% (CI 57.1-62.1%). The average score in 52 outpatient clinics (response rate 50.0%) was 61.9% (CI 57.5-66.8%).Mean scores on the six domains for care groups and outpatient clinics respectively were: 'organisation of care' 71.9% (CI 68.8-74.9%), 76.8% (CI 72.8-80.7%); 'multidisciplinary teamwork' 67.1% (CI 62.4-71.9%), 71.5% (CI 65.3-77.8%); 'patient centeredness' 46.7% (CI 42.6-50.7%), 62.5% (CI 57.7-67.2%); 'performance management' 63.3% (CI 61.2-65.3%), 50.9% (CI 44.2-57.5%); 'quality improvement policy' 52.6% (CI 49.2-56.1%), 50.9% (CI 44.6-57.3%); and 'management strategies' 56.0% (CI 51.4-60.7%), 59.0% (CI 52.8-65.2%). On subdomains, care groups scored highest on 'care program' (83.3%) and 'measured outcomes' (98.3%) and lowest on 'patient safety' (15.1%) and 'patient involvement' (17.7%). Outpatient clinics scored high on the presence of a 'diabetic foot team' (81.6%) and the support in 'self-management' (81.0%) and low on 'patient

Joining forces: collaborating internationally to deliver high-quality, online postgraduate education in pain management.

PubMed

Devonshire, Elizabeth; Siddall, Philip

2011-01-01

The effective management of pain is a complex and costly global issue, requiring a range of innovative educational strategies to enable culturally appropriate and high-quality health care provision. In response to this issue, the Pain Management Research Institute at the University of Sydney (Sydney, Australia) has established several strategic alliances with other overseas universities to deliver online postgraduate education in pain management. The present article discusses the rationale for joining forces, and the approach adopted in creating and maintaining these alliances. It also provides insights into the benefits, challenges and opportunities associated with collaborative educational initiatives of this nature, from institutional, academic and student perspectives.

Joining forces: Collaborating internationally to deliver high-quality, online postgraduate education in pain management

PubMed Central

Devonshire, Elizabeth; Siddall, Philip J

2011-01-01

The effective management of pain is a complex and costly global issue, requiring a range of innovative educational strategies to enable culturally appropriate and high-quality health care provision. In response to this issue, the Pain Management Research Institute at the University of Sydney (Sydney, Australia) has established several strategic alliances with other overseas universities to deliver online postgraduate education in pain management. The present article discusses the rationale for joining forces, and the approach adopted in creating and maintaining these alliances. It also provides insights into the benefits, challenges and opportunities associated with collaborative educational initiatives of this nature, from institutional, academic and student perspectives. PMID:22184549

Assertive Classroom Management Strategies and Students' Performance: The Case of EFL Classroom

ERIC Educational Resources Information Center

Aliakbari, Mohammad; Bozorgmanesh, Bafrin

2015-01-01

Ample research findings support the effective role that classroom management strategies play in enhancing students' learning. Drawing upon Iranian high school teachers' classroom management strategies, this article is intended to examine the extent to which these teachers follow assertive classroom management strategies and if these strategies…

[Clinical trial data management and quality metrics system].

PubMed

Chen, Zhao-hua; Huang, Qin; Deng, Ya-zhong; Zhang, Yue; Xu, Yu; Yu, Hao; Liu, Zong-fan

2015-11-01

Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry.

Total Quality Management (TQM). Process Action Team Course

DTIC Science & Technology

1990-05-30

SHET SC EXHAUSTE May 30,1990 DEPARTMENT OF DEFENSE Lfl N CI TOTAL QUALITY MANAGEMENT (TQM) Process Action Team Coursef ©990, Booz.Allen & Hamilton Inc...organization’s TQM infrastructure. If you need additional information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar that...Programs. These efforts were identified in Appendix A of Booz, Allen’s training manual Qtl Quality Management Awareness Seminar. Revision 5, November 15